Tailored Chemotherapy to Equal Toxicity: Is It Possible?

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Abstract
The intention of chemotherapy for a malignant disease can be either curative or palliative. In breast cancer the former applies to therapy of micrometastatic disease in the adjuvant setting or as a preoperative procedure, while conventionally delivered chemotherapy for metastatic disease is considered to be strictly palliative. The latter statement, however, is challenged by different dose-intensive concepts including the use of high-dose therapy supported by autologous bone marrow stem cells (Bezwoda et al. 1995). The prognosis for breast cancer has been improved by the use of early detection programmes and adjuvant therapy, while the prognosis for patients with metastatic breast cancer is still dismal (Early Breast Cancer Trialists’ Collaborative Group 1992; Nyström et al. 1993; Overgaard et al. 1997; Ragaz et al. 1997).