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First-Line Treatment of Metastatic Breast Cancer

Available Evidence and Current Recommendations

  • Review Article
  • Published:
American Journal of Cancer

Abstract

For many years, tamoxifen was the mainstay of treatment for hormone receptor-positive metastatic breast cancer (MBC). However, in recent years, newer endocrine agents, particularly aromatase inhibitors, have consistently proved their superiority over tamoxifen by improving clinical outcomes. These agents have therefore been incorporated into first-line treatment strategies for endocrine-responsive disease. The chemother-apeutic armamentarium has also been enriched with new agents and combinations that have played a role in improving breast cancer survival in recent decades. However, few chemotherapy clinical trials have claimed a clear survival benefit of one regimen over another. More recently, the development of biologic agents has further widened the spectrum of available therapies. Among these, trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2), has significantly altered the lives of patients with HER2-positive MBC.

The transfer of research findings to clinical practice is a delicate process that implies the ability to adequately tailor evidence obtained from well designed clinical trials to the individual patient. This article discusses landmark studies in the treatment of MBC, with emphasis on those treatments used as ‘first-line’ therapy following relapse.

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Acknowledgments

The authors are very grateful to Carolyn Straehle, PhD, for her editorial work.

F Puglisi has held a fellowship at the Institute Jules Bordet, Brussels, Belgium, thanks to a grant from the Associazione Italiana di Oncologia Medica (AIOM).

M Piccart has acted as a consultant or served in an advisory role to Aventis, Bristol-Myers Squibb, Novartis, and Pfizer and has received honoraria from AstraZeneca, Aventis, Novartis, Pfizer, and Roche.

No sources of funding were used to assist in the preparation of this review.

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Authors and Affiliations

  1. Department of Medical Oncology, University Hospital, Udine, Italy

    Fabio Puglisi

  2. Department of Medical Oncology, Jules Bordet Institute, Boulevard de Waterloo, 125, Brussels, 1000, Belgium

    Fatima Cardoso, Fabienne Lebrun &  Martine Piccart

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  1. Fabio Puglisi
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  2. Fatima Cardoso
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Correspondence to Martine Piccart.

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Puglisi, F., Cardoso, F., Lebrun, F. et al. First-Line Treatment of Metastatic Breast Cancer. Am J Cancer 5, 99–110 (2006). https://doi.org/10.2165/00024669-200605020-00004

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