Extending Survival with Chemotherapy in Metastatic Breast Cancer

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Identify trials that have demonstrated a survival benefit with a modern chemotherapeutic agent or regimen in MBC.Summarize recent findings of randomized trials showing survival benefits with targeted therapy–chemotherapy combinations in MBC.Discuss quality-of-life findings and their implications in clinical practice. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Metastatic breast cancer (MBC) remains essentially incurable, and goals of therapy include the palliation of symptoms, delay of disease progression, and prolongation of overall survival time without negatively impacting quality of life. Anthracycline and taxane-based therapies have traditionally shown the highest degree of activity in MBC. Though numerous randomized clinical trials have shown improvements in overall response rates, few have found clear survival benefits. In recent years, however, there has been a small but growing series of clinical trials demonstrating modest, but meaningful survival advantages in metastatic disease. A common feature in many of these trials has been the use of a taxane, and more recently, a taxane combined with an antimetabolite. In addition, the development of targeted biologic agents active against MBC, such as trastuzumab and bevacizumab, has demonstrated great potential for enhancing the effects of chemotherapy and producing meaningful survival improvements. The role of the taxanes, antimetabolites, and biologics in extending survival in MBC is discussed.