Breast Cancer Research and Treatment

, Volume 81, Supplement 1, pp 49-52

First online:

Chemotherapy for Advanced Breast Cancer – How Long Should it Continue?

  • Martin R StocklerAffiliated withDepartment of Medicine and School of Public Health, University of SydneyNHMRC Clinical Trials Centre, University of SydneyDepartment of Medical Oncology, Sydney Cancer Centre
  • , Nicholas JC WilckenAffiliated withDepartments of Medicine and School of Public Health, University of SydneyDepartment of Medical Oncology and Palliative Care, Westmead Hospital
  • , Alan S CoatesAffiliated withDepartments of Medicine and School of Public Health, University of SydneyThe Cancer Council Australia

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Chemotherapy is given to most women with advanced breast cancer, but its optimal duration is poorly defined. A systematic review identified four randomised trials comparing more with fewer cycles of the same chemotherapy in women with advanced breast cancer. Meta-analysis of these four trials including 766 women showed a modest, survival advantage for women randomized to more cycles of chemotherapy (median survival 23% longer with more cycles, p = 0.01). Small increments in survival duration are valued highly by women with breast cancer. Quality of life was also better with more cycles of chemotherapy than fewer in the one trial that measured it. The combined evidence from these trials supports a policy of continuing chemotherapy in the absence of disease progression or significant side effects. Decisions about continuing or stopping treatment should be made by the patient and doctor guided by monitoring and consideration of symptoms, signs, side effects, quality of life and preferences.

advanced breast cancer chemotherapy duration meta-analysis randomised clinical trials