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Therapeutic aspect of metastatic breast cancer: chemotherapy

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Metastasis of Breast Cancer

Part of the book series: Cancer Metastasis – Biology and Treatment ((CMBT,volume 11))

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Abstract

The main treatment aims in managing metastatic breast cancer (MBC) are to relieve symptoms by controlling disease and prolonging survival while maintaining quality of life. Endocrine therapy is considered as a primary option for oestrogen-receptor positive MBC except in those with rapidly progressive visceral disease. Chemotherapy is considered for women with hormone-receptor-negative disease, and in those whose cancer is refractory to endocrine therapy or those with symptomatic or rapidly progressive visceral metastases. The major chemotherapy programmes routinely include anthracycline or taxane but capecitabine, gemcitabine, vinorelbine, and carboplatin are also increasingly used. For HER2- overexpressing breast cancer, trastuzumab-containing chemotherapy is used as a standard but see comments about safe combinations later. Compared with single agent chemotherapy, combination regimens show a greater tumour response rate and improved time to progression in women with metastatic breast cancer, a modest improvement in overall survival but significantly worse toxicities. The newly developed targeted therapies, e.g., Lapatinib are increasingly being investigated for clinical use and potentially leading to the evolution of more effective treatment.

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References:

  1. National Cancer Institute: SEER Cancer Statistics Review (1975-2000). Available at: http://seer.cancer.gov/csr.

  2. Honig SF. Treatment of metastatic disease. In: Harris JR, Lippman ME, Morrow M et al. and Eds. Diseases of the Breast. Philadelphia: LippincottRaven Publishers, 1996; 669-734.

    Google Scholar 

  3. Cardoso F, Di LA, Lohrisch C, et al. Second and subsequent lines of chemotherapy for metastatic breast cancer: what did we learn in the last two decades? Ann Oncol 2002; 13:197-207.

    Article  PubMed  CAS  Google Scholar 

  4. Falkson G, Holcroft C, Gelman RS, et al. Ten-year follow-up study of premenopausal women with metastatic breast cancer; an Eastern Cooperative. Oncology Group study. J Clin Oncol 1995; 13:1453-1458.

    PubMed  CAS  Google Scholar 

  5. Hortobágyi GN. Can we cure limited metastatic breast cancer? J Clin Oncol 2002; 20:620-623.

    PubMed  Google Scholar 

  6. Diaz-Canton EA, Valero V, Rahman Z, et al. Clinical course of breast cancer patients with metastases confined to the lungs treated with chemotherapy. The University of Texas M.D. Anderson Cancer Centre experience and review of the literature. Ann Oncol 1998; 9:413-418.

    Article  PubMed  CAS  Google Scholar 

  7. Valagussa P, Bonadonna G, Veronesi U. Patterns of relapse and survival following radical mastectomy. Analysis of 716 consecutive patients. Cancer 1978; 41:1170-1178.

    Article  PubMed  CAS  Google Scholar 

  8. Yeatman TJ. The natural history of locally advanced primary breast carcinoma and metastatic disease. Surg Oncol Clin N Am 1995; 4:569-589.

    PubMed  CAS  Google Scholar 

  9. Kamby C, Ejlertsen B, Andersen J, et al. The pattern of metastases in human breast cancer. Influence of systemic adjuvant therapy and impact on survival. Acta Oncol 1988; 27:715-719.

    Article  PubMed  CAS  Google Scholar 

  10. Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001; 27:165-176.

    Article  PubMed  CAS  Google Scholar 

  11. Pavlakis N, Schmidt R, Stockler M. Bisphosphonates for breast cancer. Cochrane Database Syst Rev 2005; (3).

    Google Scholar 

  12. Rosen LS, Gordon D, Kaminski M, et al. Long-term efficacy and safety of zoledronic acid compared with pamidronate disodium in the treatment of skeletal complications in patients with advanced multiple myeloma or breast carcinoma: a randomised, double-blind, multicentre, comparative trial. Cancer 2003; 98:1735-1744.

    Article  PubMed  CAS  Google Scholar 

  13. Esteva FJ, Valero V, Pusztai L, Boehnke-Michaud L, Buzdar AU, Hortobagyi GN. Chemotherapy of Metastatic Breast Cancer: What to Expect in 2001 and Beyond. The Oncologist Apr 2001; 6:133-146.

    Article  PubMed  CAS  Google Scholar 

  14. Miles D, von Minckwitz G, Seidman AD. Combination versus sequential single-agent therapy in metastatic breast cancer. The Oncologist 2002; 7(suppl 6):13-16.

    PubMed  CAS  Google Scholar 

  15. Fossati R, Confalonieri C, Torri V, et al. Cytotoxic and hormonal treatment for metastatic breast cancer: A systematic review of published randomised trials involving 31,510 women. J Clin Oncol 1998; 16:3439-3460.

    PubMed  CAS  Google Scholar 

  16. Carrick S, Parker S, Wilcken N, Ghersi D, Marzo M, Simes J. Single agent versus combination chemotherapy for metastatic breast cancer. Cochrane Database of Systematic Reviews 2005.

    Google Scholar 

  17. Albain KS, Nag S, Calderillo-Ruiz G, et al. Global phase III study of gemcitabine plus paclitaxel (T) as frontline therapy for metastatic breast cancer (MBC): first report of overall survival. J Clin Oncol 2004;22:5s.

    Google Scholar 

  18. Sledge GW, Neuberg D, Ingle J, et al. Phase III trial of doxorubicin, paclitaxel and the combination of doxorubicin and paclitaxel as front-line chemotherapy for metastatic breast cancer (MBC): an Intergroup trial (E1193). J Clin Oncol 2003; 21:588-592.

    Article  PubMed  Google Scholar 

  19. Jones S, Erban J, Overmoyer B, et al. Randomised phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. J Clin Oncol 2005; 23:5542-5551.

    PubMed  Google Scholar 

  20. Chan S, Friedrichs K, Noel D, et al. Prospective randomised trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. J Clin Oncol 1999; 17:2341-2354.

    PubMed  CAS  Google Scholar 

  21. Paridaens R, Biganzoli L, Bruning P, et al. Paclitaxel versus doxorubicin as first first line single-agent chemotherapy for metastatic breast cancer: A European Organization for Research and Treatment of Cancer randomised study with crossover. J Clin Oncol 2000; 18:724-733.

    PubMed  CAS  Google Scholar 

  22. Tabernero J, Climent MA, Lluch A, et al. A multicentre, randomised phase II studies of weekly or 3-weekly docetaxel in patients with metastatic breast cancer. Ann Oncol Sep 2004; 15(9): 1358-1365.

    Article  PubMed  CAS  Google Scholar 

  23. Chemotherapy of Metastatic Breast Cancer: What to Expect in 2001 and Beyond: The Oncologist April 2001; 6(2): 133-146.

    Google Scholar 

  24. Lord S, Ghersi D, Gattellari M, Wortley S, Wilcken N, Simes J. Anti-tumour antibiotic containing regimens for metastatic breast cancer. Cochrane Database of Systematic Reviews 2004, Issue 4.

    Google Scholar 

  25. Ghersi D, Wilcken N, Simes J, Donoghue E. Taxane containing regimens for meta- static breast cancer. Cochrane Database of Systematic Reviews 2005, Issue 2.

    Google Scholar 

  26. O’Shaughnessy J, Miles D, Vukelja S, et al. Superior survival with capecitabine plus docetaxel combination therapy in anthracycline-pretreated patients with advanced breast cancer: phase III trial results. J Clin Oncol 2002; 20:2812-2823.

    Article  PubMed  CAS  Google Scholar 

  27. Nabholtz JM, Senn HJ, Bezwoda WR, et al. Prospective randomised trial of docetaxel versus mitomycin plus vinblastine in patients with metastatic breast cancer progressing despite previous anthracycline-containing chemotherapy. 304 Study Group. J Clin Oncol 1999; 17:1413-1424.

    PubMed  CAS  Google Scholar 

  28. Sjöström J, Blomqvist C, Mouridsen H, et al. Docetaxel compared with sequential methotrexate and 5-fluorouracil in patients with advanced breast cancer after anthracycline failure: a randomised phase III study with crossover on progression by the Scandinavian Breast Group. Eur J Cancer 1999; 35:1194-1201.

    Article  PubMed  Google Scholar 

  29. Bonneterre J, Roche H, Monnier A, et al. Docetaxel vs 5-fluorouracil plus vinorelbine in metastatic breast cancer after anthracycline therapy failure. Br J Cancer 2002; 87:1210-1215.

    Article  PubMed  CAS  Google Scholar 

  30. Bishop JF, Dewar J, Toner GC, et al. Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer. J Clin Oncol 1999; 17:2355-2364.

    PubMed  CAS  Google Scholar 

  31. Gradishar WJ, Tjulandin S, Davidson N, et al. Superior efficacy of albumin- bound paclitaxel, ABI-007, compared with polyethylated castor oil-based paclitaxel in women with metastatic breast cancer: results of a phase III trial. J Clin Oncol 2005; 23.

    Google Scholar 

  32. Jassem J, Pienkowski T, Pluzanska A, et al. Doxorubicin and paclitaxel versus fluorouracil, doxorubicin, and cyclophosphamide as first line therapy for women with metastatic breast cancer: Final results of a randomised phase III multicentre trial. J Clin Oncol 2001; 19:1707-1715.

    PubMed  CAS  Google Scholar 

  33. Blum JL, Jones SE, Buzdar A. Capecitabine (Xeloda) in 162 patients with paclitaxel-pretreated MBC: updated results and analysis of dose modification. Eur J Cancer 2001; 37:S190a.

    Google Scholar 

  34. Blum JL, Dieras V, Lo Russo PM, et al. Multicentre, phase II study of capecitabine in taxane-pretreated metastatic breast carcinoma patients. Cancer 2001; 92:1759-1768.

    Article  PubMed  CAS  Google Scholar 

  35. Reichardt P, Von Minckwitz G, and Luck HJ, et al. Capecitabine: the new standard in metastatic breast cancer failing anthracycline and taxane containing chemotherapy? Mature results of a large multicentre phase II trail. Eur J Cancer 2001; 37(suppl 6): S191a.

    Google Scholar 

  36. Leonard RCF, Twelves C, Breddy J, et al. Capecitabine named-patient programme for patients with advanced breast cancer: The UK experience. Eur J Cancer 2002; 38:2020-2024.

    Article  PubMed  CAS  Google Scholar 

  37. Bajetta E, Procopio G, Celio L, et al. Safety and efficacy of two different doses of capecitabine in the treatment of advanced breast cancer in older women. J Clin Oncol 2005; 23:2155-2161.

    Article  PubMed  CAS  Google Scholar 

  38. Yamamoto T, Iwase S, Kitamura K, et al. Multicentre phase II study of trastuzumab (H) and capecitabine (X) as first- or second-line treatment in HER2 over-expressing metastatic breast cancer (Japan Breast Cancer Study Group: JBCSG-003). J Clin Oncol, 2005; 23:78s.

    Google Scholar 

  39. Schaller G, Bangemann N, Weber J, et al. Efficacy and safety of trastuzumab plus capecitabine in a German multicentre phase II study of pre-treated metastatic breast cancer. J Clin Oncol 2005; 23:57s

    Google Scholar 

  40. Phase II study of gemcitabine as first-line chemotherapy in patients with advanced or metastatic breast cancer. Anticancer Drugs 1999; 10:155-162.

    Article  Google Scholar 

  41. Blackstein M, Vogel CL, and Ambinder R. Gemcitabine as first-line therapy in patients with metastatic breast cancer: A phase II trial. Oncology 2002; 62:2-8.

    CAS  Google Scholar 

  42. Spielmann M, Llombart-Cussac A, Kalla S. Single-agent gemcitabine is active in previously treated metastatic breast cancer. Oncology 2001; 60:303-307.

    Article  PubMed  CAS  Google Scholar 

  43. Chan S, Romieu G, Huober J. Gemcitabine plus docetaxel (GD) versus capecitabine plus docetaxel (CD) for anthracycline-pretreated metastatic breast cancer (MBC) patients (pts): Results of a European phase III study. J Clin Oncol 2005; 23:581.

    Google Scholar 

  44. Vogel C, O’Rourke M, Winer E, et al. Vinorelbine as first-line chemotherapy for advanced breast cancer in women 60 years of age or older. Ann Oncol 1999; 10:397-402.

    Article  PubMed  CAS  Google Scholar 

  45. Kolaric K, Vukas D. Carboplatin activity in untreated metastatic breast cancer patients—results of a phase II study. Cancer Chemotherapy Pharmacology 1991; 27:409-412.

    Article  CAS  Google Scholar 

  46. Carmo-Pereira J, Dittrich C, Keizer J, et al. Phase II trial of carboplatin in carcinoma of the breast, Ann Oncol 1990; 1:P3: 33.

    Google Scholar 

  47. Martin M, Diaz-Rubio E, and Casado A, et al. Carboplatin: an active drug in metastatic breast cancer, J Clin Oncol 1992; 10:433-437.

    PubMed  CAS  Google Scholar 

  48. Vogel CL, Cobleigh MA, Tripathy D, et al. Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer. J Clin Oncol 2002; 20:719-726.

    Article  PubMed  CAS  Google Scholar 

  49. Slamon DJ, Leyland-Jones B, Shak S, et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344:783-792.

    Article  PubMed  CAS  Google Scholar 

  50. Marty M, Cognetti F, Maraninchi D, et al. Randomised phase II trial of the efficacy and safety of trastuzumab combined with docetaxel in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer administered as first-line treatment: the M77001 study group. J Clin Oncol 2005; 23:4265-4274.

    Article  PubMed  CAS  Google Scholar 

  51. Burris HA III. Dual kinase inhibition in the treatment of breast cancer: Initial experience with the EGFR/ErbB-2 inhibitor lapatinib. Oncologist 2004; 9:10-15.

    Article  PubMed  CAS  Google Scholar 

  52. Gomez H, Chavez M, Doval D. A phase II, randomised trial using the small molecule tyrosine kinase inhibitor lapatinib as a first-line treatment in patients with FISH positive advanced or metastatic breast cancer. Am Soc Clin Oncol 2005; 23:3046.

    Google Scholar 

  53. ASCO 2006 Annual Meeting: N.U. Lin, L.A. Carey, M.C. Liu, J. Younger, S.E. Phase II trial of lapatinib for brain metastases in patients with HER2+ breast cancer. ASCO Clinical Science Symposium - Saturday, June 3, 2006: The ASCO Abstracts2View™.

    Google Scholar 

  54. ABC of Breast Diseases.

    Google Scholar 

  55. Anglo-Celtic IV: an NCRN randomised phase 3 trial of weekly versus 3 weekly paclitaxel in patients with locally advanced or metastatic breast cancer by Verril et al. NCRI Birmingham, UK 2006 (abstract).

    Google Scholar 

  56. Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer. J Clin Oncol. Oct 1998; 16(10): 3353-3361. Review. Erratum in: J Clin Oncol May 10 2006; 24(14):2220.

    Google Scholar 

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Author information

Authors and Affiliations

  1. South West Wales Cancer Institute, Singleton Hospital, Swansea, Wales, UK

    Robert C. F. Leonard

  2. South West Wales Cancer Institute, Singleton Hospital, Swansea, Wales, UK

    Thinn P. Pwint

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  1. Robert C. F. Leonard
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  2. Thinn P. Pwint
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Editor information

Editors and Affiliations

  1. Department of Surgery, Cardiff University School of Medicine, Heath Park, CF14 4XN, Cardiff, UK

    Robert E. Mansel MS, FRCS, CBE

  2. Michell Cancer Institute, University of South Alabama, 307 N. University Blvd., 2015, 36688, AL, USA

    Oystein Fodstad PhD

  3. Metastasis and Angiogenesis Research Group, Cardiff University School of Medicine, CF14 4XN, Heath Park, Cardiff, UK

    Wen G. Jiang MB, BCh, MD

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© 2007 Springer

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Leonard, R.C.F., Pwint, T.P. (2007). Therapeutic aspect of metastatic breast cancer: chemotherapy. In: Mansel, R.E., Fodstad, O., Jiang, W.G. (eds) Metastasis of Breast Cancer. Cancer Metastasis – Biology and Treatment, vol 11. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-5867-7_19

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