Capecitabine and mitomycin C is an effective combination for anthracycline- and taxane-resistant metastatic breast cancer.

Capecitabine is converted to 5-fluorouracil by thymidine phosphorylase, and mitomycin C is capable of upregulating the expression of thymidine phosphorylase suggesting a synergistic effect. Fifty- three patients ( median age 62 years) with anthracycline- and taxane- resistant, metastatic breast cancer received mitomycin C 6 mg/ m(2) on day 1, and capecitabine ( Xeloda) 2,000 mg/ m(2) / day from day 1 to day 14 with cycles repeated every 4 weeks. Overall, 77.4% had visceral metastases and 33 were pretreated with >= 3 chemotherapy lines. A median of 6 cycles were given ( range 1 - 19) with a complete response observed in 2 patients ( 3.9%), partial response in 17 ( 33.3%) and stable disease in 19 ( 37.2%). Overall response rate was 37.2% ( 95% CI, 24.0 - 50.5%), with a median duration of 10.4 months. Median time to progression was 8.1 months and median survival was 17.4 months ( 1- and 2- year survival rates of 60 and 28%, respectively). Toxicity was mild. The most frequent grade 3/ 4 events were neutropenia ( 5.7% of patients), diarrhea ( 3.8%), and deep venous thrombosis ( 3.8%). Capecitabine plus mitomycin C may represent an effective and manageable treatment option for advanced breast cancer patients resistant to anthracyclines and taxanes. This approach provides an alternative for pretreated patients with advanced breast cancer. Copyright (c) 2006 S. Karger AG, Basel