title: Metastatic breast cancer.
abstract: The management of metastatic breast cancer continues to provide enormous challenges. The taxanes have significant activity in patients with resistant disease, and combination regimens are being evaluated as first-line therapy. The combination of paclitaxel and doxorubicin appears to have substantial activity, but troublesome cardiac toxicity has been noted in a recently reported study. Docetaxel has been shown to be very active in initial phase II evaluation, notably in women with anthracycline-resistant disease. The controversy over high-dose therapy continues, and its role in the management of metastatic breast cancer outside the confines of clinical trials remains unclear. The HER-2 protein appears to be a predictive factor for patients with metastatic disease. Antibody therapy directed at this target can produce responses in a proportion of patients. Bisphosphonates appear to be beneficial to patients with lytic bony metastases when administered in conjunction with cytotoxic or hormonal therapy.
authors.affiliation: Johns Hopkins Oncology Center, Medical Oncology, Baltimore, MD 21287-8936, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kennedy
mesh_terms: D000225:Adenine; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D047072:Aromatase Inhibitors; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D002986:Clinical Trials as Topic; D017322:Clinical Trials, Phase II as Topic; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007094:Imides / Q000627:therapeutic use; D007364:Intercalating Agents / Q000627:therapeutic use; D007546:Isoquinolines / Q000627:therapeutic use; D053644:Naphthalimides; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000276:immunology; D063065:Organophosphonates; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016879:Salvage Therapy; D043823:Taxoids; D059005:Topoisomerase II Inhibitors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000911:Antibodies, Monoclonal; D000912:Antibodies, Neoplasm; D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D047072:Aromatase Inhibitors; D004164:Diphosphonates; D004791:Enzyme Inhibitors; D007094:Imides; D007364:Intercalating Agents; D007546:Isoquinolines; D053644:Naphthalimides; D009363:Neoplasm Proteins; D063065:Organophosphonates; D043823:Taxoids; D059005:Topoisomerase II Inhibitors; D003841:Deoxycytidine; D000077143:Docetaxel; C037020:amonafide; D004317:Doxorubicin; D000225:Adenine; D017239:Paclitaxel; D000093542:Gemcitabine