Skip to main content
Log in

Chemotherapy for Advanced Breast Cancer – How Long Should it Continue?

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Chemotherapy is given to most women with advanced breast cancer, but its optimal duration is poorly defined. A systematic review identified four randomised trials comparing more with fewer cycles of the same chemotherapy in women with advanced breast cancer. Meta-analysis of these four trials including 766 women showed a modest, survival advantage for women randomized to more cycles of chemotherapy (median survival 23% longer with more cycles, p = 0.01). Small increments in survival duration are valued highly by women with breast cancer. Quality of life was also better with more cycles of chemotherapy than fewer in the one trial that measured it. The combined evidence from these trials supports a policy of continuing chemotherapy in the absence of disease progression or significant side effects. Decisions about continuing or stopping treatment should be made by the patient and doctor guided by monitoring and consideration of symptoms, signs, side effects, quality of life and preferences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Early Breast Cancer Trialists' Collaborative Group: Polychemotherapy for early breast cancer: an overview of the randomised trials. Lancet 352: 930–942, 1998

    Google Scholar 

  2. Stockler M, Wilcken N: The management of advanced breast cancer: systematic reviews of randomised controlled trials regarding the use of cytotoxic chemotherapy and endocrine therapy. For the Advanced Breast Cancer Working Party of the NHMRC National Breast Cancer Centre.

  3. Stockler M, Wilcken N, Ghersi D, Simes RJ: Systematic reviews of systemic therapy for advanced breast cancer. Cancer Treatment Rev 26: 151–168, 2000

    Google Scholar 

  4. Stockler M, Wilcken N, Coates A: Chemotherapy for metastatic breast cancer-when is enough? Eur J Cancer 33: 2147–2148, 1997

    Google Scholar 

  5. Coates A, Gebski V, Bishop JF, Jeal PN, Woods RL, Snyder R et al.: Improving the quality of life during chemotherapy for advanced breast cancer. A comparison of intermittent and continuous treatment strategies. N Engl J Med 317: 1490–1495, 1987

    Google Scholar 

  6. Coates A, Byrne M, Bishop JF, Forbes JF: Intermittent versus continuous chemotherapy for breast cancer. N Engl J Med 318: 1468, 1988

    Google Scholar 

  7. Harris AL, Cantwell BM, Carmichael J, Wilson R, Farndon J, Dawes P et al.: Comparison of short-term and continuous chemotherapy (mitozantrone) for advanced breast cancer. Lancet 335: 186–190, 1990

    Google Scholar 

  8. Ejlertsen B, Pfeiffer P, Pedersen D, Mouridsen HT, Rose C, Overgaard et al.: Decreased efficacy of cyclophosphamide, epirubicin and 5-fluorouracil in metastatic breast cancer when reducing treatment duration from 18 to 6 months. Eur J Cancer 29A: 527–531, 1993

    Google Scholar 

  9. Gregory RK, Powles TJ, Chang J, Ashley S: A randomized trial of six versus twelve courses of chemotherapy in metastatic carcinoma of the breast. Eur J Cancer 33: 2194–2197, 1997

    Google Scholar 

  10. Duric V, Stockler M: A systematic review of studies assessing patients' preferences for adjuvant chemotherapy in early breast cancer: What makes it worthwhile? Lancet Oncol 2: 691–697, 2001

    Google Scholar 

  11. Slevin ML, Stubbs L, Plant HJ et al.: Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. BMJ 300: 1458–1460, 1990

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stockler, M.R., Wilcken, N.J. & Coates, A.S. Chemotherapy for Advanced Breast Cancer – How Long Should it Continue?. Breast Cancer Res Treat 81 (Suppl 1), 49–52 (2003). https://doi.org/10.1023/A:1026316806601

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026316806601

Navigation