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Capecitabine (XELODA, Roche) is the first FDA-approved oral chemotherapy for the treatment of both metastatic breast and colorectal cancers. The drug is approved for use in colorectal cancer, both as adjuvant therapy (i.e. drugs that modify the effect of other drugs) after surgery for Stage III (Dukes C) cancer and more metastatic colon cancer (Stage IV). Its use in breast cancer has been limited to metastatic breast cancer after primary drugs have failed (e.g.: docetaxel or paclitaxel).
In this video, Dr. Hyman Muss from the University of Vermont, discusses the results of a major clinical trial evaluated the oral agent capecitabine as the initial therapy compared to standard chemotherapy in women over age 65 with early-stage breast cancer. The logic is that Xeloda has been shown to be generally tolerated well by patients, especially in the older age group.
The results in over 600 elderly patients showed that standard intravenous chemotherapy gave better survival results than oral capecitabine alone. Dr Muss discusses the current state of using this drug in breast cancer patients. Details of the study, with Dr Muss as the lead author, are published in the May 14,2009 issue of the New England Journal of Medicine (vol360; pages 2055-65)