Metronomic Capecitabine and Vinorelbine as Second Line Therapy in Advanced Breast Cancer

Background and Aim: Management of metastatic breast cancer (MBC) remains a great challenge for oncologists. The aim of our study was to evaluate the efficacy and toxicity of capecitabine combined with vinorelbine as a second line treatment in MBC.Materials and Methods: Twenty-three patients with MBC received oral capecitabine (1000 mg/m2/day) for 14 days plus vinorelbine (oral 60 mg/m2 days 1, 8 and 15 or intravenous 25 mg/m2 days 1and 8 according to patients' preference and drug availability).Results: The median age of patients was 52 years and 61% of them were ER –ve / PR-ve and 91% were HER2 –ve. Eighty-three percent of patients failed treatment with anthracyclines and 48% with taxanes. The majority (83%) received the oral formulation of vinorelbine and the median number of cycles per patient was 3. The overall response rate was 56.5%; however, none of the patients achieved complete remission. The median progression free survival for the whole group of patients was 4.2 month. Grade 3- 4 hematological toxicities were more likely to occur with the oral norelbine regimen and there were no treatment-related deaths.Conclusions: Metronomic capecitabine and vinorelbine combination seems to be tolerable and effective as a second line chemotherapy in MBC. A higher dose of capecitabine in combination with vinorelbine, may improve survival and increase the response rate.