The X Factor.

By now we all know that adding capecitabine for triple-negative breast cancer (TNBC) that persists after neoadjuvant chemo improves survival. So can it add anything as a standard addition to adjuvant chemo for those undergoing upfront surgery? In the Chinese phase 3 CBCSG010 trial, 636 women with resected TNBC receiving standard adjuvant docetaxel followed by epirubicin and cyclophosphamide were randomized to +/- the addition of capecitabine throughout. Indeed, the primary endpoint of disease-free survival was significantly improved at 5 years from 80 → 86% with the addition of capecitabine and overall survival (not significantly) from <91 → >93%. Importantly, the only notable toxicity added with capecitabine was an 8% rate of grade 3+ hand-foot syndrome. TBL: Adding capecitabine to standard taxane- and anthracycline-based adjuvant chemo for TNBC improves disease-free survival. | Li, J Clin Oncol 2020