Are there any right rules for the sequence of treatment for chemotherapy for breast cancer?

Pierfranco Conte, MD of the University of Padova, Padova, Italy talks about his side of the debate on whether or not there are any correct rules for the sequence treatment of chemotherapy at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. Prof. Conte explains that he believes there are no right rules for the sequence of treatment for chemotherapy for advanced breast cancer. There are however some general and generally accepted rules. One of these is that in case of hormone receptor-positive disease you should prefer an endocrine therapy in front-line and only switch to chemotherapy in the case of endocrine resistance. The second rule is that if you have to administer chemotherapy, sequential single agent chemotherapy is better because it is more tolerable and combination chemotherapy should be reserved only for patients with high tumor burden and life-threatening disease. Apart from these two rules it is hard to say there is a right sequence of cytotoxic drugs. He says that the sequence must be customised according to the patient’s characteristics and the choice must be made after looking at the history of the patient, the desire of the patient and the physical condition of the patient.
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