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Excerpts from Oncology Treatment Updates

Medscape, Inc. 1999

Breast cancer is the most common malignancy of women in the developed world and is the second most common cause of cancer death. Despite improvements in adjuvant treatment, recurrent metastatic disease remains a significant problem and is rarely if ever curable, with a median survival of 2 years.

Chemotherapy is recommended if visceral metastatic disease is predominant and if hormonal manipulation has failed. The most active agents are the anthracyclines (doxorubicin, epirubicin) and the taxanes (paclitaxel, docetaxel), with response rates of 20%-40% as single agents.[14]

Higher response rates are possible with drug combinations, but these are generally associated with increased toxicity and demonstrate no improvement in survival. Following progression of disease after first- and second-line treatment with anthracyclines and taxanes, it is doubtful whether further chemotherapy is of benefit, as increased toxicity and diminished quality of life generally outweigh any gains from tumor regression.

In this palliative setting, treatment goals can be defined as: (1) reduction of cancer-related symptoms, (2) minimization of drug-related side-effects, (3) maintenance of quality of life, (4) improved convenience of treatment, and (5) maximized duration of survival. This is a setting where an oral agent with relatively mild toxicities would be very useful.


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One woman speaks out May 2000
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padWhy Chemotherapy May Lead To Cancer
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Cancer Cell, 2/02
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padPotentially Fatal Adverse Effects From Chemo ONGOING
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JCO, 10/03
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padChemo at the End of Life: Analyzed Decision Process
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Abstract # 6081 ASCO, 2004
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Phase II Trials Outcomes Compared to Subsq RCT's
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