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The worldwide perspective in the adjuvant treatment of primary lymph node positive breast cancer

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Abstract

Adjuvant treatment of early breast cancer has experienced major changes in the last 25 years. Since the mid 1970s when cyclophosphamide, methotrexate and 5-fluorouracil (CMF) resulted in statistically significant and clinically meaningful improvements in disease-free and overall survival, the use of adjuvant chemotherapy has become common practice worldwide. Anthracyclines have long been considered to be among the most active available agents to treat breast cancer and they have become a core component of adjuvant regimens. Anthracycline-containing polychemotherapy regimens provide a significant benefit over CMF. Regimens containing epirubicin are associated with a significant prolongation in relapse-free and overall survival rates compared with standard therapies including CMF. Epirubicin-taxane combinations are highly active in treating metastatic breast cancer and do not appear to be associated with any pharmacokinetic interactions. Epirubicin is a unique anthracycline whose introduction to the US market represents a significant advance in breast cancer treatment. Ongoing research efforts are focusing on combining anthracyclines with taxanes in an effort to continue to improve outcomes following adjuvant therapy.

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Abbreviations

AUC:

Area under the curve

CHF:

Congestive heart failure

DBCG:

Danish Breast Cancer Cooperative Group

EBCTCG:

Early Breast Cancer Trialists’ Collaborative Group

FASG:

French Adjuvant Study Group

GONO:

Northwest Oncology Group in Italy

HDC:

High dose chemotherapy

HER2:

Human epidermal growth factor-receptor 2

ICCG:

International Collaborative Cancer Group

NCI-C CTG:

National Cancer Institute of Canada Clinical Trials Group

NIH:

National Institute of Health

NSABP:

National Surgical Adjuvant Breast and Bowel Project

SECSG:

South Eastern Cancer Study Group

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Authors and Affiliations

  1. Departments of Oncology, Medicine and Pharmacology & Therapeutics, University of Calgary, Canada

    Stefan Glück

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  1. Stefan Glück
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Correspondence to Stefan Glück.

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Reprint requests to Stefan Gluck, University of Calgary, Medical Oncologist, Tom Baker Cancer Center, 1 331 -29th Street N.W., Calgary, ABT2N4N2, Canada.

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Glück, S. The worldwide perspective in the adjuvant treatment of primary lymph node positive breast cancer. Breast Cancer 8, 321–328 (2001). https://doi.org/10.1007/BF02967532

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