Increasing Dose Intensity of Chemotherapy By More Frequent Administration or Sequential Scheduling
Reducing the interval between chemotherapy treatment cycles or administering chemotherapy
medications sequentially at higher doses, rather than simultaneously at
lower doses, increases treatment efficacy and decreases the risk of breast cancer recurrence and death, a study suggests.
The study, Increasing
the dose intensity of chemotherapy by more frequent administration or
sequential scheduling: a patient-level meta-analysis of 37 298 women
with early breast cancer in 26 randomised trials, was published in The Lancet.
Previous studies have shown that conventional chemotherapy medications, such as anthracyclines (e.g., doxorubicin) and taxanes (e.g., paclitaxel and docetaxel),
reduce breast cancer mortality by one-third in women at the earlier
stages of disease. However, the optimal dosage and timing of these two
drugs is still unclear, according to the study.
Additionally, previous modeling studies proposed that increasing
chemotherapy dose intensity might enhance the elimination of cancer
cells, reduce the odds of cancer recurrence, and maximize the chances of
a cure.
In theory, there are two different ways to boost chemotherapy dose
intensity: The first is to shorten the interval between treatment
sessions; and the second is to administer chemotherapies one at a time
(sequential chemotherapy) at higher doses, instead of all at the same
time at lower doses (standard concurrent chemotherapy).
[To clarify the relative benefits and risks of dose-intense and
standard-schedule chemotherapy in early breast cancer, we did an
individual patient-level meta-analysis of trials comparing 2-weekly
versus standard 3-weekly schedules, and of trials comparing sequential
versus concurrent administration of anthracycline and taxane
chemotherapy.]
To read the entire study:
https://breastcancer-news.com/2019/02/25/high-chemotherapy-dose-reduces-breast-cancer-recurrence-death
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33137-4/fulltext