Adjuvant chemotherapy is of proven survival benefit for @entity1 with early @entity0 , but trials of new adjuvant therapies take many years to conduct and evaluate. In addition, adjuvant chemotherapy is given "blind," with no prior knowledge of the sensitivity of a @entity1 's @entity5 to the agents being used. Primary chemotherapy is an innovative approach in which chemotherapy is given as first-line treatment, before surgery. This approach was developed for @entity5 reduction in inoperable locally advanced @entity0 , and the results obtained in several studies suggested that primary chemotherapy with adjuvant surgery could be an effective alternative to the conventional approach of primary surgery with adjuvant chemotherapy. Several combination regimens have proved successful as primary chemotherapy, with response rates of 69% to 78%, including 12% to 30% complete remissions. The use of infusional @entity1487 , in combination with bolus injections of @entity1259 and @entity900 (infusional ECF), as primary chemotherapy in @entity1 with @entity3 or locally advanced @entity0 has been pioneered by The Royal Marsden NHS Trust in the United Kingdom. Infusional ECF has shown a response rate of 98%, with 66% complete remissions, in a trial involving 50 @entity1 with large operable @entity0 . Infusional ECF is now being compared with conventional @entity632 / @entity786 chemotherapy in a multicenter trial. Administering chemotherapy before surgery also allows the drug sensitivity of the @entity5 to be assessed at the time of treatment. Techniques for testing the chemosensitivity of @entity5 in vivo and adjusting the chemotherapy in line with initial results are being investigated. In this way, primary chemotherapy may offer an effective approach to testing new therapies as front-line treatments.

XXXX benefits from new treatment options and schedules for @entity0 .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient'] @entity632 :: ('MESH:D004317', 'Chemical') :: ['doxorubicin'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer', 'breast tumors'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity1259 :: ('MESH:D015251', 'Chemical') :: ['epirubicin'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastatic'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity1 :: (9606,Species) :: ['Patient']
