[Intensified chemotherapy of solid tumours]

Area of Science:

• Oncology
• Pharmacology
• Chronobiology

Context:

• Solid malignant diseases remain a challenge despite advances in cancer treatment.
• Current therapeutic outcomes for many solid tumors are unsatisfactory for oncologists.
• There is a need for novel therapeutic strategies, including optimized use of existing chemotherapeutic agents.

Purpose:

• To explore intensified cytostatic therapeutic regimens for solid malignant diseases.
• To investigate the application of chronobiology principles in chemotherapy administration.
• To evaluate the efficacy and toxicity of high-dose chemotherapy in solid tumors, particularly breast cancer.

Summary:

• High-dose chemotherapy has shown success in hematologic oncology and is being adapted for solid tumors.
• Experience with high-dose cytostatic treatment is most extensive in breast cancer, with mixed results for metastatic and inflammatory types.
• Adjuvant high-dose therapy for high-risk patients shows potential, with mathematical models supporting complete eradication of malignant cells.
• A dose-dense regimen (doxorubicin-paclitaxel-cyclophosphamide) with shortened intervals and high/equal dosage demonstrates statistically significant preliminary results in survival and toxicity.

Impact:

• The dose-dense doxorubicin-paclitaxel-cyclophosphamide regimen offers a promising approach for improving survival in high-risk solid tumor patients.
• This intensified chemotherapy strategy may lead to better treatment outcomes compared to conventional administration.
• Further clinical studies are needed to confirm the long-term benefits and refine the application of these advanced therapeutic regimes in specialized centers.