Xeloda (Capecitabine) and External Beam Radiation

The Study Treatment:

Radiation therapy and capecitabine are both designed to interfere with the growth of cancer
cells.

Study Therapy:

If you are found to be eligible to take part in this study, you will receive radiation
therapy once or twice a day, 5 days a week, for about 5 -7 weeks. The schedule and number of
weeks will be the doctor's decision based on the type of breast cancer.

The radiation treatments will take about 15-30 minutes each time.

You will take the Capecitabine pills by mouth every day during the 5-7 weeks that you receive
radiation therapy. The pills should be taken 2 times a day, about 12 hours apart, 30 minutes
after eating food. On the radiation therapy days, you will take capecitabine about 2 hours
before the radiation therapy.

You will be given a pill diary in which you should record what time you take each dose of
capecitabine.

Study Visits:

Once a week while you are receiving study treatment, you will have a physical exam.

Length of Study:

You may remain on study treatment for up to 7 weeks. You will be taken off study treatment
early if the disease gets worse or intolerable side effects occur.

Based on the status of the cancer, if you become eligible to have surgery after radiation,
you will be referred to a surgeon to discuss that option.

Follow-Up Visits:

At Month 3 after finishing radiation therapy (or surgery, if applicable), you will have a
positron emission tomography / computed tomography (PET/CT) scan or ultrasound to check the
status of the disease.

At Months 9, 17, and 29 after finishing radiation therapy or surgery, you may have a PET/CT
scan, ultrasound, and/or routine blood tests if your doctor thinks it is needed. The amount
of blood drawn, if any, will be the doctor's decision based on routine care.

This is an investigational study. Capecitabine is commercially available and FDA approved to
treat breast cancer that has spread. Radiation therapy is also commonly used to treat breast
cancer. The combination of capecitabine and radiation therapy is commonly used to treat
rectal cancer.

At this time, it is considered investigational to give the combination of capecitabine and
radiation therapy to patients with breast cancer.

Up to 60 patients will take part in this study. All will be enrolled at M. D. Anderson.

Inclusion Criteria:

1. Histological confirmation of invasive breast cancer

2. No contraindications to receiving a course of radiation treatment (pregnancy, prior
radiation to the volume with disease, or systemic disease in which radiation therapy
is an absolute contraindication)

3. Patients who have chemo-refractory gross disease in the breast causing symptoms (pain,
drainage, duress) OR gross disease in the breast (greater than or equal to T3) and/or
lymph node(s) progressive, persistent, or minimally responsive to chemotherapy deemed
inoperable or questionable inoperable OR Recurrent gross disease in a previously
unirradiated breast or on the chest wall or in the regional lymphatics (core biopsy
will not be offered to patients without gross disease in the breast).

4. Are able to swallow and retain oral medication (intact pill)

5. Age over 18

6. Female gender

Exclusion Criteria:

1. Have an active or uncontrolled infection

2. Have dementia, altered mental status, or any psychiatric condition that would prohibit
the understanding or rendering of informed consent

3. Have used an investigational drug within 21 days preceding the first dose of study
medication

4. Are receiving therapeutic anti-coagulation therapy (i.e. warfarin, heparin)

5. Uncontrolled arrhythmia or congestive heart failure (CHF) based on clinical history or
physical exam

6. Patient cannot receive whole brain irradiation concurrently with Xeloda treatment.