Abstract
At the present time, clinicians managing patients with metastatic breast cancer face a challenging problem. Therapeutic strategies that include chemotherapy, hormonal therapy, and combination approaches have been based almost exclusively on published experience from clinical trials that antedate common adjuvant systemic therapy use. In fact, most studies in advanced breast cancer excluded patients with any prior hormonal or chemotherapy use as part of the study design. Thus, although the majority of breast cancer patients who develop metastatic disease may have received prior adjuvant chemotherapy and/or hormonal therapy, few prospective trials have evaluated therapeutic approaches for this population.
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