Increased Use of Intensive Adjuvant Chemo in Stage I Breast Cancer

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An increased use of intensive regimens by patients with stage I breast cancer was observed over time with significant institutional and cost variations, according to an article published online in the journal Cancer.

A common controversy for patients with stage I breast cancer is the uncertainty regarding the optimal threshold at which to consider chemotherapy, and if patients do choose to receive chemotherapy, they must then consider non-intensive versus intensive regimens. 

The prospective cohort study involved patients treated at a National Comprehensive Cancer Network center from 2000 to 2009.

Each patient’s stage was defined according to the version of the American Joint Committee on Cancer Staging Manual that was being used at the time of diagnosis.

The patients were classified by human epidermal growth factor receptor 2 (HER2) status and then evaluated based on if they received non-intensive versus intensive adjuvant chemotherapy regimens.

Results showed that 33% of 8,907 patients with stage I breast cancer received a form of adjuvant chemotherapy. The number of patients with HER2-positive disease who received intensive regimens from 2000 to 2005 increased from 2008 to 2009 (31% to 63%, respectively).

Those patients with HER2-negative disease increased from 15% (2000 through 2005) to 41% (from 2008 to 2009).  The regimens varied sufficiently across institutions along with cost variation (due to incorporation of biologics and growth factors).

Addition of cilengitide to cetuximab and platinum-based chemotherapy indicated potential activity in
An increased use of intensive regimens by patients with stage I breast cancer was observed over time.
Among patients with stage I breast cancer, there is significant uncertainty concerning the optimal threshold at which to consider chemotherapy, and when considered, there is controversy regarding whether to consider non-intensive versus intensive regimens. 
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