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Metronomic Chemotherapy for Triple-Negative Breast Cancer

Metronomic Chemotherapy for Triple-Negative Breast Cancer
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Published on June 12, 2020

If you’ve ever taken piano or guitar lessons, you may be familiar with the metronome, a practice tool that produces a steady beat to help musicians play rhythms accurately. Metronomic chemotherapy, a recent therapeutic modality in cancer care, is a promising treatment strategy with its own reliable rhythm.    

A Steady Tempo for Maintenance Therapy in TNBC

The rhythm of metronomic chemotherapy is a low-dose continuous anti-cancer treatment with longer breaks between chemotherapy infusions. A recent study of women with triple-negative breast cancer (TNBC) who received metronomic capecitabine (Xeloda) for one year as a maintenance drug after a standard treatment regimen, showed good disease-free survival (DFS) rates.

As an added benefit, taking a metronomic approach to treatment also minimizes some toxicities, such as nausea, fatigue and hair loss. 

These are big wins in terms of quality of life for patients. However, capecitabine is not without its issues. Some patients experienced hand-foot syndrome (46 percent) and low white blood cell count (24 percent). 

About the Phase III Metronomic Capecitabine Study

A total of 434 patients were randomly assigned to one of two groups: the capecitabine group (221 patients) or the observation group (213 patients). At a median follow-up of 56.5 months, five-year DFS was significantly better in the capecitabine group than in the observation group.

This Phase III trial will hopefully lead to an approval by the U.S. Food and Drug Administration (FDA) if researchers can demonstrate that this therapy is at least as safe and effective as others already on the market. 

TNBC, a fairly aggressive breast cancer subtype, accounts for approximately 10 to 15 percent of all breast cancer diagnoses. The term triple-negative breast cancer refers to the fact that the cancer cells lack estrogen and progesterone receptors, and don’t produce an excess of the HER2 protein. People with the inherited BRCA mutation, particularly BRCA1, are at risk for this disease. Knowing your BRCA status is important.

We’re learning a lot about the different ways to treat TNBC, and the future is bright for patients keeping a steady beat to better outcomes.

Let’s Talk Metastatic Breast Cancer

For more information, join us for “Let’s Talk Metastatic Breast Cancer,” a Patient Power eight-part series of 30-minute webinars with patients and experts that will air monthly through December 2020. 

Register now for each event in the series, and send your questions in advance to

~Lauren Evoy Davis

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Wang X, et al. Phase III trial of metronomic capecitabine maintenance after standard treatment in operable triple-negative breast cancer (SYSUCC-001). J Clin Oncol38: 2020 (suppl; abstr 507).


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