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 HighWire Citing Articles via Google Scholar Google Scholar Articles by Verma, S. Articles by Clemons, M. Search for Related Content PubMed PubMed Citation Articles by Verma, S. Articles by Clemons, M.

Breast Cancer

First-Line Treatment Options for Patients with HER-2–Negative Metastatic Breast Cancer: The Impact of Modern Adjuvant Chemotherapy

^aDivision of Medical Oncology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada; ^bPrincess Margaret Hospital, Toronto, Canada

Key Words. Metastatic breast cancer • Taxane • Anthracycline • Adjuvant • Capecitabine • First-line

Correspondence: Sunil Verma, M.D., M.S.Ed., FRCP(C), Division of Medical Oncology, Sunnybrook and Women's College Health Sciences Centre, T-Wing, 2nd Floor, TSRCC, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. Telephone: 416-480-5248; Fax: 416-480-6002; e-mail: sunil.verma{at}sunnybrook.ca

The management of early breast cancer has evolved rapidly in recent years. Consequently, the range of first-line treatment options for metastatic breast cancer (MBC) is becoming increasingly complicated and therapy depends on a complex interaction of tumor, patient, and physician variables. Arguably one of the most important factors determining choice of first-line chemotherapy is prior adjuvant therapy. We have reviewed data from large, randomized clinical trials to identify the most effective regimens and help clinicians to select first-line treatment based on previous adjuvant therapy. In this review we provide recommendations on the most appropriate first-line therapy according to the type of previous adjuvant therapy. With such a wide array of treatment options available, none is likely to become the gold-standard first-line treatment for MBC. Furthermore, as increasing emphasis is placed on the quality as well as the duration of survival after development of MBC, treatment decisions should take into account tumor characteristics, toxicity, convenience, potential impact on quality of life, and patient preference, in addition to robust efficacy data.

Disclosure of potential conflicts of interest is found at the end of this article.

This article has been cited by other articles:

				E. A. Perez, D. W. Hillman, T. Dentchev, N. A. Le-Lindqwister, L. H. Geeraerts, T. R. Fitch, H. Liu, D. L. Graham, S. P. Kahanic, H. M. Gross, et al. North Central Cancer Treatment Group (NCCTG) N0432: phase II trial of docetaxel with capecitabine and bevacizumab as first-line chemotherapy for patients with metastatic breast cancer Ann. Onc., February 1, 2010; 21(2): 269 - 274. [Abstract] [Full Text] [PDF]