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Abstract

Adjuvant chemotherapy and antibody therapy in breast cancer

If the indication for an adjuvant chemotherapy is given after a risk/benefit evaluation, anthracycline-based combination chemotherapy is regarded as standard treatment. As shown in a metaanalysis, these regimen induce an additional benefit with a reduction of the relapse rate and mortality compared with adjuvant CMF-therapy. In the treatment of nodal-positive disease, taxane-containing regimen improve relapse-free survival as well as overall survival compared to taxane-free options. For nodal-negative patients, the situation is not completely clear. In the sequence AC followed by a taxane, both taxanes are equally effective;however, the weekly administration of paclitaxel offers a better DFS (disease free survival) and OS (overall survival) compared to the three-weekly regime.The sequence of anthracyclines and docetaxel is equally effective as the combination.

If under the consideration of the risks (cardiac toxicity, secondary leukaemia) the potential additional benefit of an anthracycline-based combination therapy is regarded as too low, an anthracycline-free combination of docetaxel and cyclophosphamide can be chosen. Current study designs will evaluate the role of this non-anthracycline regimens.

All studies demonstrating a benefit for adjuvant trastzumab therapy including node-negative and node-positive patients and subgroup analysis showed a benefit for both groups of patients.Therefore, trastuzumab-containing regimens should be also applied in node-negative patients with risk factors.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2010; 6(1):68-79

Keywords
Breast Cancer,adjuvant chemotherapy,AGO guidelines, Trastuzumab

Volkmar Müller1, Elmar Stickeler2
1 Klinik und Poliklinik für Gynäkologie, Universitätsklinikum
Hamburg-Eppendorf,Hamburg
2Universitäts-Frauenklinik Freiburg, Freiburg
Für die Kommission Mammakarzinom der AGO

Reviewer: Christoph Thomssen, Halle
und Nadia Harbeck,Köln

Müller V. Adjuvante ... Gynakol Geburtsmed Gynakol Endokrinol 2010;6(1):68-79 publiziert 31.03.10 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2010 ISSN 1614-8533