This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Morabito, A. Search for Related Content PubMed PubMed Citation Articles by Morabito, A.

Breast Cancer

First-Line Chemotherapy for HER-2–Negative Metastatic Breast Cancer Patients Who Received Anthracyclines as Adjuvant Treatment

^aClinical Trials Unit and ^bMedical Oncology C, National Cancer Institute, Naples, Italy; ^cDepartment of Medicine and Public Health, Second University of Naples, Italy

Key Words. Metastatic breast cancer • Adjuvant anthracyclines • First-line chemotherapy • Taxanes

Correspondence: Francesco Perrone, M.D., Ph.D., Clinical Trials Unit, National Cancer Institute, Via Mariano Semmola, 80131 Naples, Italy. Telephone: 390815903522; Fax: 390817702938; e-mail: francesco.perrone{at}uosc.fondazionepascale.it

Disclosure: No potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

The treatment decision for patients with metastatic breast cancer who have received anthracyclines within the course of adjuvant chemotherapy is troublesome, particularly if trastuzumab and hormonal treatment are not indicated. In the first part of this review we discuss the value of retreatment with anthracyclines, a topic that has been indirectly evaluated by retrospective studies with conflicting results and within a small phase III trial with a negative outcome. Evidence on liposomal anthracyclines is also reviewed. In the second part of the review, alternative options of first-line chemotherapy are discussed. These include taxanes as single agents, taxanes in combination with other cytotoxic drugs, combinations without anthracyclines and taxanes, and innovative treatments including target-based agents. Both the amount and the quality of evidence on these treatments are poor. Few phase III studies are available and most of them have been performed with registrative aims sponsored by the companies who own the winning drug. Beyond indications derived from such studies, there is a great need for more clinical research in this setting.