Individualized chemotherapy based on organ selectivity: a retrospective study of vinorelbine and capecitabine for patients with metastatic breast cancer

Abstract

Objectives:

This study proposed a conception of individualized chemotherapy based on organ selectivity of drug distribution by retrospectively comparing the effect of vinorelbine and capecitabine in patients with metastatic breast cancer.

Methods:

Between January 2002 and December 2009, 133 patients with lung metastasis and 87 patients with liver metastasis were analyzed and followed up until December 2012. The survival analysis was performed by Kaplan–Meier. Multivariate analysis was conducted to identify independent prognostic factors.

Results:

The median time to progression of the vinorelbine, capecitabine and anthracycline/taxane groups of patients with lung metastasis was 5.7, 2.9 and 2.1 months, respectively. Median overall survival of the vinorelbine group (27.4 months) was longer than the capecitabine (12.2 months, P = 0.027) and anthracycline/taxane groups (9.1 months, P < 0.001) in patients with lung metastasis. The median time to progression of the vinorelbine, capecitabine and anthracycline/taxane groups of patients with liver metastasis was 2.3, 7.3 and 2.6 months, respectively. Median overall survival of the capecitabine group (15.2 months) was longer than the vinorelbine (9.0 months, P = 0.029) and anthracycline/taxane groups (6.4 months, P = 0.004) in patients with liver metastasis.

Conclusions:

Our results indicate that vinorelbine and capecitabine have different advantageous effects in breast cancer patients with lung/liver metastasis. Thus, we propose individualized chemotherapy based on organ specificity and pharmacokinetics.

Keywords::

• Capecitabine
• Individualized chemotherapy
• Liver
• Lung
• Metastatic breast cancer
• Pharmacokinetics
• Vinorelbine

Transparency

Declaration of funding

This work was supported by grants from the National Science Foundation of China (No. 81173376) and New Century Excellent Talent (NCET-11-1068).

Declaration of financial/other relationships

X.-H.L., Y.-N.M., R.C., C.L., and X.-Z.W. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

This retrospective study was performed with the approval of Tianjin Medical University Cancer Institute and Hospital Ethics Committee (approval number: E2013064B).