New developments in chemotherapy for metastatic breast cancer

Breast cancer remains a major cause of morbidity and early death for women. Despite aggressive implementation of preventive measures including screening and adjuvant therapy, this disease will likely continue to have a significant impact unless better treatments are found. A number of new agents have recently been developed that show promising results in the setting of metastatic disease including losoxantrone, vinorelbine, edatrexate, paclitaxel and docetaxel. Some have shown exciting activity where tumor progression has occurred following anthracycline therapy. Appropriate evaluation of new chemotherapeutic agents requires a clear description of the population studied as well as standardized assessments of outcomes. Evaluations are more relevant and more quickly done in multicenter trials. Because of the heterogeneity of metastatic breast cancer and differences in outcome measurement, randomized trials continue to be essential in defining which agents are the most appropriate candidates for further study.