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Chemotherapy Dose Density in Early‐Stage Breast Cancer and Non‐Hodgkin's Lymphoma
Author(s) -
Goldspiel Barry R.
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.14.1347.43154
Subject(s) - medicine , breast cancer , chemotherapy , neutropenia , oncology , stage (stratigraphy) , lymphoma , non hodgkin's lymphoma , cancer , paleontology , biology
Delivering standard‐dose chemotherapy on schedule is important for survival in early‐stage breast cancer and non‐Hodgkin's lymphoma. Trials of dose‐escalated regimens, in which higher‐than‐standard doses of chemotherapy are used, have produced equivocal results. In contrast, dose‐dense regimens, in which standard doses are given with shorter (usually 14‐day) intervals between cycles, have been more efficacious than standard 21‐day regimens in trials in both early‐stage breast cancer and non‐Hodgkin's lymphoma. Furthermore, a shorter course of chemotherapy is likely to cause less disruption in patients' lives. Despite the evidence of the importance of maintaining chemotherapy dose intensity (the amount of drug administered/unit of time), undertreatment of patients with early‐stage breast cancer and non‐Hodgkin's lymphoma is common. Neutropenia is the primary dose‐limiting toxicity of many chemotherapy regimens, and it is frequently managed by dose reductions and delays that decrease dose intensity. Colony‐stimulating factors reduce the prevalence and severity of neutropenia and its complications, and their proactive use can improve adherence to the planned schedule of both standard‐dose and dose‐dense chemotherapy. The promising results with dose‐dense chemotherapy in early‐stage breast cancer and non‐Hodgkin's lymphoma indicate that it should be tested in patients with other chemosensitive tumors.