Chemotherapy is one of the main treatment options for advanced breast cancer, so how should the chemotherapy regimen be chosen? How long should the treatment course be? Here is a description of each.
These are the preferred chemotherapy regimens recommended by doctors
For advanced breast cancer, doctors usually recommend single-agent sequential chemotherapy or combination chemotherapy, either the same regimen used in adjuvant chemotherapy or other new treatment options, sometimes in combination with targeted therapy.
Single-agent sequential chemotherapy
Physicians often choose single-agent chemotherapy regimens if patients with advanced breast cancer have reduced responsiveness to drugs and have made quality of life a priority.
- Chemotherapy drugs commonly used in single-agent regimens include the following.
- Anthracyclines, such as doxorubicin, epirubicin, pirarubicin, and doxorubicin liposomes.
- Paclitaxel, such as paclitaxel, docetaxel, and albumin-bound paclitaxel. To reduce allergic reactions, paclitaxel or docetaxel can be replaced with albumin-bound paclitaxel, but doctors will be careful to administer no more than a certain amount per week.
- Anti-metabolites, such as capecitabine and gemcitabine;
- Non-paclitaxel microtubule formation inhibitors, such as vincristine (Vinorelbine), eribulin (Eribulin).
- Other chemotherapeutic agents used in single-agent regimens include cyclophosphamide (Cyclophosphamide), cisplatin (Cisplatin), etoposide (Etoposide), vincristine (Vinblastine), mitoxantrone (Mitoxantrone), and fluorouracil (Fluorouracil).
Combination chemotherapy
Patients with advanced breast cancer whose tumors need to shrink quickly or whose symptoms resolve quickly are often treated with combination chemotherapy regimens. Compared with single-agent chemotherapy, combination chemotherapy provides better disease remission and delayed progression (i.e., higher objective remission rates and longer time to disease progression), but is more toxic, and patients often have limited benefit in terms of long-term survival.
- Commonly used combination chemotherapy regimens include the following.
- cyclophosphamide, doxorubicin, and fluorouracil (FAC/CAF) regimens;
- Fluorouracil, epirubicin, and cyclophosphamide (FEC) regimens;
- Cyclophosphamide, epirubicin, and fluorouracil (CTF) regimens;
- Doxorubicin, cyclophosphamide (AC) regimens;
- epirubicin, cyclophosphamide (EC) regimen;
- Doxorubicin combined with docetaxel or paclitaxel (AT) regimens;
- Cyclophosphamide, methotrexate (Meth) and fluorouracil (CMF) regimens;
- docetaxel in combination with capecitabine regimen;
- Gicitabine in combination with paclitaxel regimen.
- Gicitabine plus carboplatin (Carboplatin) or cisplatin regimens (for triple-negative breast cancer).
- Doctors will be more cautious about the combination of chemotherapy with targeted therapy. When analyzing the available studies, chemotherapy combined with the targeted therapy drug bevacizumab in the treatment of advanced breast cancer provides a limited benefit in terms of progression-free survival (PFS), meaning that there is some delay in disease progression, but it does not extend survival (OS). Therefore, for advanced breast cancer, physicians are still usually cautious when considering chemotherapy in combination with targeted agents.
How long should I do chemotherapy?
For advanced breast cancer, it is now standard practice to use 1 treatment regimen until the disease progresses and then switch drugs.
Because there is no difference in overall survival for advanced breast cancer between combination chemotherapy and single-agent sequential chemotherapy, physicians usually weigh efficacy, adverse drug effects, and the demands on the patient’s quality of life in a combination of whether to use long-term chemotherapy or to stop or maintain therapy after a short course of chemotherapy.
In summary, chemotherapy is an important treatment tool for many patients with advanced breast cancer. The best way to deal with breast cancer is to follow your doctor’s advice and choose the right chemotherapy regimen, to closely monitor and pay attention to the various considerations during chemotherapy, and to complete chemotherapy safely and effectively.