Higher Chemo Dose Has Better OutcomesC. Dixon
A large study shows that giving chemo more frequently or in sequence can result in better outcomes for breast cancer patients.
The study was led by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). It culled data from 26 randomized trials that took place all over the world and included over 37,000 women with early stage, operable breast cancer. Most of the women were under age 70 and had cancer that had spread to some lymph nodes.
The researchers compared the standard schedule of chemo (administering the drugs every three weeks) against a high intensity dosing schedule of chemo (raising the amount of drug delivered in a specific time frame), to see if it lessened recurrence and death rates.
Increasing the dose intensity can happen in a couple of different ways. One way is to administer the chemo in the same dose but every two weeks instead of every three.
Another option is to administer sequential chemotherapy, where multiple chemo drugs are administered individually and in order, instead of administering them all together at the same time. Using this method, higher doses of chemotherapy are given in each cycle, without increasing terrible side effects.
The results of both methods were promising. In fact, Dr. Richard Gray, a co-author of the study and professor of Medical Statistics in the Nuffield Department of Population Health at the University of Oxford, was surprised by the strength of their findings.
Patients with increased dose intensity who had chemo every two weeks were 17% less likely to experience recurrence than those who had it every three weeks, and 15% less likely to die from breast cancer within 10 years.
For sequential chemo, positive results were also seen. There was a 14% reduction in risk of recurrence, and a 13% reduction in risk of death due to breast cancer within 10 years.
There weren’t many additional side effects with the more intensive dosage, either.
“Some centers prefer giving chemotherapy every 3 weeks and offer treatment every 2 weeks less frequently because of concerns about side effects and uncertainty about the additional benefit. Looking at the data from large numbers of women receiving dose-intense chemotherapy, we have found no evidence to justify these concerns, and the results show consistent benefit from the more intense treatments,” one of the study’s authors said.
There were limitations that affected the study, however. The chemo administered varied in dosage, total number of treatment cycles, and type used. Because of this, it makes it hard to recommend a specific method of dose-intensive chemo.