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CREATE-X Capecitabine — SCE Medical Oncology MCQ

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ModerateBreast CancerCREATE-X CapecitabineSCE Medical Oncology

A 58-year-old woman with triple-negative breast cancer achieves pCR after neoadjuvant chemotherapy (without pembrolizumab). She asks about adjuvant capecitabine. What does the CREATE-X trial show?

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Correct answer: C — CREATE-X showed adjuvant capecitabine (6-8 cycles) significantly improved DFS and OS in HER2-negative breast cancer patients with residual invasive disease after neoadjuvant chemotherapy — the benefit was most pronounced in TNBC

CREATE-X (Masuda et al NEJM 2017): non-pCR HER2-negative → adjuvant capecitabine 6-8 cycles. OS benefit overall, most pronounced in TNBC (OS HR 0.52). This patient achieved pCR so CREATE-X does not apply — but the question tests knowledge of the trial eligibility (non-pCR).

Reference: CREATE-X Masuda et al NEJM 2017; ESMO 2024