Drugs such as capecitabine have very little associated myelosuppression, and they are often chosen when the patient's bone marrow has been damaged by previous therapy or when coadministering a myelosuppressive agent for more rapid effect is desired. As a single agent, capecitabine has an overall response rate (ORR) of 25%-30%, with minimal toxicity. When combined with a taxane, an ORR of 40%-50% has been observed, along with a median overall survival benefit of 3-15 months.
Treatment of breast cancer with a taxane in the metastatic setting after treatment in the adjuvant setting may be difficult because of residual toxicity. Although taxanes are not cardiotoxic, they can produce lingering neuropathy (especially paclitaxel) or problems with edema (docetaxel especially), as well as pulmonary toxicity, which makes further administration problematic. Substitution of one taxane for another is possible, depending on the nature of the chronic toxicity. Another antimetabolite, gemcitabine is typically given in combination with paclitaxel.
Learn more about the treatment of metastatic breast cancer.
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Cite this: Winston W. Tan. Fast Five Quiz: Test Your Knowledge of Systemic Treatment for Metastatic Breast Cancer - Medscape - Jan 25, 2022.
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