Advertisement

Adjuvant Chemotherapy of Breast Cancer

  • Sérgio Daniel Simon
  • Pedro H. Z. de Moraes
  • Vladimir Galvão de Aguiar
Chapter

Abstract

Adjuvant chemotherapy treatment refers to the systemic administration of cytotoxic agents after surgical treatment. It aims at treating micrometastatic disease and consequently eliminating or lowering the chances of recurrence.

Recommended Reading

  1. 1.
    Bonilla L, et al. Dose-dense chemotherapy in nonmetastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials. J Natl Cancer Inst. 2010;102:1845–54. Systematic analysis and meta-analysis with 10 studies and more than 11,000 patients who evaluated a dense dose chemotherapy regimen in high-risk patients. Interpretation: dense-dose chemotherapy showed a gain in overall survival with HR 0.85 (95% CI 0.77–0.93) and progression-free survival gain at HR 0.81 (95% CI 0.75–0.88). CrossRefGoogle Scholar
  2. 2.
    Gnanta M, Harbeckb N, Thomssen C, Panel Members. St. Gallen/Vienna 2017: a brief summary of the consensus discussion about escalation and de-escalation of primary breast cancer treatment. Breast Care. 2017;12:102–7. Review of the St Gallen conference in 2017. Updates in the areas of genetics and molecular biology, creating a panel to guide the adjuvant treatment of breast cancer. Interpretation: the therapeutic decision must be individualized, taking into account the patient’s characteristic and molecular biology of the tumor. CrossRefGoogle Scholar
  3. 3.
    Lo S, Mumby PB, Norton J, Rychlik K, Smerage J, Kash J, Chew HK, Gaynor ER, et al. J Clin Oncol. 2010;28:1671–6. Validation of the recurrence score through analysis of 21 genes (Oncotype) by 17 oncologists and 89 patients regarding their power to alter the adjuvant therapeutic decision. There was a change in the treatment of oncologists in 31.5% of cases and by patients in 27%. Interpretation: multigene analysis has an impact on the recommendation of adjuvant treatment. CrossRefGoogle Scholar
  4. 4.
    Masuda N, et al. Adjuvant capecitabine for breast cancer after preoperative chemotherapy. N Engl J Med. 2017;376:2147–59. Patients with negative Her2 neoplasia who have residual disease after neoadjuvant treatment have a worse prognosis than patients with complete pathological response. In this context, the addition of Xeloda adjuvant was evaluated. Interpretation: Xeloda adjuvant predicts a 5-year progression-free survival benefit with HR 0.7 (95% CI 0.53–0.92) and overall survival at 5 years with HR 0.59 (95% CI 0.39–0.9). This benefit was even more pronounced in triple-negative. However the study was performed exclusively with Japanese and Korean population. CrossRefGoogle Scholar
  5. 5.
    Sparano JA, et al. Long-term follow-up of the E1199 phase III trial evaluating the role of taxane and schedule in operable breast cancer. J Clin Oncol. 2015;33(21):2353–60. E1199. A prospective study comparing four cycles of AC followed by four distinct schemes of taxane: paclitaxel and docetaxel weekly and every 3 weeks. Interpretation: increased progression-free survival for the weekly paclitaxel and docetaxel groups every 3 weeks. CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sérgio Daniel Simon
    • 1
  • Pedro H. Z. de Moraes
    • 1
  • Vladimir Galvão de Aguiar
    • 2
  1. 1.Clinical OncologyOncoclínicas do BrasilSão PauloBrazil
  2. 2.Clinical OncologyAlbert Einstein HospitalSão PauloBrazil

Personalised recommendations