Update on adjuvant chemotherapy for early breast cancer

Adjuvant chemotherapy represents a significant advance in the management of early-stage breast cancer and, as such, has saved many lives, Worldwide, a djuvant chemotherapy has benefitted all groups tested, including pre- and p ostmenopausal women, those with node-negative and node-positive disease, an d those with estrogen-receptor (ER)-positive and ER-negative disease. Howev er, the significant number of women who relapse despite adjuvant therapy pr ovides the impetus to develop more efficacious regimens. Results from large randomized clinical trials, which will mature over the next few years, wil l clarify the potential benefits of the taxanes in the adjuvant setting, pr ovide answers as to the efficacy of a dose-dense approach, and define a rol e, if any, for high-dose chemotherapy. A shift toward targeted therapies ha s also begun, with the incorporation of trastuzumab (Herceptin) into the ad juvant setting. Minimizing the long-term toxicity of adjuvant therapy for t he large number of women who survive their disease is paramount. This artic le highlights the need to develop predictive factors to help tailor individ ual therapy.