990WBOB
  • WBOB Radio
  • Crush Cancer
  • Past Casts
  • Weather
  • Contact
  • About
    • WBOB Press Releases
    • Join Our Team!
    • CHARITY GALA

Maintaining Full Doses of Chemotherapy Can Be Key for Breast Cancer Survival, According to New Research in JNCCN

8/20/2019

Comments

 
Picture
Physicians should attempt to maintain full doses of chemotherapy, especially early in the treatment course, for intermediate or high risk breast cancer patients, according to new research published in the August 2019 issue of JNCCN—Journal of the National Comprehensive Cancer Network. The study, which looked at the impact of dose reduction with the adjuvant (post-surgery) chemotherapy combination of 5-fluorouracil, epirubicin, cyclophosphamide, and docetaxel (FEC-D), found early dose reductions negatively impacted survival rates. However, outcomes were not seemingly compromised for dose reductions that came later in the treatment course.
​"What surprised us the most was how dramatically early reductions in chemotherapy affect survival compared to later modifications," said Zachary Veitch, MSc, MD, FRCPC, Department of Oncology, University of Calgary, Tom Baker Cancer Centre. "This became even more apparent when patients were further separated based on chemotherapy dose cut-offs. Early dose reductions can be related to age, weight, or the number of other medical issues a patient has, such as kidney disease or diabetes, among other factors. Often the first cycle of chemotherapy can be difficult for patients, and oncologists must convey the need for maintaining initial dose intensity, while using other medications to control side effects and manage comorbidities."
​
John Ward, MD, Huntsman Cancer Institute at the University of Utah, and Member, NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Breast Cancer, who was not part of the research team, agreed. "Adjuvant therapy in early-stage breast cancer leads to improved survival. When chemotherapy is part of the adjuvant treatment, it is important to give the prescribed doses. This study adds further support for the need to do so. Balancing side effects with efficacy is always a challenge. When a treatment is palliative, quality of life factors into dosing choices. When cure is the goal, as it is with adjuvant therapy, it is important to strive to give the therapy as planned. The juice is worth the squeeze."

The study focused on data from 1,302 women with stage I-III, HER2-negative breast cancer, who were treated with adjuvant FEC-D chemotherapy between 2007 and 2014. That data came from the Alberta Cancer Registry (ACR) in Alberta, Canada. Patients received at least four cycles of FEC-D, but no more than six. The total dose was averaged across the treatments, with a value of zero percent assigned for any missed cycles.

The researchers determined that 16% of the patients received less than 85% of the total recommended dose; and that the 'lower-dose' group had inferior five-year disease-free survival (79.2% vs 85.9%) and inferior overall survival (80.7% vs 88.8%) compared with those who received higher cumulative doses. However, when they split the 'lower-dose' group into 2 cohorts based on dose reduction during cycles one-to-three versus cycles four-to-six, they found that outcomes were not compromised when dose reduction occurred only during the later cycles (which are the only cycles to include docetaxel).

"There may be a few reasons for this," speculated Dr. Veitch. "First, the amount of docetaxel that was prescribed in the last three cycles may be higher than needed for the FEC-D regimen. Lower doses have been shown to be as effective in other standard of care chemotherapy regimens, and lower doses have been used in other countries with good outcomes. Second, the majority of cancer cells that are sensitive to chemotherapy may be killed in the first few treatments, rather than in the later treatments. Thus, reducing the dose late may not have as much of an impact."

To read the entire study and view the corresponding data tables, visit JNCCN.org. Complimentary access to "Impact of Cumulative Chemotherapy Dose on Survival with Adjuvant FEC-D Chemotherapy for Breast Cancer" is available until November 10, 2019.


About JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about best clinical practices, health services research, and translational medicine. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit http://www.nccn.org/jnccn/subscribe.asp. Follow JNCCN on Twitter @JNCCN.

Read More 990WBOB

  • Gays for Trump; My Experience at Trump's NH Rally
  • How Words Really Hurt
  • Taste Test: Sonic's New Big Scoop Cookie Dough Sundae
  • Christian Martinelli's 2019 Fantasy Football Guide
Comments

    WBOB
    Original
    ​Reads

    Picture

    Unbiased, Unfiltered. WBOB's Original Reads feature our brightest and boldest personalities, offering their two-cents on the goings on of news, sports, politics, entertainment, and business. -- Are our opinions always PC? Nope. Are they always perfect? Nah. But, are they always 100% authentic? Absolutely!


    LISTEN
    ​TO WBOB ORIGINAL PODCASTS

    Picture
    Listen to
    ​Past BOBCasts

    WBOB 
    Best Reads
    Brought To You By
    TripAdvisor.com

    Picture

    Celebrating David Clyde: A Wild Passionate Friend To All


    Picture

    Search 
    The Archives


    Reads From Our Friends

    Picture

    The Best Game Development Tools: How to Make Your Own Game


    Contact Us
    [email protected]


    Archives

    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    January 2013
    December 2012
    November 2012
    October 2012
    September 2012
    August 2012
    July 2012
    June 2012
    May 2012
    April 2012
    March 2012
    February 2012

Search For Your Favorite WBOB Author,
​or BobCast

990WBOB 
An Independent Media Outlet.

The views opinions and thoughts expressed do not  reflect those of 990WBOB, its management or its staff. All Rights Reserved 990WBOB.com 2007-2020
​
Contact WBOB HERE
Photo from nzhamstar
  • WBOB Radio
  • Crush Cancer
  • Past Casts
  • Weather
  • Contact
  • About
    • WBOB Press Releases
    • Join Our Team!
    • CHARITY GALA