Dear Editor,


I want to congratulate Torres and their colleagues [1] in which they investigated evaluated the efficacy and safety of the Vinorelbine/Capecitabine doublet (VINOCAP) in heavily pretreated HER2 negative metastatic breast cancer (MBC) patients with vinorelbine 22.5 mg/m2 IV on days 1 and 8 combined with capecitabine 1 g PO BID for 14 consecutive days of 21 day cycles. They concluded that VINOCAP appears to be an active and well-tolerated regimen in women with MBC, particularly as fourth or greater line of chemotherapy. Authors cited phase I and phase II clinical trials that used the combination of intravenous vinorelbine and capecitabine. Of note, among these, one study used oral vinorelbine instead of IV vinorelbine combined with capecitabine [2]. Furthermore, for many patients especially receiving third or fourth line chemotherapy, an active all-oral combination chemotherapy regimen that avoids the need for intravenous treatment administration visits at the clinic might be preferable [3]. The results of two consecutive phase II studies may suggest that oral and iv vinorelbine, in combination with capecitabine, can achieve similar responses in patients with MBC refractory to anthra-taxane combinations [4]. Taken all together all-oral combination regimen such as oral vinorelbine plus capecitabine might be offered as an alternative to VINOCAP, particularly if patients wish to avoid frequent clinic visits for intravenous therapy administration.