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Increasing the dose intensity of chemotherapy by more frequent administration or sequential scheduling: A patient-level meta-analysis of 37,298 women with early breast cancer in 26 randomized trials

The Lancet Apr 11, 2019

Boddington C, et al. - In this individual patient-level meta-analysis of trials comparing 2-weekly vs standard 3-weekly schedules and sequential vs concurrent administration of anthracycline and taxane chemotherapy, authors quantified the relative advantages and hazards of dose-intense vs standard-schedule chemotherapy in early breast cancer. They noted a similar reduction in 10-year breast cancer mortality (18.9% vs 21.3%) and all-cause mortality (22.1% vs 24.8%) with dose-intense vs standard-schedule chemotherapy. They also noted similar reductions in recurrence in the seven trials (n=10,004) comparing 2-weekly chemotherapy with the same chemotherapy given 3-weekly (10-year risk 24.0% vs 28.3%), in the six trials (n=11,028) assessing sequential vs concurrent anthracycline plus taxane chemotherapy (28.1% vs 31.3%), and in the six trials (n=6532) testing both shorter intervals and sequential administration (30.4% vs 35.0%). They also recorded similar and highly significant proportional reductions in recurrence with dose-intense chemotherapy in estrogen receptor (ER)-positive and ER-negative disease; these did not differ significantly by other patient or tumor features.

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