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International guidelines for management of metastatic breast cancer: combination vs sequential single-agent chemotherapy Cardoso F; Bedard PL; Winer EP; Pagani O; Senkus-Konefka E; Fallowfield LJ; Kyriakides S; Costa A; Cufer T; Albain KSJ Natl Cancer Inst 2009[Sep]; 101 (17): 1174-81Compared with treatment options for early-stage breast cancer, few data exist regarding the optimal use of chemotherapy for metastatic breast cancer (MBC). The choice of using a combination of cytotoxic chemotherapies vs sequential single agents is controversial. At the 6th European Breast Cancer Conference, the European School of Oncology Metastatic Breast Cancer Task Force convened an open debate on the relative benefits of combination vs sequential therapy. Based on the available data, the Task Force recommends sequential monotherapy as the preferred choice in advanced disease, in the absence of rapid clinical progression, life-threatening visceral metastases, or the need for rapid symptom and/or disease control. Patient- and disease-related factors should be used to choose between combination and sequential single-agent chemotherapy for MBC. Additional research is needed to determine the impact of therapy on patient-rated quality of life and to identify predictive factors that can be used to guide therapy.|*Patient Selection[MESH]|*Practice Guidelines as Topic/standards[MESH]|Age Factors[MESH]|Anthracyclines/administration & dosage[MESH]|Antineoplastic Agents/*administration & dosage[MESH]|Antineoplastic Combined Chemotherapy Protocols/administration & dosage[MESH]|Biomarkers, Tumor/analysis[MESH]|Breast Neoplasms/chemistry/*drug therapy/*pathology[MESH]|Capecitabine[MESH]|Comorbidity[MESH]|Congresses as Topic[MESH]|Cross-Over Studies[MESH]|Deoxycytidine/administration & dosage/analogs & derivatives[MESH]|Drug Administration Schedule[MESH]|Europe[MESH]|Evidence-Based Medicine[MESH]|Female[MESH]|Fluorouracil/administration & dosage/analogs & derivatives[MESH]|Humans[MESH]|International Cooperation[MESH]|Karnofsky Performance Status[MESH]|Menopause[MESH]|Quality of Life[MESH]|Randomized Controlled Trials as Topic[MESH]|Severity of Illness Index[MESH]|Socioeconomic Factors[MESH]|Taxoids/administration & dosage[MESH]|Vinblastine/administration & dosage/analogs & derivatives[MESH]|Vinorelbine[MESH] |