Systemic therapy of metastatic breast cancer: a review of the current trends.

This paper reviews the different options of systemic therapy available for the management of patients with metastatic breast cancer. Endocrine therapy with tamoxifen, aminoglutethimide, progestins or androgens are useful for approximately one half of the patients either before or after chemotherapy. Combination chemotherapy is effective in approximately 75% of the patients and offers the best palliation for the majority of the patients. Adriamycin-containing regimens have resulted in slightly superior results than combination regimens which exclude adriamycin from first line chemotherapy. Secondary chemotherapy is useful only in 25-30% of the patients and responses usually do not last longer than 4-6 months. With carefully planned and properly sequenced treatment approaches, patients with metastatic breast cancer have a median survival of 2 years and a 5-year survival of 10-15%.