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September 1, 1989

New Evidence May Expand Indications for Chemotherapy in Breast Cancer

JAMA. 1989;262(9):1153. doi:10.1001/jama.1989.03430090013002

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IT'S TIME TO RETHINK the role of chemotherapy in treating mammary carcinoma.

That was the message delivered by Gianni Bonadonna, MD, in the 20th Karnofsky Award lecture at the annual meeting of the American Society of Clinical Oncology in San Francisco, Calif. Bonadonna, who is director, division of medical oncology, Istituto Nazionale Tumori, Milan, Italy, indicated that it may be time to go beyond current guidelines and employ combination chemotherapy as an adjuvant in some additional patient populations and as a primary therapy in others.

The guidelines Bonadonna would like to expand were developed in response to the publication in December of a meta-analysis of 61 randomized trials that involved 28 896 women (N Engl J Med. 1988;319:1681-1692). All of the patients underwent surgical tumor resection with or without radiation.

The study determined that mortality was lower in patients who also underwent subsequent drug therapy than in those who did