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What factors influence your decision regarding whether to administer a dose-dense chemotherapy regimen in the adjuvant setting to patients with hormone-receptor postive disease?
Data presented at the 2017 SABCS (abstract GS1-01) of the EBCTCG meta-analysis stating a benefit of dose-dense chemotherapy applies to ER positive and negative patients seems to conflict with prior data reflected in a 2015 meta-analysis of >17,000 patients (Petrelli et al. Breat Cancer Reserach & Treatment 2015) which found the OS benefit was not seen in ER positive patients (HR 0.93, 95% CI 0.82-1.05, p=0.25).
Answer from: Medical Oncologist at Academic Institution
Many of the studies included in the analyses treated ER+ cases that we would call lower risk using modern genomic testing with adjuvant chemotherapy. So the observed effect of chemotherapy on recurrence and OS in ER+ disease can vary from study to study, depending on the numbers of low vs high risk ...
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Answer from: Medical Oncologist at Academic Institution
The disparate results in the two meta-analysis can also be explained by the larger numbers in the current meta-analysis. Moreover, studies with longer follow up are needed in HR-positive breast cancer to evaluate the efficacy of a given chemotherapy with its ovarian function effect.