title: Cytotoxic chemotherapy: Still the mainstay of clinical practice for all subtypes metastatic breast cancer.
abstract: Cytotoxic chemotherapy remains central to the treatment of all subtypes of metastatic breast cancer (MBC). We review evidence-based chemotherapy options for women with MBC after an anthracycline and a taxane including re-challenge with anthracycline or taxane, capecitabine, eribulin and ixabepilone as a single agent or combination with capecitabine (not approved in the EU); and the vinca alkaloid vinflunine as single agent or combined with either capecitabine/gemcitabine (also not approved EU or USA). Etirinotecan pegol, comprising irinotecan bound to polyethylene glycol by a biodegradable linker, is a new cytotoxic agent for patients with MBC that has achieved encouraging response rates in phase II studies; it has been further evaluated in the phase III BEACON trial. New cytotoxics should address novel targets or modes of delivery, achieve meaningful improvements in outcomes and seek to identify predictive biomarker(s).
authors: Leeds Institute of Cancer and Pathology, St. James's University Hospital, Leeds, UK; St James's Institute of Oncology, St. James's University Hospital, Bexley Wing, Level 4, Beckett Street, LS9 7TF Leeds, UK. Electronic address: C.J.Twelves@leeds.ac.uk.
authors: Chris
authors: C
authors: Twelves
authors: St James's Institute of Oncology, St. James's University Hospital, Bexley Wing, Level 4, Beckett Street, LS9 7TF Leeds, UK. Electronic address: M.Jove@leeds.ac.uk.
authors: Maria
authors: M
authors: Jove
authors: Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, B-1000 Brussels, Belgium. Electronic address: andrea.gombos@bordet.be.
authors: Andrea
authors: A
authors: Gombos
authors: Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, B-1000 Brussels, Belgium. Electronic address: ahmad.awada@bordet.be.
authors: Ahmad
authors: A
authors: Awada
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans
chemical_list: D000970:Antineoplastic Agents
keywords: Anthracycline; Capecitabine; Eribulin; Etirinotecan pegol; Metastatic breast cancer; Taxane