Skip to main content
SpringerLink
Log in

Adjuvant chemotherapy in breast cancer

  • Review article
  • Published:
memo - Magazine of European Medical Oncology Aims and scope Submit manuscript

Summary

Breast cancer is the most common malignancy in women in Western Europe and the U.S. Adjuvant chemotherapy reduces the rate of cancer recurrence, thereby contributing to the recent decline of breast cancer mortality. Notably, a number of important developments occurred over the past decades. Starting with first generation regimens like CMF, the next step was the introduction of anthracyclines into the adjuvant setting, although the role of these drugs is again dubious today. Modern regimens followed with the introduction of taxanes into the adjuvant setting, and a number of further developments are under way: Dose dense regimens as well as targeted therapies have led to a new era of treatment of women with early breast cancer. Neoadjuvant chemotherapy, while sometimes still debated, has increased the rate of breast conserving surgeries. Obviously, both neoadjuvant, therefore preoperative, and adjuvant chemotherapy have their specific advantages and drawbacks. This will be dealt with in detail. Also a short overview of available data on adjuvant chemotherapy in the elderly is provided. The history, recent developments, as well as open questions will be discussed in this review.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Cancer Society Facts and Figures 2005. Accessed 1 February 2007. URL: http://www.cancer.org

  • Jemal A, Siegel R, ward E, et al. Cancer Statistics 2006. CA Cancer J Clin, 56: 106–130, 2006

    Article  PubMed  Google Scholar 

  • World Health Organization Facts and Figures. Accessed 1 February 2007. URL: http://www.who.int

  • Early Breast Cancer Trialist's Collaborative Group: polychemotherapy for early breast cancer: an overview of randomized trails. Lancet, 352: 930–942, 1998

    Google Scholar 

  • Rubens RD, Hayward JL. Estrogen receptors and response to endocrine therapy and cytotoxic chemotherapy in advanced breast cancer. Cancer, 46: 2922–2924, 1980

    Article  PubMed  CAS  Google Scholar 

  • Young PCM, Ehrlich CE, Einhorn LH, et al. Relationship between steroid receptors and response to endocrine therapy and cyctotoxic chemotherapy in metastatic breast cancer. Cancer, 46: 2961–2963, 1980

    Article  PubMed  CAS  Google Scholar 

  • Chang JC, Wergowske G. Correlation of estrogen-receptors and response to chemotherapy of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in advanced breast cancer. Cancer, 48: 2503–2506, 1981

    Article  PubMed  CAS  Google Scholar 

  • Early Breast Cancer Trialist's Collaborative Group: adjuvant chemotherapy in oestrogen-receptor-poor breast cancer: patient-level meta-analysis of randomised trials. Lancet, 371: 29–40, 2008

    Google Scholar 

  • Goldhirsch A, Wood WC, Gelber RD, et al. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol, 18: 1133–1144, 2007

    Article  PubMed  CAS  Google Scholar 

  • Marchionni L, Wilson RF, Wolff AC, et al. Systematic review: gene expression profiling assays in early-stage breast cancer. Ann Intern Med, 2008 [Epub ahead of print]

  • Bonadonna G, Valagussa P. Dose-response effect of adjuvant chemotherapy in breast cancer. N Engl J Med, 304: 10–15, 1981

    PubMed  CAS  Google Scholar 

  • Bonadonna G, Brusamolino E, Valagussa P, et al. Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med, 294: 405–410, 1976

    PubMed  CAS  Google Scholar 

  • Goldhirsch A, Colleoni M, Coates AS, et al. Adding adjuvant CMF chemotherapy to either radiotherapy or tamoxifen: are all CMFs alike? Ann Oncol, 9: 489–493, 1998

    Article  PubMed  CAS  Google Scholar 

  • A'Hern RP, Smith IE, Ebbs SR. Chemotherapy and survival in advanced breast cancer: the inclusion of doxorubicin in Cooper-type regimens. Br J Cancer, 67: 801–805, 1993

    PubMed  Google Scholar 

  • Fisher B, Brown AM, Dimitrov NV, et al. Two months of doxorubicin-cyclophosphamide with and without interval reinduction therapy compared with 6 months of cyclophosphamide, methotrexate, and fluorouracil in positive-node breast cancer patients with tamoxifen-nonresponsive tumors: results from the National Surgical Adjuvant Breast and Bowel Project B-15. J Clin Oncol, 8: 1485–1496, 1990

    Google Scholar 

  • Fisher B, Anderson S, Tan-Chiu E, et al. Tamoxifen and chemotherapy for axillary node-negative, estrogen receptor-negative breast cancer: findings from National Surgical Adjuvant Breast and Bowel project B-23. J Clin Oncol, 19: 931–942, 2001

    PubMed  CAS  Google Scholar 

  • Martin M, Villar A, Sole-Calvo A, et al. Doxorubicin in combination with fluorouracil and cyclophosphamide (iv FAC regimen, day 1, 21) versus methotrexate in combination with fluorouracil and cyclophosphamide (iv CMF regimen, day 1, 21) as adjuvant chemotherapy for operable breast cancer: a study by the GEICAM group. Ann Oncol, 14: 833–842, 2003

    Article  PubMed  CAS  Google Scholar 

  • Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of randomised trials. Lancet, 365: 1687–1717, 2005

    Google Scholar 

  • Henderson IC, Berry DA, Demetri GD, et al. Improved outcomes from adding sequential Paclitaxel but not from escalating Doxorubicin dose in adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol, 21: 976–983, 2003

    Article  PubMed  CAS  Google Scholar 

  • Roche H, Fumoleau P, Spielmann M, et al. Sequential adjuvant epirubicin-based and docetaxel chemotherapy for node-positive breast cancer patients: the FNCLCC PACS 01 Trial. J Clin Oncol, 24: 5664–5671, 2006

    Article  PubMed  CAS  Google Scholar 

  • Mano MS, Rosa DD, De Azambuja E, et al. The 17q12-q21 amplicon: Her2 and topoisomerase-IIα and their importance to the biology of solid tumours. Cancer Treat Rev, 33: 64–77, 2007

    Article  PubMed  CAS  Google Scholar 

  • Di Leo A, Gancberg D, Larsimont D, et al. HER-2 amplification and topoisomerase IIα gene aberrations as predictive markers in node-positive breast cancer patients randomly treated either with an anthracycline-based therapy or with cyclophosphamide, methotrexate, and 5-Fluorouracil. Clin Cancer Res, 8: 1107–1116, 2002

    PubMed  CAS  Google Scholar 

  • Rowinsky EK, Cazenave LA, Donehower RC. Taxol: a novel investigational antimicrotuble agent. J Natl Cancer Inst, 82: 1247–1259, 1990

    Article  PubMed  CAS  Google Scholar 

  • Ring AE, Ellis PA. Taxanes in the treatment of early breast cancer. Cancer Treat Rev, 31: 618–627, 2005

    Article  PubMed  CAS  Google Scholar 

  • 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, 17: 2355–2364, 1999

    PubMed  CAS  Google Scholar 

  • Paridaens R, Biganzoli L, Bruning P, et al. Paclitaxel versus doxorubicin as first-line single-agent chemotherapy for metastatic breast cancer: a European Organization for Research and Treatment of Cancer Randomized Study with cross-over. J Clin Oncol, 18: 724–733, 2000

    PubMed  CAS  Google Scholar 

  • Mamounas EP, Bryant J, Lembersky B, et al. Paclitaxel after doxorubicin plus cyclophosphamide as adjuvant chemotherapy for node-positive breast cancer: results from NSABP B-28. J Clin Oncol, 23: 3686–3696, 2005

    Article  PubMed  CAS  Google Scholar 

  • Albain KS, Green SJ, Ravdin PM, et al. Adjuvant chemohormonaltherapy for primary breast cancer should be sequential instead of concurrent: initial results from intergroup trial 0100 (SWOG-8814). Proc Am Soc Clin Oncol, 21: 143, 2002

    Google Scholar 

  • Martin M, Pienkowski T, Mackey J, et al. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med, 353: 2302–2313, 2005

    Article  Google Scholar 

  • Burnell MJ, Levine MN, Chapman JA, et al. A phase III adjuvant trial of sequenced EC + filgrastim + epoetin alpha followed by paclitaxel compared to sequenced AC followed by paclitaxel compared to CEF in women with node-positive o high-risk node negative breast cancer (NCIC CTG MA.21). J Clin Oncol, 25 (Suppl 18): S550, 2007

    Google Scholar 

  • Citron ML, Berry DA, Cirrincione C, et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/cancer and Leucemia Group B Trial 9741. J Clin Oncol, 21: 1431–1439, 2003

    Article  PubMed  CAS  Google Scholar 

  • Venturini M, Del Mastro L, Aitini E, et al. Dose-dense adjuvant chemotherapy in early breast cancer patients: results from a randomized trial. J Natl Cancer Inst, 97: 1724–1733, 2005

    Article  PubMed  CAS  Google Scholar 

  • Kaufmann M, von Minckwitz G, Bear HD, et al. Recommendations from an international expert panel on the issue of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006. Ann Oncol, 18: 1927–1934, 2007

    Article  PubMed  CAS  Google Scholar 

  • Buzdar AU. Preoperative chemotherapy treatment of breast cancer – a review. Cancer, 110: 2394–2407, 2007

    Article  PubMed  CAS  Google Scholar 

  • Kuerer HM, Newman LA, Smith TL, et al. Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol, 17: 460–469, 1999

    PubMed  CAS  Google Scholar 

  • Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: 9-year results from National Surgical Breast and Bowel Project B-18. J Natl Cancer Inst, 30: 96–102, 2001

    Google Scholar 

  • Bear HD, Anderson S, Smith RE, et al. Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Breast and Bowel Project B-27. J Clin Oncol, 24: 2019–2027, 1999

    Article  CAS  Google Scholar 

  • Sahin A. Surgical margin evaluation in patients treated with breast-conserving therapy. In: Singletary SE, Robb G, Hortobagyi RN (eds) Advanced therapy of breast disease, 2nd edn. Hamilton, Ontario, Canada: BC Becker, pp. 341–438, 2004

    Google Scholar 

  • Clarke M, Collins R, Derby S, et al. Early Breast Cancer Trialist's Collaborative Group (EBCTCG). Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of randomised trials. Lancet, 366: 2087–2106, 2005

    PubMed  CAS  Google Scholar 

  • Wenzel C, Bartsch R, Hussian D, et al. Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast differ in response following neoadjuvant therapy with epidoxorubicin and docetaxel + G-CSF. Breast Cancer Res Treat, 104: 109–114, 2007

    Article  PubMed  Google Scholar 

  • Steger GG, Galid A, Gnant M, et al. Pathologic complete response with 6 vs. 3 cycles of neoadjuvant epirubicin/Docetaxel plus G-CSF in operable breast cancer: results of ABSCG-14. J Clin Oncol, 25: 2012–2018, 2007

    Article  PubMed  CAS  Google Scholar 

  • Romieu G, Tubiana-Hulin M, Fumoleau P. A multicenter randomized phase II study of 4 or 6 cycles of adriamycin/taxol (paclitaxel) AT as neoadjuvant treatment of breast cancer (BC). Ann Oncol, 13 (Suppl 5): 33–34, 2002

    Google Scholar 

  • Nabholtz JM, Riva A. Taxane/anthracycline combinations: setting a new standard in breast cancer? Oncologist, 6 (Suppl 3): 5S–12S, 2001

    Article  Google Scholar 

  • Dierras V, Fumoleau P, Romieu G, et al. Randomized parallel study of doxorubicin plus paclitaxel and doxorubicin plus cyclophosphamide as neoadjuvant treatment of patients with breast cancer. J Clin Oncol, 22: 4958–4965, 2004

    Article  CAS  Google Scholar 

  • Wenzel C, Locker GJ, Bartsch R, et al. Preoperative second-line chemotherapy induces objective responses in primary breast cancer. Wien Klin Wochenschr, 117: 48–52, 2005

    Article  PubMed  CAS  Google Scholar 

  • Von Minckwitz G, Blohmer JU, Raab G, et al. In vivo chemosensitivity-adapted preoperative chemotherapy in patients with early-stage breast cancer: the Gepar-TRIO pilot study. Ann Oncol, 16: 56–63, 2005

    Article  PubMed  CAS  Google Scholar 

  • Thomas E, Holmes FA, Smith TL, et al. The use of alternate, non-cross-resistant adjuvant chemotherapy on the basis of pathologic response to a neoadjuvant doxorubicin-based regimen in women with operable breast cancer: long term results from a prospective randomized trial. J Clin Oncol, 22: 2294–2302, 2007

    Article  CAS  Google Scholar 

  • Knauer M, Haid A, De Vries A, et al. Does combination of neoadjuvant and adjuvant chemotherapy improve outcome in operable breast cancer patients? Breast Cancer Res Treat, 106 (Suppl 1): 228S, 2007

    Google Scholar 

  • Buzdar A, Ibrahim N, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol, 23: 3676–3685, 2005

    Article  PubMed  CAS  Google Scholar 

  • Bargmann CI, Hung MC, Weinberg RA. The neu oncogene encodes an epidermal growth factor receptor-related protein. Nature, 319: 226–230, 1986

    Article  PubMed  CAS  Google Scholar 

  • Akiyama T, Saito T, Ogawara H, et al. Tumor promoter and epidermal growth factor stimulate phosphorylation of the c-erbB-2 gene product in MKN-7 human adenocarcinoma cells. Mol Cell Biol, 8: 1019–1026, 1998

    Google Scholar 

  • Yen L, You XL, Al Moustafa AE, et al. Heregulin selectively upregulates vascular endothelial growth factor secretion in cancer cell and stimulates angiogenesis. Oncogene, 19: 3460–3469, 2000

    Article  PubMed  CAS  Google Scholar 

  • Izumi Y, Xu L, di Tomaso E, et al. Tumor biology: herceptin acts as an anti-angiogenic cocktail. Nature, 416: 279–280, 2002

    Article  PubMed  CAS  Google Scholar 

  • Cho HS, Mason K, Ramyar KX, et al. Structure of the extracellular region of HER2 alone and in complex with the Herceptin Fab. Nature, 421: 756–760, 2003

    Article  PubMed  CAS  Google Scholar 

  • Casalini P, Iorio MV, Galmozzi E, et al. Role of HER receptors family in development and differentiation. J Cell Physiol, 200: 343–350, 2004

    Article  PubMed  CAS  Google Scholar 

  • Cooley S, Burns LJ, Repka T, et al. Natural killer cell cytotoxicity of breast cancer targets is enhanced by two distinct mechanisms of antibody dependent cellular cytotoxicity against LFA-3 and HER2/neu. Exp Hematol, 27: 1533–1541, 1999

    Article  PubMed  CAS  Google Scholar 

  • Gennari R, Menard S, Fagnoni F, et al. Pilot study of the mechanism of action of preoperative trastuzumab in patients with primary operable breast tumors overexpressing HER2. Clin Cancer Res, 10: 5650–5655, 2004

    Article  PubMed  CAS  Google Scholar 

  • Clynes RA, Towers TL, Presta LG, et al. Inhibitory Fc receptors modulate in vivo cytotoxicity against tumor targets. Nat Med, 6: 443, 2006

    Google Scholar 

  • Cuello M, Ettenberg SA, Clark AS, et al. Down-regulation of the erbB-2 receptor by trastuzumab (Herceptin) enhances tumor necrosis factor-related apoptosis-inducing ligand-mediated apoptosis in breast and ovarian cancer cell lines that overexpress erbB-2. Cancer Res, 61: 4892–4900, (2001)

    PubMed  CAS  Google Scholar 

  • Lane HA, Motoyama AB, Beuvink I, et al. Modulation of p27/Cdk2 complex formation through 4D5-mediated inhibition of HER2 receptor signalling. Ann Oncol, 12 (1 Suppl): 21S–22S, 2001

    Article  Google Scholar 

  • Yakes FM, Chinratanalab W, Ritter CA, et al. Herceptin-induced inhibition of phophatidylinositol-3 kinase and Akt is required for antibody-mediated effects on p27, cyclin D1, and antitumor action. Cancer Res, 62: 4132–4141, 2002

    PubMed  CAS  Google Scholar 

  • Nahta R, Yu D, Hung MC, et al. Mechanisms of disease: understanding resistance to Her2-targeted therapy in human breast cancer. Nat Clin Pract Oncol, 3: 269–280, 2006

    Article  PubMed  CAS  Google Scholar 

  • Baselga J, Tripathy D, Mendelsohn J, et al. Phase II study of weekly intravenous recombinant humanized anti-p185HER2 monoclonal antibody in patients with HER2/neu-overexpressing metastatic breast cancer. J Clin Oncol, 14: 737–744, 1996

    PubMed  CAS  Google Scholar 

  • Pegram MD, Lipton A, Hayes DF, et al. Phase II study of receptor-enhanced chemosensitivity using recombinant humanized anti-p185HER2/neu monoclonal antibody plus cisplatin in patients with HER2/neu-overexpressing metastatic breast cancer refractory to chemotherapy treatment. J Clin Oncol, 16: 2659–2671, 1998

    PubMed  CAS  Google Scholar 

  • Cobleigh MA, Vogel CL, Tripathy D, et al. Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease. J Clin Oncol, 17: 2639–2648, 1999

    PubMed  CAS  Google Scholar 

  • 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, 344: 783–792, 2001

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  • Slamon DJ, Godolphin W, Jones LA, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science, 244: 707–712, 1989

    Article  PubMed  CAS  Google Scholar 

  • Boss JS, Fletcher JA, Linette GP. The HER-2/neu gene and protein in breast cancer 2003: biomarker and target of therapy. Oncologist, 8: 307–325, 2003

    Article  Google Scholar 

  • Piccart-Gebhart MJ, Proctet M, Leyland-Jones B, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med, 353: 1659–1672, 2005

    Article  PubMed  CAS  Google Scholar 

  • Smith IE, on behalf of The HERA Study Team. Trastuzumab following adjuvant chemotherapy in HER2-positive early breast cancer (HERA trial): disease-free and overall survival after 2 year median follow-up. Paper presented at: 42nd Annual Meeting of the American Society of Clinical Oncology; June 2-6, 2006; Atlanta, GA

  • Romond EH, Perez EA, Bryant J, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med, 353: 1673–1684, 2005

    Article  PubMed  CAS  Google Scholar 

  • Slamon D, Eiermann W, Robert N, et al. BCIRG 006: 2nd interim analysis phase III randomized trial comparing doxorubicin and cyclophosphamide followed by docetaxel (AC → T) with doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (AC → TH) with docetaxel, carboplatin and trastuzumab (TCH) in Her2neu positive early breast cancer patients. Breast Cancer Res Treat, 100 (Suppl 1): 2006 (abstr 52)

  • Joensuu H, Kellokumpu-Lehtinen P-L, Bono P, et al. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med, 354: 809–820, 2006

    Article  PubMed  CAS  Google Scholar 

  • Wenzel C, Hussian D, Bartsch R, et al. Preoperative therapy with epidoxorubicin and docetaxel plus trastuzumab in patients with primary breast cancer: a pilot study. J Cancer Res Clin Oncol, 130: 400–404, 2004

    Article  PubMed  CAS  Google Scholar 

  • Burstein H, Harris L, Gelman R, et al. Preoperative therapy with trastuzumab and paclitaxel followed by sequential adjuvant doxorubicin/cyclophosphamide for HER2 overexpressing stage II or III breast cancer: a pilot study. J Clin Oncol, 21: 46–53, 2003b

    Article  CAS  Google Scholar 

  • Jahanzeb M, Brufsky A, Erban J, et al. Dose-dense neoadjuvant treatment of women with breast cancer utilizing docetaxel, vinorelbine and trastuzumab with growth factor support. J Clin Oncol, 23 (16 Suppl): 16S, 2005

    Google Scholar 

  • Hurley J, Doliny P, Reis I, et al. Docetaxel, cisplatin, and trastuzumab as primary systemic therapy for human epidermal growth factor receptor 2-positive locally advanced breast cancer. J Clin Oncol, 24: 1831–1838, 2006

    Article  PubMed  CAS  Google Scholar 

  • Available from: http://clinicaltrials.gov

  • American College of Surgeons Oncology Group. Accessed 1 February 2008. http://www.acosog.org

  • Bartsch R, Wenzel C, Zielinski CC, et al. Her-2 positive breast cancer: hope beyond trastuzumab. Bio Drugs, 21: 69–77, 2007

    CAS  Google Scholar 

  • Rugo HS. Bevacizumab in the treatment of breast cancer: rationale and current data. Oncologist, 9 (Suppl 1): 43S–49S, 2004

    Article  Google Scholar 

  • Rugo HS. Bevacizumab in the treatment of breast cancer: rationale and current data. Oncologist, 9 (Suppl 1): 43S–49S, 2004

    Article  Google Scholar 

  • Sandler A, Gray R, Perry MC, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med, 355: 2542–2550, 2006

    Article  PubMed  CAS  Google Scholar 

  • Escudier B, Pluzanska A, Koralewski P, et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet, 370: 2103–2111, 2007

    Article  PubMed  Google Scholar 

  • Zon R, Miller K, Wang M, et al. A randomized phase III trial of paclitaxel with or without bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer: Eastern Cooperative Oncology Group trial E2100. Eur J Cancer Suppl, 2: 46, 2006

    Google Scholar 

  • Xia W, Bisi J, Strum J, et al. Regulation of survivin by ErbB2 signaling: therapeutic implications for ErbB2-overexpressing breast cancers. Cancer Res, 66: 1640–1647, 2006

    Article  PubMed  CAS  Google Scholar 

  • Konecny GE, Pegram MD, Venkatesan N, et al. Activity of the dual kinase inhibitor lapatinib (GW572016) against HER-2-overexpressing and trastuzumab-treated breast cancer cells. Cancer Res, 66: 1630–1639, 2006

    Article  PubMed  CAS  Google Scholar 

  • Xia W, Bisi J, Strum J, et al. Regulation of survivin by ErbB2 signaling: therapeutic implications for ErbB2-overexpressing breast cancers. Cancer Res, 66: 1640–1647, 2006

    Article  PubMed  CAS  Google Scholar 

  • Geyer CE, Forster J, Lindquist D, et al. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med, 355: 2733–2743, 2006

    Article  PubMed  CAS  Google Scholar 

  • Lin NU, Carey LA, Liu MC, et al. Phase II trial of lapatinib for brain metastases in patients with Her2+ breast cancer. J Clin Oncol, 24 (Suppl 18): 503S, 2006

    Google Scholar 

  • Crivellari D, Aapro M, Leonard R, et al. Breast Cacer in the Elderly. J Clin Oncol, 25: 1882–1890, 2007

    Article  PubMed  Google Scholar 

  • Extermann M, Balducci L, Lyman GH. What threshold for adjuvant therapy in older breast cancer patients? J Clin Oncol, 18: 1709–1717, 2000

    PubMed  CAS  Google Scholar 

  • Grann VR, Troxel AB, Zojwalla NJ, et al. Hormone receptor status and survival in a population-based cohort of patients with breast carcinoma. Cancer, 103: 2241–2251, 2005

    Article  PubMed  CAS  Google Scholar 

  • Holmes FF. Clinical course of cancer in the elderly. Cancer Cont, 1: 108–114, 1994

    Google Scholar 

  • Feyer G, Braud AC, Chaibi P, et al. Dealing with metastatic breast cancer in elderly women: results from a French study on a large cohort carried out by the "Observation on elderly patients". Ann Oncol, 17: 211–216, 2006

    Article  Google Scholar 

  • Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst, 92: 550–556, 2000

    Article  PubMed  CAS  Google Scholar 

  • Giordano SH, Duan Z, Kuo YF, et al. Use and outcome of adjuvant chemotherapy in older women with breast cancer. J Clin Oncol, 24: 2750–2756, 2006

    Article  PubMed  Google Scholar 

  • Wildiers H, Kunkler I, Biganzoli L, et al. Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology. Lancet Oncol, 8: 1101–1115, 2007

    Article  PubMed  Google Scholar 

  • Du XL, Osborne C, Goodwin JS. Population-based assessment of hospitalization for toxicity from chemotherapy in older women with breast cancer. J Clin Oncol, 20: 4636–4642, 2002

    Article  PubMed  Google Scholar 

  • Giordano SH, Pinder M, Duan Z, et al. Congestive heart failure in older women treated with anthracycline (A) chemotherapy (C). J Clin Oncol, 24 (Suppl 18): 8S, 2006

    Google Scholar 

  • Doyle JJ, Neugut AI, Jacobson JS, et al. Chemotherapy and cardiotoxicity in older breast cancer patients: a population-based study. J Clin Oncol, 23: 8597–8605, 2005

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Medicine and Cancer Centre, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria

    R. Bartsch & G. G. Steger

Authors
  1. R. Bartsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. G. Steger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. G. Steger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bartsch, R., Steger, G. Adjuvant chemotherapy in breast cancer. memo 1, 91–98 (2008). https://doi.org/10.1007/s12254-008-0019-0

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12254-008-0019-0

Keywords

Search

Navigation