Abstract
Impact of a reduced dose intensity of adjuvant anthracycline based
Highlights
The benefits of adjuvant chemotherapy on clinical outcomes in early stage breast cancer have been well established [1, 2]
The concept of dose intensity (DI), defined as the amount of drug delivered per unit time, and its impact on breast cancer outcomes has been an area of intensive research
We have examined the impact of a reduced DI of four cycles of AC on clinical outcomes of patients with early stage breast cancer treated at the British Columbia Cancer Agency (BCCA) between 1990 and 1995
Summary
The benefits of adjuvant chemotherapy on clinical outcomes in early stage breast cancer have been well established [1, 2]. A dose effect of escalating cyclophosphamide has not been identified as beneficial in two randomized trials [6, 7] Taken together these trials demonstrate that within the standard anthracycline dose range a threshold effect exists, meaning it is less efficacious to deliver adjuvant chemotherapy, using sub-optimal dose intensity and/or lower cumulative doses of anthracyclines. In order to maximally improve survival for women with early stage breast cancer, a critical (or threshold) dose intensity and/or cumulative anthracycline dose must be reached. Reductions in the dose intensity (DI) of adjuvant anthracycline-based chemotherapy in early stage breast cancer are frequently required due to treatment toxicity or poor tolerance, but the implications of a minimal reduction in DI on clinical outcome remain uncertain
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