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 .
Comparison of EQ-5D scores among anthracycline-containing regimens followed by taxane and taxane-only regimens for node-positive breast cancer patients after surgery: the N-SAS BC 02 trial.
OBJECTIVE To examine health-related quality of life , we investigated the effect of adjuvant chemotherapy regimens on utility scores assessed by the EuroQoL-5D ( EQ-5D ) instrument in a r and omized , controlled trial for breast cancer patients after surgery . We also investigated the relationship between Functional Assessment of Cancer Therapy ( FACT ) scale scores and EQ-5D utilities . METHODS Patients were r and omly assigned to the following four chemotherapy regimens : four cycles of anthracycline followed by paclitaxel ( ACP ) , four cycles of anthracycline-containing regimens followed by docetaxel ( ACD ) , eight cycles of paclitaxel ( PTX ) , and eight cycles of docetaxel ( DTX ) .  Of 1060 registered , the first 300 consecutive patients were included in the current utility study . Utility scores were assessed using the EQ-5D instrument at baseline ; cycles 3 , 5 , and 7 ; 7 months ; and 1 year . We also evaluated the correlation between these scores and FACT-G , -B , and -Taxane scores at each time point . RESULTS Utility scores were significantly lower in the DTX group than in the ACP and ACD groups . Mean utility scores in the DTX group were lowest at 7 months and tended to remain low for a long time . The combined anthracycline followed by taxane group had significantly higher utility scores that the taxane-alone group , with no significant difference depending on the type of taxane . Only the FACT-G social/family well-being subscale had no relationship with EQ-5D responses and utility scores . CONCLUSIONS Although the regimens in this study were similar in that they included taxane , the mean utility scores and longitudinal patterns of utility scores were different among regimens
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 .