Is Dose-Dense Better?


There are so many options available for breast cancer treatment today, so many more than just 10 years ago. Now, we often have the choice of adjuvant versus neo-adjuvant chemotherapy and dose-dense versus standard. Choices can be tough and differences between therapies can be challenging to decipher. However, a recent meta-analysis including a total of 25 trials and 34,000 women comparing standard (every 3 week) to dose-dense (about 1.5 higher average dose given every 2 weeks along with granulocyte stimulating factor) has verified the benefit of dose-dense chemotherapy. For estrogen receptor-negative patients, there was an 18% reduction in recurrence (P=0.00004) and for estrogen receptor-positive patients, there was a 14% reduction in recurrence (P=0.00001). Overall, there was a 15% reduction in recurrence when comparing dose-dense to standard chemotherapy. At ten years, observed recurrence rates were 32% for standard chemotherapy and 28.4% for dose-dense chemotherapy. That is an absolute difference in recurrence of 3.6%. There was also an absolute decrease of 2.6% in mortality. Although there appeared to be little difference in toxicity and tolerability, these important details were not directly assessed in this meta-analysis. The results of this very important meta-analysis performed by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) were reported in the December 25, 2017 issue of ASCO Post and can be found at ASCOPOST.COM. Also see the interview with Richard G. Gray, MSc on the ASCOP Post newsreels at www.ascopost.com/videos.


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#dosedensechemotherapy #triplenegativebreastcancer #recurrencerates

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