[Current trends in pharmacotherapy of breast cancer].
BACKGROUND
Breast cancer is a systemic disease, unfortunately clinically undetectable micrometastases are present in many women even in early stages of the disease. Many of these patients can be cured with combined modality treatment of surgery, radiation and chemo- or hormone therapy.


OBJECTIVE
To survey the treatment of breast cancer.


METHODS
The author presents an overview of the treatment of breast cancer based on the relevant literature and experience.


RESULTS
Systemic adjuvant treatments include cytotoxic and hormone therapy. The most commonly used cytotoxic agents are cyclophosphamide, methotrexate, 5-fluorouracil, doxorubicin and epirubicin. The anthracycline-containing regimens are slightly superior, and the addition of taxane to an anthracycline-containing regimen may further increase the efficacy of adjuvant chemotherapy. Patients with metastatic disease cannot be cured, the goal of the treatment is to improve quality of life, and prolong survival. Up to 60-80% of these patients may experience objective tumor response to first-line combination chemotherapy. The taxanes (paclitaxel or docetaxel) with anthracyclines are the most active chemotherapy drugs against breast cancer. The best results are achieved with second-, third-line chemotherapy drugs: capecitabine, vinorelbine, gemcitabine, 5-fluorouracil and a variety of its oral pro-drugs. The most recent developments are represented by the biologically-targeted drugs, the first agent developed trastuzumab, has already been introduced in the clinic. The combination of chemotherapy with various response modifiers is a rapidly developing field of clinical cancer research. Several other new agents including growth factor receptor antagonists, tumor vaccines, antiangiogenic agents are tested in clinical trials alone and in combination with chemotherapy.


CONCLUSIONS
The combination of chemotherapy with the new generation of drugs is a rapidly advancing and important field of clinical oncology.
Boér
Katalin
K
Onkológiai Osztály, Szent Margit Kórház, Budapest.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D012307:Risk Factors; D012720:Severity of Illness Index
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic