Tailored versus high-dose chemotherapy as adjuvant breast cancer treatment

Excerpt

Efforts to improve the efficacy of adjuvant chemotherapy in patients with high risk EBC include the use of increased doses, both within the conventional dose range and at high doses, where the associated haematological toxicity necessitates bone marrow support. Whether adjuvant HDC impacts upon survival remains controversial, with recent publications generally not supporting superiority over standard therapies. Patients receiving standard chemotherapy all receive the same mg/m² dose, but it has been shown that drug distribution varies greatly among individual patients. Thus, some patients may be overdosed while others may be under-dosed. The authors developed an individualised FEC regimen in an attempt to improve outcomes in these patients. The treatment was tailored to achieve haematologic equitoxicity between patients, using this as a surrogate marker for equieffective doses. …