Over the past decades, many oncologists assume that prolonged chemotherapy for metastatic breast cancer can affect survivability of patients. But if the following piece of information is to be believed then, this is not true. According to recent meta-analysis, patients with metastatic breast cancer live longer if chemotherapy is extended after cancer is brought under control.
Often oncologists are unable to gauge the accurate time when chemotherapy can be halted, for accurately treating metastatic breast cancer by avoiding toxicity. Generally, the number of chemotherapy cycles is suggested to patients on the basis of response achieved to treatment, improvement in symptoms and toxicity reported from the treatment. Experts focused of analyzing whether prolonged chemotherapy after disease response or stabilization is related to an improvement in survival and time to progression.
“The take-home message is that despite what many oncologists believe, prolongation of chemotherapy in metastatic breast cancer after the achievement of disease control affects the history of the disease and, in the presence of acceptable toxicity, may be considered routinely. This meta-analysis addresses an extremely important topic. The duration of first-line chemotherapy in breast cancer is a matter of debate and most oncologists would consider stopping chemotherapy when the disease is controlled, and continuing with endocrine therapy in case of hormone-sensitive disease. For patients with negative hormone receptors this possibility is not available, making the question of duration of chemotherapy even more important,” elucidated Dr. Monica Castiglione from University Hospital Geneva, Switzerland.
11 randomized studies were evaluated by the investigators. These studies compared longer and shorter durations of chemotherapy in a total of 2,269 metastatic breast cancer patients. It appeared that the overall longer chemotherapy duration is linked with 34 percent decline in the rate of disease progression. Scientists refer progression as a considerable elevation in the size of metastatic lesions and/or the appearance of new metastatic lesions. Longer chemotherapy durations were possibly associated with a 9 percent decrease in the rate of death.
Further investigations can be initiated to ascertain the effectiveness of chemotherapeutic agents combined with targeted agents in prolonged treatments. Detail on effects of continued chemotherapy in different subgroups of patients like whose tumors are hormone-receptor positive and negative, may be extremely beneficial for scientists.
The study was presented at the 35th Congress of the European Society for Medical Oncology (ESMO).