Dr. Rugo on Chemotherapy for Metastatic Breast Cancer

Hope S. Rugo, MD, professor of medicine and director of breast oncology and clinical trials education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discusses the treatment of patients with metastatic breast cancer with chemotherapy.

Treating a patient with metastatic breast cancer with chemotherapy is controversial for a number of reasons, Rugo says. Several factors come into consideration in this setting: the choice of combination or single therapy, sequencing, treatment schedule, and length of treatment.

There is data that shows a better outcome for patients who continue on chemotherapy after response compared with those who go on a chemotherapy holiday. The caveat of this data is that many patients had hormone receptor-positive disease but did not receive hormone therapy during the chemotherapy holiday. The standard in the U.S. is to treat this group of patients with hormone therapy during a break.

For patients with triple-negative hormone-resistant disease, continued therapy was better for outcome than stopping and restarting.