Dr. Rugo on the Standard for Front-Line Chemotherapy

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 standard for front-line chemotherapy in patients with breast cancer.

Rugo explains that there is an understanding of the differences in treatment standards based on tumor biology. While patients with HER2-positive disease are treated with a HER2 targeted therapy, 80% of patients are not HER2-positive. In these patients, treatment still depends on tumor biology.

In patients with slow-growing disease who are hormone-responsive, the decision to treat with first-line chemotherapy is not particularly important. Conversely, in patients with aggressive, hormone-resistant disease, the choice of chemotherapy is crucial.

Rugo notes that the CALGB 40502 study showed that older agents can be just as effective as newer ones and demonstrate more tolerable side effects. Rugo stressed the need for more data to determine if single agents can be optimal for specific subclasses of breast cancer.

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