Ohno Shinji, Mitsuyama Shoshu, Tamura Kazuo, Nishimura Reiki, Tanaka Maki, Hamada Yuzo, Kuroki Shoji
Department of Breast Oncology, National Kyushu Cancer Center Hospital, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Anticancer Res. 2007 Mar-Apr;27(2):1009-13.
Capecitabine is a highly effective and well-tolerated treatment for metastatic breast cancer (MBC) and extends survival when combined with docetaxel. Capecitabine and cyclophosphamide are orally administered and have preclinical synergy and non-overlapping toxicities.
Sixteen pretreated MBC patients received escalating doses of oral capecitabine 628 to 829 mg/m2 twice daily (bid) plus oral cyclophosphamide 33 to 50 mg/m2 bid, on days 1 to 14 every 21 days.
Among the ten patients receiving capecitabine/cyclophosphamide 829/33 mg/m2 bid on days 1 to 14, two experienced dose-limiting toxicities (DLT, treatment delay > 1 week due to grade 2 leukopenia). Because neither patient developed further grade > 1 toxicity and none of the patients experienced grade 3/4 toxicities or further DLTs, this dose level is the recommended regimen, producing partial responses in two of five evaluable patients.
The recommended all oral capecitabine/cyclophosphamide combination regimen is well tolerated and active in MBC, and is being evaluated in a phase II study in anthracycline-pretreated MBC.
卡培他滨是转移性乳腺癌（MBC）一种高效且耐受性良好的治疗药物，与多西他赛联合使用时可延长生存期。卡培他滨和环磷酰胺均为口服给药，具有临床前协同作用且毒性不重叠。
16例经预处理的MBC患者每21天的第1至14天接受递增剂量的口服卡培他滨628至829mg/m²，每日两次（bid），加口服环磷酰胺33至50mg/m²，每日两次。
在第1至14天接受卡培他滨/环磷酰胺829/33mg/m² bid的10例患者中，2例出现剂量限制性毒性（DLT，因2级白细胞减少导致治疗延迟>1周）。由于这两名患者均未出现进一步的>1级毒性，且无患者出现3/4级毒性或进一步的DLT，因此该剂量水平为推荐方案，在5例可评估患者中有2例产生部分缓解。
推荐的全口服卡培他滨/环磷酰胺联合方案耐受性良好，对MBC有效，目前正在蒽环类药物预处理的MBC的II期研究中进行评估。
