Maintenance chemotherapy compared to observation only for metastatic breast cancer patients after obtaining disease control with chemotherapy

This article looks at two treatment options for people who have obtained a complete, partial or stable state disease after first round combination chemotherapy for metastatic breast cancer.

Metastatic breast cancer is cancer that has spread from the breast to distant organs or tissues in the body. Treatment for metastatic breast cancer aims to control the symptoms and to extend the patient’s life as long as possible, while maintaining a good quality of life. Chemotherapy with a combination of drugs has shown to give longer survival rates and progression free survival (time patients survive without the cancer progressing) than single drug chemotherapy regimens. However, there is little evidence what the best treatment approach is in patients who obtain a good response from combination chemotherapy. 

This article looks at two treatment choices for patients with metastatic breast cancer who, after combination chemotherapy with paclitaxel and gemcitabine, obtained a complete response, partial response or stable disease. 231 patients took part in this study. 115 of these patients had no further chemotherapy and were observed until their cancer progressed (observation group), while 116 participants continued to receive combination chemotherapy of paclitaxel and gemcitabine (maintenance chemotherapy group). These participants received paclitaxel on day 1 and then every 21 days, and gemcitabine on day 1 and 8 and then every 21 days.

After approximately 3 years of follow up, patients who continued to receive chemotherapy had longer progression free survival compared to patients who stopped receiving chemotherapy (7.5 months compared to 3.8 months). Overall survival (time patients survived with or without breast cancer) was also higher in patients in the maintenance chemotherapy groups (32.3 months) than in patients in the observation group (23.5 months). However, 61% of patients in the maintenance chemotherapy group experienced low white blood count. This increases the risk of developing infections. 

In conclusion, maintenance chemotherapy after a complete or partial response to first round combination chemotherapy extended survival in patients with metastatic breast cancer. 

Ask to your doctor whether maintaining chemotherapy is an option for your situation.