Retrospective SEER-Medicare database analysis of use of adjuvant capecitabine in older patients with early-stage triple-negative breast cancer

Patients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant chemotherapy (NACT) benefit from adjuvant capecitabine. Older patients (> 65 years) are not always treated according to guidelines, likely due to concerns regarding tolerance. Retrospective analysis of the SEER-Medicare database identified 1799 older patients with a diagnosis early TNBC from 2010 to 2019. Among these patients, 239 (13.3%) received adjuvant capecitabine. Use of capecitabine increased from 1.3% in 2010 to 29.6% in 2019. Age > 70 years (OR 0.54; 95% CI 0.32-0.92) and ≥ 2 comorbidities (0.42; 0.20-0.90) were associated with decreased odds of receiving ≥ 6 cycles of capecitabine. Receiving ≥ 4 cycles of capecitabine was assocated with decreased risks of death (HR 0.74; 95% CI 0.66-0.83) and breast cancer-specific death (0.73; 0.61-0.89). 55 patients (23%) treated with capecitabine experienced emergency room visits or hospitalization. The author conclude that in recent years adjuvant capecitabine is increasingly used for older patients with early-stage TNBC and was associated with better survival.