[Dose density and dose intensity in the treatment of breast cancer].
Since 10 years, high-dose chemotherapy has been evaluated for the treatment of breast cancer in numerous randomized clinical trials. Preliminary results of some of these studies have shown an advantage in relapse-free survival in both metastatic and high-risk breast cancer. Although follow-up is short in most of the studies, no impact on overall survival has been detected. Based on available results, high-dose chemotherapy cannot be proposed either in metastatic or in high-risk breast cancer patients outside a clinical trial. Conversely, two randomized trials have demonstrated that dose-dense scheduled chemotherapy with G-CSF support, containing an anthracycline, cyclophosphamide and paclitaxel, improves clinical outcomes compared with the same regimen administered every 3 weeks. These results establish dose-dense scheduled chemotherapy containing an anthracycline and paclitaxel as an option for the adjuvant treatment of positive lymph nodes breast cancer patients. Data are not sufficient to conclude in the neoadjuvant and metastatic setting. High-dose chemotherapy and dose-dense chemotherapy seem to increase the pathological complete response rate in inflammatory breast cancer. However, prospective and comparative survival data are lacking.
Saintigny
Pierre
P
Service d'oncologie médicale, hôpital Avicenne, 125 rue de Stalingrad, 93009 Bobigny. pierre.saintigny@avc.ap-hop-paris.fr
Assouad
Sabine
S
Gligorov
Joseph
J
Selle
Frédéric
F
Roché
Henri
H
Breau
Jean-Luc
JL
Morère
Jean-François
JF
Lotz
Jean-Pierre
JP
D018943:Anthracyclines / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic
D018943:Anthracyclines; D000970:Antineoplastic Agents; D017239:Paclitaxel