ABSTRACT
Residual disease following neoadjuvant chemotherapy (NACT) is considered a prognostic indicator for disease recurrence and reduced survival rates, when compared to achieving a pathological complete response (pCR), which is associated with a favourable outcome. In patients with HER2-negative disease, options for additional systemic therapy are limited, particularly in cases of triple-negative breast cancer (TNBC) where endocrine therapy is ineffective. Capecitabine, an oral prodrug of fluorouracil, has been utilised in the treatment of metastatic breast cancer and various other solid cancers. Previous trials investigating adjuvant therapy involving capecitabine, in combination with other chemotherapeutic agents for breast cancer, failed to demonstrate significant survival benefits. The Capecitabine for Residual Cancer as Adjuvant Therapy (CREATE X) trial has re-established capecitabine as a valuable tool for managing patients with residual breast cancer after previous NACT for women who have not had a pCR. 1 The study is one of several practice-changing trials showing that biological response to NACT can be used to tailor therapy to target resistant disease and so improve outcomes.
