Introduction
Methods
Patients
Study design and treatment
Assessments
Statistical methods
Results
Study conduct, patients, and treatment administration
Patient characteristics | Sunitinib (N = 238) | Capecitabine (N = 244) |
---|---|---|
Age, years | ||
Mean | 53 | 53 |
Range | 25–80 | 23–80 |
ECOG PS, n (%)a
| ||
0 | 142 (60) | 126 (52) |
1 | 86 (36) | 110 (45) |
2 | 4 (2) | 5 (2) |
Primary diagnosis, n (%) | ||
Metastatic | 228 (96) | 233 (95) |
Locally recurrent | 10 (4) | 11 (5) |
Histologic classification, n (%) | ||
Ductal | 202 (85) | 218 (89) |
Lobular | 24 (10) | 17 (7) |
Other | 11 (5) | 7 (3) |
Location of disease, n (%) | ||
Visceral | 173 (73) | 175 (72) |
Non-visceral | 65 (27) | 67 (28) |
Number of involved sites, n (%)a
| ||
1 | 52 (22) | 64 (26) |
≥2 | 184 (77) | 178 (73) |
Most commonly affected sites, n (%) | ||
Liver | 115 (48) | 125 (51) |
Bone | 114 (48) | 104 (43) |
Lymph node | 107 (45) | 109 (45) |
Lung | 101 (42) | 91 (37) |
Receptor status, n (%)a
| ||
Hormone receptor-positive | 148 (62) | 160 (66) |
Hormone receptor-negative | 87 (37) | 82 (34) |
Triple-negativeb
| 86 (36) | 81 (33) |
Prior taxane treatment, n (%)a
| ||
Sensitive | 84 (35) | 83 (34) |
Refractory | 154 (65) | 159 (65) |
Prior lines of systemic therapy for advanced disease, n (%) | ||
0 | 38 (16) | 39 (16) |
≥1 | 200 (84) | 205 (84) |
Sunitinib (N = 238) | Capecitabine (N = 240) | |
---|---|---|
Median number of cycles started (range) | 4 (1–27) | 5 (1–40) |
Median number of days on drug (range)a
| 61 (1–485) | 61 (4–540) |
Dosing interruptions,b
n (%) | 124 (52) | 110 (46) |
Median average duration (range), days | 10 (3–43) | 7 (3–35) |
Dosing delays, n (%) | NA | 109 (45) |
Median average duration (range), days | NA | 7 (3–33) |
Dose reductions,c
n (%) | 66 (28) | 84 (35) |
Median relative dose intensity (range), % | 73 (5–114) | 95 (19–124) |
Efficacy
Variable | Sunitinib (N = 238) | Capecitabine (N = 244) | Hazard ratio | 95% CI |
P
|
---|---|---|---|---|---|
Progression-free survival | |||||
Events, n (%) | 151 (63) | 147 (60) | |||
Median, months | 2.8 | 4.2 | 1.47 | 1.16–1.87 | 0.999a
0.002b
|
95% CI | 2.4–4.0 | 3.8–5.5 | |||
Overall survival | |||||
Events, n (%) | 78 (33) | 71 (29) | |||
Median, months | 15.3 | 24.6 | 1.17 | 0.84–1.63 | 0.825a
0.350b
|
95% CI | 11.4–25.3 | 12.6–26.0 | |||
Objective response rate, % | 11 | 16 | 0.65c
| 0.4–1.1 | 0.109d
|
95% exact CI | 8–16 | 12–22 | |||
Duration of response | |||||
Events, n (%) | 27 (11) | 40 (16) | |||
Median, months | 6.9 | 9.3 | 2.79 | 1.04–7.46 | NA |
95% CI | 3.1–8.5 | 5.5–9.7 | |||
Clinical benefit rate, % | 19 | 27 | 0.65c
| 0.4–1.0 | 0.045d
|
95% exact CI | 15–25 | 22–33 |
Safety
Adverse event | n (%) | |||||
---|---|---|---|---|---|---|
Sunitinib (N = 238) | Capecitabine (N = 240) | |||||
Any grade | Grade 3 | Grade 4 | Any grade | Grade 3 | Grade 4 | |
Any adverse event | 218 (92) | 110 (46) | 17 (7) | 219 (91) | 71 (30) | 6 (3) |
Diarrhea | 94 (40) | 11 (5) | 2 (1) | 81 (34) | 9 (4) | 2 (1) |
Hand–foot syndrome | 77 (32) | 19 (8) | 0 | 146 (61) | 38 (16) | 0 |
Nausea | 76 (32) | 2 (1) | 0 | 68 (28) | 1 (<1) | 0 |
Fatigue | 71 (30) | 13 (6) | 2 (1) | 49 (20) | 3 (1) | 0 |
Vomiting | 66 (28) | 5 (2) | 0 | 27 (11) | 3 (1) | 0 |
Dysgeusia | 59 (25) | 0 | 0 | 11 (5) | 0 | 0 |
Mucosal inflammation | 59 (25) | 7 (3) | 0 | 36 (15) | 2 (1) | 1 (<1) |
Anorexia | 54 (23) | 2 (1) | 0 | 38 (16) | 1 (<1) | 0 |
Hypertension | 46 (19) | 8 (3) | 1 (<1) | 1 (<1) | 0 | 0 |
Asthenia | 41 (17) | 14 (6) | 1 (<1) | 28 (12) | 1 (<1) | 0 |
Neutropenia | 41 (17) | 24 (10) | 2 (1) | 27 (11) | 8 (3) | 1 (<1) |
Stomatitis | 38 (16) | 2 (1) | 0 | 20 (8) | 0 | 0 |
Thrombocytopenia | 38 (16) | 15 (6) | 4 (2) | 6 (3) | 1 (<1) | 2 (1) |
Dyspepsia | 29 (12) | 2 (1) | 0 | 10 (4) | 0 | 0 |
Hypothyroidism | 29 (12) | 1 (<1) | 0 | 1 (<1) | 0 | 0 |
Decreased platelet count | 28 (12) | 12 (5) | 3 (1) | 3 (1) | 0 | 0 |
Headache | 27 (11) | 2 (1) | 0 | 9 (4) | 0 | 0 |
Rash | 26 (11) | 0 | 0 | 17 (7) | 2 (1) | 0 |