Efficacy of adjuvant capecitabine in triple-negative breast cancer with residual disease after neoadjuvant therapy: a real-world study

Purpose

To determine the beneficiaries of capecitabine in patients with triple-negative breast cancer (TNBC) who failed to achieve pathological complete response (pCR) by analyzing the efficacy of the drug in different HER2 statuses and TNM stages.

Methods

The Kaplan–Meier survival curve was plotted to estimate the effect of capecitabine therapy on disease-free survival (DFS) and overall survival (OS). Furthermore, the Cox proportional hazards model was used to analyze the factors that influence DFS and OS.

Results

A total of 296 patients with TNBC who had non-pCR after undergoing neoadjuvant therapy (NAT) were included in this study. There were 152 patients (51.4 %) in the capecitabine group and 144 patients (48.6 %) in the no-capecitabine group. The 3-year DFS and OS rates of the capecitabine group were better than those of the no-capecitabine group (DFS 80.0 % vs. 68.0 % p = 0.012, OS 95.9 % vs. 86.9 % p = 0.011). In addition, the capecitabine group exhibited significantly better DFS and OS than the no-capecitabine group in the HER2-low (DFS p = 0.004, OS p = 0.009) and stage III (DFS p = 0.004, OS p = 0.008) populations but not in the HER2-0 or stage II population.

Conclusion

Adjuvant capecitabine therapy significantly improved the prognosis of patients with TNBC who had residual disease after NAT, and the improvements in the outcomes were significant in patients with HER2-low expression and stage III disease. Other effective treatment methods should be explored for patients with HER2-0 expression or stage II disease.