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 .
Phase III randomized trial of doxorubicin and docetaxel versus doxorubicin and cyclophosphamide as primary medical therapy in women with breast cancer: an anglo-celtic cooperative oncology group study.
PURPOSE To compare the clinical and pathologic response rates of doxorubicin and cyclophosphamide ( AC ) with doxorubicin and docetaxel ( AD ) as primary chemotherapy in women with primary or locally advanced breast cancer . PATIENTS AND METHODS Eligible patients with histologically proven breast cancer with primary tumors > /= 3 cm , inflammatory or locally advanced disease , and no evidence of metastases were r and omly assigned to receive a maximum of six cycles of either doxorubicin ( 60 mg/m(2 ) ) plus cyclophosphamide ( 600 mg/m(2 ) ) administered intravenously ( IV ) every 3 weeks or doxorubicin ( 60 mg/m(2 ) ) plus docetaxel ( 75 mg/m(2 ) ) IV every 3 weeks , followed by surgery on completion of chemotherapy . Results A total of 363 patients were r and omly assigned to AC ( n = 180 ) or AD ( n = 183 ) . A complete clinical response was observed in 17 % and 20 % of patients treated with AC and AD , respectively ( P = .42 ) . Overall ( complete and partial ) clinical response rates for AC and AD were 61 % and 70 % , respectively ( P = .06 ) . There was no significant difference in either the pathologic complete response rates in the breast with AC ( 24 % ) and AD ( 21 % ; P = .61 ) or in the number of patients with positive axillary nodes at surgery with AC ( 61 % ) and AD ( 66 % ; P = .28 ) . At a median follow-up of 32 months , there is no significant difference between the two groups for the number of relapses . CONCLUSION In contrast to the positive results reported for sequential docetaxel after AC as primary chemotherapy of breast cancer , our data do not suggest a benefit for simultaneous AD over AC
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 .