title: International guidelines for management of metastatic breast cancer: combination vs sequential single-agent chemotherapy.
abstract: Compared with treatment options for early-stage breast cancer, few data exist regarding the optimal use of chemotherapy for metastatic breast cancer (MBC). The choice of using a combination of cytotoxic chemotherapies vs sequential single agents is controversial. At the 6th European Breast Cancer Conference, the European School of Oncology Metastatic Breast Cancer Task Force convened an open debate on the relative benefits of combination vs sequential therapy. Based on the available data, the Task Force recommends sequential monotherapy as the preferred choice in advanced disease, in the absence of rapid clinical progression, life-threatening visceral metastases, or the need for rapid symptom and/or disease control. Patient- and disease-related factors should be used to choose between combination and sequential single-agent chemotherapy for MBC. Additional research is needed to determine the impact of therapy on patient-rated quality of life and to identify predictive factors that can be used to guide therapy.
authors: Department of Medical Oncology, Medical Oncology & Translational Research Unit, Jules Bordet Institute, Brussels, Belgium. fatima.cardoso@bordet.be
authors: Fatima
authors: F
authors: Cardoso
authors: Philippe L
authors: PL
authors: Bedard
authors: Eric P
authors: EP
authors: Winer
authors: Olivia
authors: O
authors: Pagani
authors: Elzbieta
authors: E
authors: Senkus-Konefka
authors: Lesley J
authors: LJ
authors: Fallowfield
authors: Stella
authors: S
authors: Kyriakides
authors: Alberto
authors: A
authors: Costa
authors: Tanja
authors: T
authors: Cufer
authors: Kathy S
authors: KS
authors: Albain
mesh_terms: D000367:Age Factors; D018943:Anthracyclines / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology*; D000069287:Capecitabine; D015897:Comorbidity; D003226:Congresses as Topic; D018592:Cross-Over Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005060:Europe; D019317:Evidence-Based Medicine; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007391:International Cooperation; D017567:Karnofsky Performance Status; D008593:Menopause; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D043823:Taxoids / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D043823:Taxoids; D003841:Deoxycytidine; D014747:Vinblastine; D000069287:Capecitabine; D000077235:Vinorelbine; D005472:Fluorouracil