Increasing the dose intensity of chemotherapy for primary breast cancer patients – by either shortening the intervals between the cycles or by administering the different chemotherapeutic drugs sequentially rather than all at once – reduces the risk of recurrence and death compared with standard chemotherapy regimens.
This is according to data from an EBCTCG meta-analysis study presented at the 2017 San Antonio Breast Cancer Symposium. In the new study led by Professor Richard Gray at the University of Oxford, and funded by Cancer Research UK and the UK Medical Research Council, researchers aimed to find out whether increasing the dose intensity was more effective at lowering recurrence and mortality rates than standard chemotherapy regimens for primary breast cancer. The researchers used individual patient data from seven randomized trials (10,004 women) that tested chemotherapy given every two weeks versus every three weeks, and from nine randomized trials (11,533 women) that tested sequential versus concurrent anthracycline and taxane-based chemotherapies.
Patients who received chemotherapy every two weeks were 17 percent and 15 percent less likely to have disease recurrence and die from breast cancer within 10 years, respectively, compared with those who received treatment every three weeks. Similarly, patients who received sequential chemotherapy were 14 percent and 13 percent less likely to have disease recurrence and die from breast cancer within 10 years, respectively, compared with those who received concurrent treatment.
There were few additional side-effects with dose-intense schedule compared with standard schedule chemotherapy, and fewer patients who received dose-intense treatment died from non-breast cancer causes than those who received standard treatment.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
“That this major study demonstrates that we could save more lives by optimising a cornerstone breast cancer drug is extremely exciting.
“These important results demonstrate that shortening the time between chemotherapy sessions reduces the risk of their disease returning and their risk of dying from the disease, without substantially increasing the side-effects. We now hope to see this approach made routinely available to NHS patients in the near future, as well as any necessary support to manage the risk of any particular side-effects.
“However, this study did not identify the ideal dose-intense regimen, and so further research is now needed to help give clinicians and patients even more reassurance that they are choosing the most appropriate and effective treatment schedule possible.
“Finding even more effective ways of using the drugs we already have is crucial, alongside the development of new targeted drugs, to ensure that by 2050, everyone who develops breast cancer will live, and live well.”