Capecitabine Not Effective as First-line Therapy When Added to Taxanes and Bevacizumab

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the Cancer Therapy Advisor take:

Although the survival rates for metastatic breast cancer have improved over the past two decades, recent data suggest that the biology of metastatic breast cancer has become more aggressive, resulting in resistance to a number of treatment options for the disease.

There have been previous studies that showed that the combination of taxanes and capecitabine improved PFS and OS compared with a taxane alone or an anthracycline combination, so the next logical step was to test a combination of a taxane, capecitabine, and bevacizumab in the hopes it would improve survival rates even more significantly.

In a phase III study that was recently conducted in Germany and published in the journal Breast Cancer Research and Treatment, researchers aimed to investigate whether adding capecitabine to taxanes plus bevacizumab improve progression-free survival in patients with HER2-negative, locally advanced or metastatic breast cancer.

The TABEA trial randomly assigned 116 patients to a taxane plus bevacizumab (TB), and 111 patients to TB plus capecitabine (TBX).  After a preplanned interim futility and safety analysis was performed, however, no efficacy benefit was demonstrated with the addition of capecitabine, and higher toxicity was observed.

The study was therefore halted, and in a final analysis the researchers concluded that adding capecitabine to TB cannot be recommended as first-line therapy in MBC.

PIK3CA, PAM50 Do Not Predict Adjuvant Trastuzumab Response in HER2-Positive Breast Cancer
Biology of metastatic breast cancer has become more aggressive, resulting in resistance to a number of treatment options.
Taxanes plus bevacizumab and taxanes plus capecitabine showed better progression-free survival compared to taxanes alone. The data suggest that adding capecitabine to TB cannot be recommended as first-line therapy in MBC.
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