Safety and Efficacy of Low-Dose Metronomic Capecitabine in the Treatment of Elderly Patients with Breast Cancer: Report of Two Cases and Literature Review

SummaryCapecitabine, a 5-fluorouracil prodrug, is increasingly used in breast cancer due to its more convenient oral route of administration compared to 5-fluorouracil. Despite its widespread use, there are only a few reports on low-dose efficacy, while the clinical significance of such agents remains to be illustrated. Here, we report two cases of breast cancer in women older than 85 years. Both were treated with capecitabine 500 mg t.i.d. every day for 9 and 12 courses, respectively; each course was 21 days. After treatment with low-dose capecitabine, both patients achieved partial tumor response. The side-effects were analyzed during chemotherapy; the primary adverse effects included mild fatigue, loss of appetite, and diarrhea. In conclusion, we observed that the administration of low-dose metronomic capecitabine improved two elderly patients with advanced breast cancers. It might be a well-tolerated treatment option, but its clinical significance still remains to be explored in large scale cohorts