Chemotherapy: How Much Is Enough?

How long chemotherapy should be continued in patients with metastatic breast cancer has been the subject of many clinical trials during the last 2 decades. In practice, patients frequently request “chemo breaks,” and physicians often offer them, particularly when disease response has reached a plateau or when treatment toxicity is adversely affecting quality of life. If switching to an endocrine agent is an option, the decision is often less difficult. But when that is not an option, the appropriate duration of chemotherapy is unclear.

To revisit the question of maintenance chemotherapy for responding advanced disease, investigators conducted a prospective, randomized, multicenter, phase III trial of 231 patients with metastatic breast cance…