Breast cancer - capecitabine

Summary

If a person has locally advanced or metastatic breast cancer, NICE considers that capecitabine in combination with docetaxel should be used in preference to docetaxel on its own if:

• the person has already tried a medicine known as an anthracycline and this has failed to have an effect on the cancer, or 
• treatment with an anthracycline is unsuitable.

NICE has recommended capecitabine monotherapy as an option for locally advanced or metastatic breast cancer if: 

• a person has not already taken capecitabinein combination with docetaxel but has tried treatment with an anthracycline and a medicine going by the general name of ataxane without success, or 
• further treatment with an anthracycline is unsuitable.

The choice about which medicine to take should be made jointly by the patient and her or his doctor. The patient should be informed about the differences between the medicines and the potential suitability of alternative approaches for locally advanced and metastatic breast cancers so that she or he can be fully involved in the decision.

NICE also noted that the use of capecitabine should be overseen by doctors (oncologists) specialising in the use of medicines for breast cancer.

Documents

For healthcare professionals

• TA62 Breast cancer - capecitabine: Summary
• TA62 Breast cancer - capecitabine: Guidance

For patients, carers and the public

• TA62 Breast cancer - capecitabine: Information for the public

Background information

• Review decision
• Review proposal
• Media briefing - Capecitabine for locally advanced and metastatic breast cancer
• 2003/019 NICE extends range of advice for people with cancer
• A rapid and systematic review of the clinical effectiveness and cost-effectiveness of capecitabine (Xeloda®) for locally advanced and/or metastatic breast cancer

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• None found