Older Women Do Better on Conventional Chemo Compared to Xeloda

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Taking chemotherapy medicine orally (by mouth) may seem like a better option than getting chemotherapy intravenously for some women, especially older women. But a study found that women older than 65 who got standard intravenous chemotherapy after surgery to remove early-stage breast cancer were less likely to have breast cancer come back or to die compared to women who got Xeloda (chemical name: capecitabine), an oral chemotherapy.

Chemotherapy often is used after breast cancer surgery to reduce the risk of breast cancer coming back. This type of chemotherapy -- called adjuvant chemotherapy -- aims to weaken and destroy any cancer cells that may be left behind after surgery.

The women in this study were all 65 or older and received one of three adjuvant chemotherapy regimens:

  • the standard combination of cyclophosphamide, methotrexate, and 5-fluorouracil, commonly referred to as CMF
  • the standard combination of Adriamycin (chemical name: doxorubicin) and cyclophosphamide, commonly referred to as AC
  • Xeloda, which is taken by mouth

Xeloda currently isn't approved as adjuvant chemotherapy for early-stage breast cancer, but is approved to treat advanced (metastatic) breast cancer. Because Xeloda is taken by mouth, the researchers wanted to know if it would work as well as traditional intravenous adjuvant chemotherapy regimens in older women.

The women also received adjuvant hormonal therapy medicine if the breast cancer was hormone-receptor-positive.

The researchers ended this study early because it became clear that women who got Xeloda were more than twice as likely to have the breast cancer come back or to die during the 3 years after they were diagnosed compared to the women who got one of the other two intravenous chemotherapy regimens. Women who got Xeloda also were twice as likely to have severe side effects. This study supports other research that has shown that older women tend to tolerate traditional intravenous chemotherapy as well as younger women.

If you've been diagnosed with early-stage breast cancer, work with your doctor to create a treatment plan that makes the most sense based on available research results and your unique situation. Your age should be a factor only if research results suggest that it should be. As this and other studies show, treatment approaches that may seem easier for an older woman may turn out to cause more side effects and not work as well. Together, you and your doctor can decide on the treatment plan that is best for YOU.

To learn more about chemotherapy medicines, visit the Breastcancer.org Chemotherapy section.

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