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New information on drug resistance: implications for the adjuvant treatment of breast cancer.

Abstract
We would suggest on the basis of our analysis that drug resistance still appears to represent a plausible explanation for drug treatment failure in adjuvant breast chemotherapy. It may not be the only factor, but, if present, clearly has to be circumvented if treatment results are to be improved. Since it seems most unlikely that a new wonder drug for breast cancer will emerge in the next few years, then it is to our existing armamentarium of antineoplastic agents that we will have to turn for improved therapeutic results. Fundamental questions will need to be asked about what indeed are the most appropriate agents to be used in combination chemotherapy protocols for this disease and what are the optimal dose ratios. Our own institutional experience in a number of areas has suggested that many chemotherapeutic protocols that are widely used represent significant underdosing and that achieving optimal results requires pushing therapeutic agents closer to the reasonable limits of tolerance. Enhanced techniques for patient support during programs of more intensive chemotherapy are now available, and it has also been our experience that patients tolerate briefer, intensive programs of chemotherapy better than they do protracted, less intensive protocols. The role of new drug combinations that incorporate synergistic or significant biochemical modulation effects (i.e., platinum-etoposide, 5-fluorouracil-leucovorin) need to be examined in the context of the management of breast cancer. We appear to have reached something of a plateau with existing protocols and approaches, and it is time to move ahead.
AuthorsJ H Goldie
JournalRecent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer (Recent Results Cancer Res) Vol. 115 Pg. 8-16 ( 1989) ISSN: 0080-0015 [Print] Germany
PMID2696044 (Publication Type: Journal Article, Review)
Chemical References
  • Adjuvants, Pharmaceutic
  • Antineoplastic Agents
Topics
  • Adjuvants, Pharmaceutic (pharmacology, therapeutic use)
  • Antineoplastic Agents (therapeutic use)
  • Breast Neoplasms (drug therapy, pathology)
  • Drug Resistance (physiology)
  • Humans
  • Models, Biological

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