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Dose-dense anthracycline-based chemotherapy for node-positive breast cancer
Georgiana K Ellis1, Robert B Livingston, Julie R Gralow
1Division of Medical Oncology, University of Washington, and Fred Hutchinson Cancer Research, Seattle, WA. gellis@u.washington.edu
Summary
Dose-dense chemotherapy using doxorubicin and cyclophosphamide showed promising results for breast cancer patients. This regimen, supported by G-CSF, achieved an 86% event-free survival at 5 years.
Area of Science:
- Oncology
- Chemotherapy
- Breast Cancer Research
Background:
- Dose-dense chemotherapy regimens are theorized to improve outcomes.
- Clinical experience suggests potential benefits over standard chemotherapy schedules.
Purpose of the Study:
- To evaluate a dose-dense adjuvant chemotherapy regimen of doxorubicin and cyclophosphamide.
- To assess the efficacy and safety of this regimen, with or without fluorouracil, in high-risk breast cancer patients.
Main Methods:
- A cohort of 52 node-positive or Her-2-neu positive, estrogen receptor-negative breast cancer patients received dose-dense doxorubicin and cyclophosphamide.
- Filgrastim (granulocyte colony-stimulating factor) was administered for G-CSF support.
- Fluorouracil was included in the initial 30 patients but omitted in the latter 22 due to hand-foot syndrome.
Main Results:
- The mean delivered dose-intensity for doxorubicin was 18.6 mg/m(2)/wk.
- Hospitalization for febrile neutropenia occurred in 6% of patients.
- At 5 years, event-free survival was 86% (95% CI, 75% to 95%).
Conclusions:
- Continuous dose-dense chemotherapy with G-CSF support demonstrated encouraging results in adjuvant breast cancer therapy.
- The observed outcomes appear superior to standard doxorubicin and cyclophosphamide chemotherapy.
- A randomized trial is warranted to compare this dose-dense approach with intermittent administration.