New horizons in treating metastatic disease.

The management of metastatic breast cancer is changing as a consequence of extraordinary discoveries in cancer research and the development of more advanced diagnostic technologies. Although traditional chemotherapeutics such as anthracyclines and taxanes still represent the mainstay of treatment for this disease, new drugs are demonstrating significant clinical activity and sometimes a better toxicity profile. Furthermore, the successful introduction into clinical practice of biological agents, in particular the monoclonal antibody trastuzumab, offers a key to the future of managing metastatic breast cancer. A therapeutic approach based on modifications of a specific molecular target (e.g., gene therapy, vaccines, and antiangiogenesis) alone or combined with the traditional chemotherapeutic drugs is expected to be used more commonly and will, we hope, bring significant improvement in the clinical response and quality of care of our patients.