In general , single-agent chemotherapy is not recommended for the adjuvant treatment of breast cancer in any patient population .
Anthracycline-taxane-based polychemotherapy regimens are , overall , considered superior to earlier-generation regimens and have the most significant impact on patient survival outcomes .
Regimens with varying anthracycline and taxane doses and schedules are options ; in general , paclitaxel given every 3 weeks is inferior .
Evidence does not support the use of bevacizumab in the adjuvant setting ; other systemic therapy agents such as metformin and vaccines remain investigatory .
BACKGROUND The Program in Evidence -Based Care ( pebc ) of Cancer Care Ontario recently created an evidence -based consensus guideline on the systemic treatment of early breast cancer .
The evidence for the guideline was compiled using a systematic review to answer the question " What is the optimal systemic therapy for patients with early-stage , operable breast cancer , when patient and disease factors are considered ? "
The question was addressed in three parts : cytotoxic chemotherapy , endocrine treatment , and human epidermal growth factor receptor 2 (her2)-directed therapy .
Oral uracil and tegafur compared with classic cyclophosphamide, methotrexate, fluorouracil as postoperative chemotherapy in patients with node-negative, high-risk breast cancer: National Surgical Adjuvant Study for Breast Cancer 01 Trial.
PURPOSE The primary aim of this study was to compare the effectiveness of oral uracil-tegafur ( UFT ) with that of classical cyclophosphamide , methotrexate , and fluorouracil ( CMF ) given as postoperative adjuvant treatment to women with node-negative , high-risk breast cancer . PATIENTS AND METHODS Women with node-negative , high-risk breast cancer were r and omly assigned to receive either 2 years of UFT or six cycles of CMF after surgery . The primary end point was relapse-free survival ( RFS ) . Overall survival ( OS ) , toxicity , and quality of life ( QOL ) were secondary end points . The hypothesis was that UFT was not inferior to CMF in terms of RFS . RESULTS Between October 1996 and April 2001 , a total of 733 patients were r and omly assigned to receive either treatment . The median follow-up time was 6.2 years . The RFS rates at 5 years were 88.0 % in the CMF arm and 87.8 % in the UFT arm . OS rates were 96.0 % and 96.2 % , respectively . The hazard ratios of the UFT arm relative to the CMF arm were 0.98 for RFS ( 95 % CI , 0.66 to 1.45 ; P = .92 ) and 0.81 for OS ( 95 % CI , 0.44 to 1.48 ; P = .49 ) . The toxicity profiles differed between the two groups . The QOL scores were better for patients given UFT than those given CMF . CONCLUSION RFS and OS with oral UFT were similar to those with classical CMF . Given the higher QOL scores , oral UFT is a promising alternative to CMF for postoperative adjuvant chemotherapy in women with node-negative , high-risk breast cancer
In general , single-agent chemotherapy is not recommended for the adjuvant treatment of breast cancer in any patient population .
Anthracycline-taxane-based polychemotherapy regimens are , overall , considered superior to earlier-generation regimens and have the most significant impact on patient survival outcomes .
Regimens with varying anthracycline and taxane doses and schedules are options ; in general , paclitaxel given every 3 weeks is inferior .
Evidence does not support the use of bevacizumab in the adjuvant setting ; other systemic therapy agents such as metformin and vaccines remain investigatory .
BACKGROUND The Program in Evidence -Based Care ( pebc ) of Cancer Care Ontario recently created an evidence -based consensus guideline on the systemic treatment of early breast cancer .
The evidence for the guideline was compiled using a systematic review to answer the question " What is the optimal systemic therapy for patients with early-stage , operable breast cancer , when patient and disease factors are considered ? "
The question was addressed in three parts : cytotoxic chemotherapy , endocrine treatment , and human epidermal growth factor receptor 2 (her2)-directed therapy .