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 .
Disease-free survival advantage of adjuvant cyclophosphamide, methotrexate, and fluorouracil in patients with node-negative, rapidly proliferating breast cancer: a randomized multicenter study.
PURPOSE According to one of the most recent key scientific questions concerning the use of biomarkers in clinical trials , we investigated whether node-negative breast cancer patients , defined as high-risk cases on the basis of tumor cell proliferation , could benefit from cyclophosphamide , methotrexate , and fluorouracil ( CMF ) adjuvant therapy . PATIENTS AND METHODS Two hundred eighty-one patients with negative nodes and rapidly proliferating tumors , defined according to thymidine labeling index ( TLI ) , were r and omized to receive six cycles of CMF or no further treatment after surgery + /- radiotherapy . RESULTS The 5-year disease-free survival ( DFS ) was 83 % for patients treated with CMF compared with 72 % in the control group ( P : = .028 ) . Adjuvant treatment reduced both locoregional and distant metastases . When clinical outcome was analyzed in cell kinetic subgroups characterized according to tertile criteria , compared with patients in the control arm , 5-year DFS was significantly higher after adjuvant CMF in patients with TLI values in the second ( 78 % v 88 % , respectively ; P : = .037 ) and third tertiles ( 58 % v 78 % , respectively ; P : = .024 ) . CONCLUSION The results from this r and omized clinical study indicate that patients with node-negative , rapidly proliferating tumors significantly benefit from adjuvant CMF
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 .