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 .
Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy: a companion study to cancer and leukemia group B 49907.
PURPOSE A phase III trial ( Cancer and Leukemia Group B CALGB-49907 ) was conducted to test whether older patients with early-stage breast cancer would have equivalent relapse-free and overall survival with capecitabine compared with st and ard chemotherapy . The quality of life ( QoL ) sub study tested whether capecitabine treatment would be associated with a better QoL  than st and ard chemotherapy . PATIENTS AND METHODS QoL was assessed in 350 patients r and omly assigned to either st and ard chemotherapy ( cyclophosphamide , methotrexate , and fluorouracil [ CMF ] or doxorubicin and cyclophosphamide [ AC ] ; n = 182 ) or capecitabine ( n = 168 ) . Patients were interviewed by telephone before treatment ( baseline ) , midtreatment , within 1 month post-treatment , and at 12 , 18 , and 24 months postbaseline by using question naires from the European Organisation for Research and Treatment of Cancer Quality of Life Question naire C30 ( EORTC QLQ-C30 ) , a breast systemic adverse effects scale ( EORTC BR23 ) , and the Hospital Anxiety and Depression Scale ( HADS ) . RESULTS Compared with patients who were treated with st and ard chemotherapy , patients who were treated with capecitabine had significantly better QoL , role function , and social function , fewer systemic adverse effects , less psychological distress , and less fatigue during and at the completion of treatment ( P ≤ .005 ) . Capecitabine treatment was associated with less nausea , vomiting , and constipation and with better appetite  than st and ard treatment ( P ≤ .004 ) , but worse h and -foot syndrome and diarrhea ( P < .005 ) . These differences all resolved by 12 months . CONCLUSION St and ard chemotherapy was superior to capecitabine in improving relapse-free and overall survival for older women with early-stage breast cancer .  Although capecitabine was associated with better QoL during treatment , QoL was similar for both groups at 1 year . The brief period of poorer QoL with st and ard treatment is a modest price to pay for a chance at improved survival
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 .