Adjuvant Chemotherapy. Since there is no established treatment strategy for stage I gastric cancer, decisions to administer AC in those patients were based on their surgeons' or oncologists' preference [25, 26].
For patients with high risk tumours, the benefits of
adjuvant chemotherapy have been demonstrated [14].
A majority of Stage III/IV patients can benefit from
adjuvant chemotherapy.[sup][6],[7],[8] However, it is controversial when it comes to patients with Stage II colorectal cancer due to the difficulty in distinguishing the target high-risk patients.[sup][8],[9] According to the National Comprehensive Cancer Network (NCCN) Guidelines, such clinicopathologic characteristics are considered high-risk Stage II patients for adjuvant treatment: fewer lymph nodes (LNs) retrieved (<12) during surgery,[sup][10],[11] T4 staging, poorly differentiated tumor, lymphovascular or perineural invasion,[sup][9],[12] obstructing or perforating cancers [sup][8],[13],[14] and positive margins.
11 years' follow-up of trastuzumab after
adjuvant chemotherapy in HER2-positive early breast cancer: Final analysis of the HERceptin Adjuvant (HERA) trial.
Metaanalysis of the association of breast cancer subtypes and complete pathologic response to neo
adjuvant chemotherapy. Eur J Cancer 2012; 48(18): 3342-54.
Five-year follow-up analysis of the trial results concluded that, compared to CP criteria, use of MammaPrint could help identify an extra 14% of women with early breast cancer who could be safely spared
adjuvant chemotherapy. However, in the group of patients categorized as at high risk using CP criteria, performance of the MammaPrint test would result in a 46% reduction in chemotherapy usage.
LCCB is rare but therapeutic success has been seen in select cases of localized disease treated with neoadjuvant or
adjuvant chemotherapy plus aggressive surgery [3].
Furthermore, diminished total dose and dose intensity of
adjuvant chemotherapy both have been associated with lower breast cancer survival rates.
The study, to be presented to the European Breast Cancer Conference in Amsterdam, analysed data from two large clinical trials that compared
adjuvant chemotherapy given every two weeks, known as a "dose dense" regimen, or every three weeks - the standard interval.
(9,10) In a meta-analysis, the delay of
adjuvant chemotherapy of more than 8 weeks for colon cancer was associated with an inferior outcome.
Cognitive function in breast cancer patients receiving
adjuvant chemotherapy. Journal of Clinical Oncology, 18, 2695-2701.
Cisplatin-based
adjuvant chemotherapy is recommended by the American Society of Clinical Oncology for
adjuvant chemotherapy and adjuvant radiation therapy of stages II to IIIA NSCLC published on JCO in 2007.7 However, standard chemotherapy has not been applied in clinical research and the selection of appropriate chemotherapy remains a challenge.
Receipt of indicated
adjuvant chemotherapy, radiation, and hormonal therapy significantly reduces disease recurrence and improves survival among women with early-stage breast cancer (Clarke et al.
Although
adjuvant chemotherapy is recommended for stage III and high-risk stage II colon cancer, uncertainty remains around the benefits of such chemotherapy for patients with stage II and III rectal cancer [7].