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Maintenance Chemotherapy Improves Survival for Some Breast Cancer Patients

According to results recently published in the Journal of Clinical Oncology, maintenance chemotherapy may improve survival among patients with metastatic breast cancer. However, this improvement appears most pronounced among premenopausal women with hormone-negative breast cancer.

Chemotherapy remains an important component of treatment for metastatic breast cancer. Although other treatments are available, particularly for those with hormone-positive and HER2-positive breast cancers, chemotherapy is still often used as part of a treatment combination.

Typically, chemotherapy is delivered to a patient for a specified length of time, and then stopped. However, researchers have questioned whether longer-term, continued use of the chemotherapy, especially in a lower-dose or reduced-dose schedule, would benefit some patients. This type of therapy is referred to as maintenance chemotherapy.

Researchers recently conducted a clinical trial to further explore the potential of maintenance chemotherapy among women with metastatic breast cancer. This was a phase III trial that included 231 patients from 10 different cancer centers.

All patients had achieved a regression or stabilization of their cancer following initial chemotherapy with paclitaxel and gemcitabine (PG). Patients then were either given maintenance PG chemotherapy, or no further chemotherapy (observation) until cancer progression. The median age of patients was 48 years and the median follow-up was nearly 3 years (33 months).

After patients began maintenance chemotherapy or were on observation, the following was observed:

Median survival time without progression of cancer (PFS) was 7.5 months for those who received maintenance chemotherapy, compared with only 3.8 months for those on observation.
Median overall survival (OS) time was 32.3 months for those treated with maintenance chemotherapy compared with 23.5 months for those on observation.
The researchers concluded that “maintenance PG chemotherapy resulted in better PFS and OS compared with observation.”

However, the author in an accompanying editorial commented that this survival improvement was most pronounced in premenopausal women with hormone-negative breast cancers and further study is required to fully integrate this type of therapy into treatment for all patients with metastatic breast cancer. Furthermore, it remains important to weigh side effects of maintenance chemotherapy against its potential gains.

References:

Park Y H, Jung K H, Im S-A, et al. Phase III, Multicenter, Randomized Trial of Maintenance Chemotherapy Versus Observation in Patients With Metastatic Breast Cancer After Achieving Disease Control With Six Cycles of Gemcitabine Plus Paclitaxel As First-Line Chemotherapy: KCSG-BR07-02. Journal of Clinical Oncology. Published online before print April 8, 2013, doi:10.1200/JCO.2012.45.2490