[Advances in breast cancer chemotherapy]

Progress in chemotherapy for breast cancer was reviewed in the management of primary and metastatic diseases. In the metastatic setting, a survival advantage from combinations of drugs has not been proved over single agents given in sequence. Currently, active agents include anthracyclines, taxanes, vinorelbine, and fluoropyrimidines. Prospective randomized trials demonstrated that adjuvant systemic chemotherapy reduced annual odds of recurrence and death with combination therapy, regardless of age, stage, nodel status and hormone receptor status. One of the recent important questions in the adjuvant setting is the role of taxanes. Although many adjuvant taxane studies are still on going, 4 cycles of anthracycline-containing regimen sequenced with 4 cycles of a taxane appear to be the most beneficial treatment for advanced disease. Controversies and future directions are the high cost of treatment and the prediction of response to each drug for individual patients.