[New therapeutic approaches in advanced breast carcinoma. Palliative measures are increasingly more tolerable]

Advances in palliative chemotherapy are based on the development of new substances or new treatment strategies, such as, for example, high-dose chemotherapy. New cytostatic agents are developed with the aim of improving therapeutic efficacy and tolerability. Taxanes rapidly became part of standard treatment, and their combination with the anthracyclines represents the most effective treatment currently available. Liposomal encapsulation of anthracyclines can reduce their cardiotoxicity without loss of efficacy. Recent antimetabolites and the vinca alkaloid, vinorelbine, combine a good antitumoral effect with a favorable toxicity profile. The use of the monoclonal antibody, trastuzumab, has made specific immunotherapy possible for the first time. The role of high-dose chemotherapy remains uncertain, and further randomized studies are urgently needed.