Recent advances in systemic therapy. Advances in adjuvant systemic chemotherapy of early breast cancer
Open Access
- 19 March 2009
- journal article
- review article
- Published by Springer Nature in Breast Cancer Research
- Vol. 11 (2) , 204
- https://doi.org/10.1186/bcr2226
Abstract
Adjuvant treatment for early breast cancer is an evolving field. Since the advent of the initial cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimens, which reduced risk for recurrence and death, anthracyclines and subsequently taxanes were added to the cytotoxic armamentarium for use sequentially or in combination in the adjuvant setting. The efficacy and toxicity of each chemotherapy regimen must be viewed within the context of host co-morbidities and the specific biologic phenotype of the tumor. In the era of mammographic screening, small, node-negative breast cancer is the most frequent presentation of the disease. Patient selection for adjuvant chemotherapy has become a key issue. Traditional prognostic factors continue to be of value in determining the risk for relapse, but new and sophisticated genomic tools (such as Oncotype Dx® and Mammaprint®) are now available and may improve our ability to select patients. For those patients who do require adjuvant chemotherapy, the 'one size fits all' paradigm should never again feature in the treatment of early breast cancer, following the important insights yielded by biomarker research to identify those who will benefit the most from a particular drug. In this review we focus on some of the current controversies and potential future steps in adjuvant chemotherapy for treatment of early breast cancer.Keywords
This publication has 65 references indexed in Scilit:
- Randomized Phase 3 Trial of Fluorouracil, Epirubicin, and Cyclophosphamide Alone or Followed by Paclitaxel for Early Breast CancerJNCI Journal of the National Cancer Institute, 2008
- Weekly Paclitaxel in the Adjuvant Treatment of Breast CancerNew England Journal of Medicine, 2008
- Sequential Preoperative or Postoperative Docetaxel Added to Preoperative Doxorubicin Plus Cyclophosphamide for Operable Breast Cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27Journal of Clinical Oncology, 2006
- Estrogen-Receptor Status and Outcomes of Modern Chemotherapy for Patients With Node-Positive Breast CancerJAMA, 2006
- Trastuzumab after Adjuvant Chemotherapy in HER2-Positive Breast CancerNew England Journal of Medicine, 2005
- Adjuvant Docetaxel for Node-Positive Breast CancerNew England Journal of Medicine, 2005
- Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trialsThe Lancet, 2005
- Randomized Trial of Dose-Dense Versus Conventionally Scheduled and Sequential Versus Concurrent Combination Chemotherapy as Postoperative Adjuvant Treatment of Node-Positive Primary Breast Cancer: First Report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741Journal of Clinical Oncology, 2003
- Polychemotherapy for early breast cancer: an overview of the randomised trialsThe Lancet, 1998
- Adjuvant Cyclophosphamide, Methotrexate, and Fluorouracil in Node-Positive Breast Cancer — The Results of 20 Years of Follow-upNew England Journal of Medicine, 1995