Significant Association between Hand-Foot Syndrome and Efficacy of Capecitabine in Patients with Metastatic Breast Cancer
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概要
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Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is a promising treatment for colorectal, breast and gastric cancers, but often causes hand-foot syndrome (HFS), the most common dose-limiting toxicity. The current study was conducted to investigate the relationship between HFS and efficacy of capecitabine in 98 patients with metastatic breast cancer. Possible associations between HFS and efficacy endpoints, including time-to-treatment failure (TTF), tumor response in metastatic lesions and changes in tumor markers, were investigated retrospectively using electronic medical records. The TTF of group with HFS of grade 1 and ≥2 was significantly longer than that of group with no HFS, respectively (hazard ratio (HR), 0.39; 95% confidence interval (CI), 0.18–0.87 for group with grade 1; HR, 0.42, 95% CI, 0.19–0.90 for group with grade ≥2). Significantly higher disease control rates for the liver metastasis were observed in patients with HFS (grade 1 and greater) than in those without HFS (92.9 vs. 42.9%, p=0.009). Furthermore, prevention of increases in tumor marker levels (carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3) and National Cancer Center-Stomach-439 (NCC-ST439)) was evident in patients with HFS. This study clearly showed a significant correlation between HFS and some efficacy markers of capecitabine therapy in patients with metastatic breast cancer, and suggests that early dose adjustment based on severity of HFS might improve efficacy. Studies are needed to explore predictive biomarkers for HFS/efficacy, so that capecitabine therapy can be further tailored to patient response.
著者
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Sai Kimie
Division Of Biosignaling National Institute Of Health Sciences
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Saito Yoshiro
Division Of Biochemistry And Immunochemistry National Institute Of Health Science
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TOHKIN Masahiro
Division of Medicinal Safety Science, National Institute of Health Sciences
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Morikawa Norifumi
Department Of Clinical Pharmacotherapy Graduate School Of Biomedical Sciences Hiroshima University
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Tohkin Masahiro
Division Of Medicinal Safety Science National Institute Of Health Sciences
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MAKINO Yoshinori
Department of Molecular Pathobiology, Research Center for Zoonosis Control, Hokkaido University
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Yamamoto Hiroshi
Departmemt Of Chemical Engineering University Of Tokyo
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Saito Yoshiro
Division of Medicinal Safety Science, National Institute of Health Sciences
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Fujiwara Yasuhiro
Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital
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Azuma Yuichiro
Division of Medicinal Safety Science, National Institute of Health Sciences
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Hata Kojiro
Department of Pharmacy, National Cancer Center Hospital
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Udagawa Ryoko
Department of Pharmacy, National Cancer Center Hospital
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Hirakawa Akihiro
Department of Management Science, Tokyo University of Science
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Ryushima Yasuaki
Department of Pharmacy, National Cancer Center Hospital
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Yokote Nobuaki
Department of Pharmacy, National Cancer Center Hospital
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Makino Yoshinori
Department of Pharmacy, National Cancer Center Hospital
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Sai Kimie
Division of Medicinal Safety Science, National Institute of Health Sciences
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