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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 3 (1983), S. 117-127 
    ISSN: 1573-7217
    Keywords: chemotherapy ; combined chemoendocrine therapy ; endocrine therapy ; systemic management of breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Standard approaches to the systemic management of breast cancer have probably reached a plateau. Endocrine therapy leads to responses in only 1/3 of patients, probably even less ifno clinical preselection is applied, and the median benefit probably does not exceed one year. Although three-drug chemotherapeutic combinations yield responses in 55–65% of patients, the median duration of response is at best only 10 months, and addition of more drugs does not seem to offer much additional benefit. Although combining these approaches seems attractive initially, the theoretical improvement would be modest even if the effects were additive, and in fact the endocrine component may well perturb the cell cycle kinetics to reduce sensitivity to the cytotoxic component so that results would be less than additive. Clinical trials of combined chemoendocrine regimens have tended to evaluate only the initial response rate, whereas a valid comparison must consider the total response duration and survival given either combined or the usual sequential approaches. Combining endocrine and cytotoxic chemotherapies may have a greater effect when a more rational means for their amalgamation is employed. Early trials using endocrine manipulation to synchronize cell sensitivity to cytotoxic treatment have been promising. Increasing attention needs to be directed towards more innovative trial design which is respectful of the biological realities of cancer.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 4 (1984), S. 69-77 
    ISSN: 1573-7217
    Keywords: breast cancer ; chemotherapy ; clinical trials ; combined chemoendocrine therapy ; immunotherapy ; non-myelosuppressive agents ; prognostic factors ; response rates ; targeting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Over the past twenty years, breast cancer has come to be much more commonly regarded and treated as a systemic disease. Conventional chemotherapy and endocrine therapy used according to schedules that are tolerable to patients are generally effective and often induce worthwhile responses; nevertheless, the responses in general have a median duration of less than a year, and these therapies are rarely if ever curative. Continued efforts to use available agents with mere modifications of schedule and intensity seem unlikely to substantially improve upon the modest success already achieved. Rather, we desperately need radically new schedules, new agents (especially non-myelosuppressive agents), and new approaches (e.g. monoclonal antibody targeting of drugs, toxins, or radionuclides, perhaps combined with tumor sensitizing agents such as heat). It is our hope that consideration of some of these issues will encourage others to be bolder in devising the next generation of clinical trials.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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