Breast cancer in the clinic: treatments past, treatments future.

Therapeutic options for the patient with systemic breast cancer were long limited to either chemotherapy and hormonal therapy. While these therapies provide palliation for many patients with advanced disease, and occasionally cure the patient with micrometastatic disease, they are not optimal either with regard to toxicity or efficacy. This paper reviews the past of systemic therapy (chemotherapy and hormonal therapy), then discusses developing treatment strategies. These strategies include the recently introduced anti-HER-2 antibody trastuzumab, novel agents targeting other aspects of tumor growth mechanisms, as well as agents blocking angiogenesis.