QOL, Adverse Effects Better With Capecitabine After Adjuvant Epirubicin for Breast Cancer

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Use of capecitabine resulted in patients experiencing fewer adverse effects, according to researchers.
Use of capecitabine resulted in patients experiencing fewer adverse effects, according to researchers.

Women with breast cancer who received capecitabine after adjuvant epirubicin had better quality of life (QOL) compared with those who received CMF (cyclophosphamide, methotrexate, fluorouracil) after adjuvant therapy, according to new data from the TACT2 trial published in the journal The Lancet Oncology.

For the study, researchers at The Institute of Cancer Research, London, and the Cancer Research UK Edinburgh Centre enrolled 4391 patients who were treated with adjuvant epirubicin followed by either capecitabine or CMF.

The researchers found that capecitabine resulted in patients experiencing fewer adverse effects and having a better quality of life, and it was as effective at preventing disease recurrence as CMF. In addition, they investigated whether an accelerated course of epirubicin (2 weeks instead of 3) was more effective or better tolerated, which it was not.

The findings showed that most patients experienced some side effects regardless of treatment. However, those receiving CMF were more likely to experience severe side effects including early menopause, nausea, infection, thrombosis, and anemia. 

During the trial, patients were followed up at 12, 18, and 24 months, and then yearly for at least 10 years. More than 85% of patients did not experience disease recurrence for at least 5 years. The UK TACT2 trial, a multicenter, phase 3, open-label, randomized, controlled trial, is the largest single study to look at the benefits of these treatments and chemotherapy schedules to treat breast cancer.


1. Cameron D, Morden JP, Canney P, et al.  Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial.

Lancet Oncol. doi: 10.1016/S1470-2045(17)30404-7
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