Early capecitabine metronomic chemotherapy improves patient prognosis and safety in early-stage triple-negative breast cancer.

OBJECTIVE: To evaluate the effect of different initiation times of capecitabine metronomic chemotherapy on prognosis and safety in patients with early-stage triple-negative breast cancer (TNBC). METHODS: This retrospective study included 206 early-stage TNBC patients treated between March 2018 and January 2022. The patients were divided into early (≤ 4 weeks after surgery, n = 104) and delayed (> 4 weeks, n = 102) initiation groups. Clinical data, laboratory indicators (carcinoembryonic antigen [CEA], carbohydrate antigen 125 [CA125], neutrophil-to-lymphocyte ratio [NLR]), survival, and adverse reactions were compared between the two groups. RESULTS: The early initiation group showed significantly longer 3-year progression-free survival (PFS) (P < 0.05) but similar overall survival (OS) (P > 0.05). Reductions in CEA, CA125, and NLR were more prominent in the early initiation group (P < 0.05). Subgroup analysis indicated a PFS advantage for T2-stage patients. Adverse reactions, mainly hand-foot syndrome and bone marrow suppression, were comparable between groups, with most cases being grade 1-2. CONCLUSION: Early initiation of capecitabine metronomic chemotherapy can improve the PFS in early-stage TNBC patients, especially for patients with T2 stage, with manageable safety.