Chemotherapy for metastatic breast cancer-report of a European expert panel.
The anthracyclines doxorubicin and epirubicin, and the taxanes paclitaxel and docetaxel, are effective chemotherapeutic agents for the first-line and second-line treatment of metastatic breast cancer, and their clinical use is widespread. However, for women whose disease has progressed despite receiving these drugs, treatment options are limited. These women often have a good performance status, and may survive for many months or even years, so they should be given the opportunity to benefit from further chemotherapy. The goals of chemotherapy in these patients are to obtain maximum control of symptoms, prevent serious complications, and increase survival without diminishing quality of life. Several agents are used for this purpose, including fluorouracil, docetaxel (in patients who have already received paclitaxel), vinorelbine, and mitomycin c, but because data from controlled trials are limited, a standard regimen has not yet been established. Moreover, these agents may be inconvenient to administer and can be associated with adverse events requiring hospitalisation. Therefore, there is a clear need for additional therapeutic options for patients with metastatic breast cancer. Ideally, agents should have a convenient method of administration, eg, oral, and should be suitable for home-based rather than hospital-based therapy. Treatment should control disease in at least 20-30% of patients with an acceptable side-effect profile. Novel oral therapies have now been developed and are being used increasingly in patients whose disease has progressed following taxane therapy.
Crown
John
J
Vincent's University Hospital, Dublin, Ireland.
Diéras
Véronique
V
Kaufmann
Manfred
M
von Minckwitz
Gunter
G
Kaye
Stan
S
Leonard
Robert
R
Marty
Michel
M
Misset
Jean-Louis
JL
Osterwalder
Bruno
B
Piccart
Martine
M
D000903:Antibiotics, Antineoplastic / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D001952:Bridged-Ring Compounds / Q000494:pharmacology; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D005060:Europe; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy*; D010347:Patient Care Planning; D016879:Salvage Therapy; D043823:Taxoids
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane