Finland Capecitabine Trial: For Interpretation, Time Is of the Essence

Thymidine phosphorylase (TP) mediates the final step in conversion of the prodrug capecitabine to 5-flourouracil. Preclinical data have shown that TP expression is increased in tumor tissue after exposure to taxanes and cyclophosphamide; therefore, integration of capecitabine into such regimens could be advantageous. Although trials in metastatic breast cancer have suggested that combining capecitabine with a taxane might be more effective than taxane therapy alone, results in the adjuvant setting have been inconsistent. In the industry-supported Finland Capecitabine Trial (FinXX), 1500 women with node-positive or high-risk node-negative (tumors >2 cm and progesterone receptor–negative) breast cancer were randomized to receive 3 cycles of d…