Marc L. Citron, MD
Note: Dr. Citron is the principal investigator of the U.S. Breast Cancer Intergroup Trial C9741.
Citron ML. Dose-Dense Chemotherapy for Node-Positive Breast Cancer. Ann Intern Med. 2005;142:227. doi: 10.7326/0003-4819-142-3-200502010-00023
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Published: Ann Intern Med. 2005;142(3):227.
TO THE EDITOR:
In the 2004 Update in Oncology (1), Dr. Steven H. Stein discussed a study by the U.S. Breast Cancer Intergroup on dose-dense therapy for node-positive breast cancer (2) and questioned the expense of filgrastim support. Dose-dense chemotherapy increases the dose intensity of the adjuvant regimen by delivering standard-dose chemotherapy with shorter intervals between the cycles. Filgrastim support enables the delivery of dose-dense chemotherapy and reduces the risk for neutropenia and its complications (3). Although the U.S. Breast Cancer Intergroup Trial C9741 acknowledged the added cost, concerns over the added expense must be weighed against the savings that result from fewer hospitalizations for febrile neutropenia; the productivity gained by sparing the patient 2 months of therapy; and, most important, a reduced chance of recurrence and freedom from future treatment with chemotherapy for advanced disease (2).
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