Oral treatment of metastatic breast cancer (MBC) with capecitabine (X): What influences the decision-making process?

Abstract

1111 Background: MBC may be considered a chronic disease. Many treatments require frequent clinic visits or hospitalization. Oral X is active, well tolerated, and offers several opportunities per cycle for dose adjustment. This observational study assessed patient (pt) preferences determining treatment choice. Methods: Female MBC pts eligible for X answered a questionnaire about influences on their preference for oral therapy: desire to continue their job, possibility of staying at home during treatment, more convenient way of taking medication, medical contraindications for i.v. treatment, and/or contraindication for combination therapy. Data on medical history (stage, treatment, metastatic sites) were also collected. Results: 218 questionnaires were analyzed. Median age at diagnosis was 52 years (range 27–77). Prior therapy included neoadjuvant chemotherapy (CT; 32%), surgery (93%, including 5% breast-conserving), adjuvant CT (62%), adjuvant endocrine therapy (ET; =52%), and ET for MBC (48%). X was given 1st-line for MBC in 38 pts (17%), 2nd-line in 85 (39%), and =3rd-line in 95 (44%). The most common reason for choosing oral X was more convenient form of drug delivery (154/218; 71%). 147 pts (67%) gave >1 reason for choosing oral therapy. In pts with only one reason (n=71), the most common were possibility of staying at home during treatment (30/71; 42%) and more convenient form of drug (15/71; 21%). Pts receiving 2nd-line X preferred to receive drugs in a more friendly way (62/85; 73%) and stay at home during therapy (63/85; 74%). Corresponding values in pts receiving =3rd-line X were 68/95 (72%) and 53/95 (56%), respectively. Conclusions: MBC causes many psychologic and social problems. Pts prefer to receive drugs in a more friendly way at home. Therefore exploration and introduction of new, effective oral drugs into MBC treatment is vital. No significant financial relationships to disclose.