Dose-dense chemotherapy for breast cancer: what does the future hold?

Within the last several decades adjuvant polychemotherapy for breast cancer has evolved with the development of anthracyclines and taxanes. Parallel to these developments, granulocyte-colony stimulating factor support has permitted the safe delivery of chemotherapy at shorter ('dose-dense') intertreatment intervals, which, as predicted by preclinical models, has further improved survival. Recently, insights into tumor biology have led the development of targeted therapies, such as trastuzumab for HER2-positive disease, and this has now been successfully incorporated into dose-dense therapy. Newer targeted agents may be similarly incorporated into dose-dense regimens to further improve patient outcomes. This article reviews dose-dense therapy and discusses its role as a chemotherapy foundation for additional targeted agents.