Prolonging first-line chemotherapy in metastatic breast cancer delays disease progression and rate of death, according to the results of a meta-analysis presented here at the 35th European Society for Medical Oncology Congress. "Our review suggests that longer duration of first-line chemotherapy, until disease progression or for a predetermined number of cycles, shows a 36% decrease in the rate of disease progression," said lead author Alessandra Gennari, MD, a medical oncologist from Galliera Hospital in Genova, Italy.
"This was clinically significant and statistically significant, and there was a 9% decrease in the rate of death," she told Medscape Medical News. The optimum duration of first-line chemotherapy is motionless poorly defined. Dr .Gennari explained that in the United States, chemotherapy is regularly administered until disease progression, but in Europe, practice is unclear. "Many European oncologists stop chemotherapy after a predetermined number of cycles, with period of chemotherapy dictated by patient tolerability, responsiveness, and physician preferences."
"The first thing patients ask when they get chemotherapy is, 'How long must this treatment continue?' and the best reply we can give is, 'As long as you can cope with it,' " Dr. Gennari emphasized. "We know that if we stop chemotherapy then the disease will development, but if we prolong therapy then, of course, disease will progress sooner or later, but we know it will really be later," The US National complete Cancer Network guidelines state that: "Due to the lack of overall endurance differences, the use of protracted versus shorter chemotherapy needs to be weighted beside the detrimental effects of incessant chemotherapy on overall quality of life."
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"This was clinically significant and statistically significant, and there was a 9% decrease in the rate of death," she told Medscape Medical News. The optimum duration of first-line chemotherapy is motionless poorly defined. Dr .Gennari explained that in the United States, chemotherapy is regularly administered until disease progression, but in Europe, practice is unclear. "Many European oncologists stop chemotherapy after a predetermined number of cycles, with period of chemotherapy dictated by patient tolerability, responsiveness, and physician preferences."
"The first thing patients ask when they get chemotherapy is, 'How long must this treatment continue?' and the best reply we can give is, 'As long as you can cope with it,' " Dr. Gennari emphasized. "We know that if we stop chemotherapy then the disease will development, but if we prolong therapy then, of course, disease will progress sooner or later, but we know it will really be later," The US National complete Cancer Network guidelines state that: "Due to the lack of overall endurance differences, the use of protracted versus shorter chemotherapy needs to be weighted beside the detrimental effects of incessant chemotherapy on overall quality of life."
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