Significance of Using Capecitabine Combination after Systemic Polychemotherapy in Patients with Triple Negative Breast Cancer

Abstract

Triple-negative breast cancer (TNBC) is a heterogeneous disease characterized by varied prognosis and sensitivity to anticancer therapy. This variability is due to a range of genetic aberrations leading to the development and progression of the disease. The study included 126 patients with a verified diagnosis of TNBC who received inpatient and outpatient treatment between 2011 and 2017. The patients were divided into three groups: Group 1 consisted of 47 patients who received neoadjuvant polychemotherapy (NPCT), underwent radical surgery, and received radiotherapy (RT) according to the standard method; Group 2 included 43 patients who underwent radical surgery with adjuvant polychemotherapy (APCT) and RT according to the standard method; and Group 3 consisted of 34 patients who received NPCT, followed by radical surgery and RT, along with monochemotherapy with capecitabine. A study of the survival of these patients showed that the 5-year disease-free survival (DFS) rate was 49.5% ± 6.4% for invasive lobular carcinoma, compared with 79.8% ± 3.7% for the nonspecific variant, and 88.2% ± 2.7% for the medullary variant. Similar differences were noted in the analysis of 5-year overall survival (OS), with rates of 73.2% ± 3.9% for the invasive nonspecific type and 62.5% ± 17.6% for the invasive lobular type. The most aggressive histological form was the metaplastic subtype, which had a poor prognosis, with a 3-year DFS of 43.4% ± 3.2% and an OS of 38.2% ± 3.9%, with no patient surviving more than 5 years. In contrast, the medullary and apocrine subtypes showed no signs of disease progression, and the 5-year OS was 97%. Optimal long-term treatment results were achieved with the use of NPCT—a combination of platinum and taxanes—while combinations involving anthracyclines yielded worse results, falling behind standard chemotherapy regimens in terms of long-term outcomes.