Fast Five Quiz: Test Your Knowledge of Systemic Treatment for Metastatic Breast Cancer

Winston W. Tan, MD


January 25, 2022

In the setting of metastatic breast cancer, combination therapy is currently considered up front, depending on the patient's performance status, because of its higher response rates. According to guidelines from the National Comprehensive Cancer Network (NCCN), a combination of systemic therapy and targeted therapy should be considered for patients with symptomatic, visceral disease. Targeted agents often have very low response rates when given as monotherapy, but they provide added benefit when given in combination with cytotoxic chemotherapy. The NCCN guidelines also note that most patients are candidates for multiple lines of systemic therapy to palliate advanced breast cancer. However, at each reassessment of patients, clinicians should weigh the value of continuing treatment, including the risk-benefit ratio, patient performance status, and patient preference.

Hormonal therapy alone is not recommended for patients with aggressive visceral disease.

If 1 year or more has elapsed since completion of adjuvant therapy, a patient's tumor is likely to respond to a previously administered drug or combination as though that drug or combination had never been given. If the tumor has recurred quickly after administration of adjuvant chemotherapy containing a taxane, then changing the schedule of administration can be an effective strategy. At least one third of breast cancer patients with taxane resistance due to administration of every-3-week paclitaxel show a response when the same drug is administered on a weekly schedule at a lower dose.

For additional information, refer to the NCCN treatment guidelines.

Learn more about the treatment of metastatic breast cancer.


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