Systematic Review
. 2010 Nov; 102(24):1845-54.
doi: 10.1093/jnci/djq409.

Dose-dense chemotherapy in nonmetastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials

Luisa Bonilla 1 Irit Ben-Aharon  Liat Vidal  Anat Gafter-Gvili  Leonard Leibovici  Salomon M Stemmer  
  • PMID: 21098761
  •     27 References
  •     55 citations


Background: Dose-dense chemotherapy has become a mainstay regimen in the adjuvant setting for women with high-risk breast cancer. We performed a systematic review and meta-analysis of the existing data from randomized controlled trials regarding the efficacy and toxicity of the dose-dense chemotherapy approach in nonmetastatic breast cancer.

Methods: Randomized controlled trials that compared a dose-dense chemotherapy protocol with a standard chemotherapy schedule in the neoadjuvant or adjuvant setting in adult women older than 18 years with breast cancer were identified by searching The Cochrane Cancer Network register of trials, The Cochrane Library, and LILACS and MEDLINE databases (from January 1966 to January 2010). Hazard ratios (HRs) of death and recurrence and relative risks of adverse events were estimated and pooled. All statistical tests were two-sided.

Results: Ten trials met the inclusion criteria and were classified into two categories based on trial methodology. Three trials enrolling 3337 patients compared dose-dense chemotherapy with a conventional chemotherapy schedule (similar agents). Patients who received dose-dense chemotherapy had better overall survival (HR of death = 0.84, 95% confidence interval [CI] = 0.72 to 0.98, P = .03) and better disease-free survival (HR of recurrence or death = 0.83, 95% CI = 0.73 to 0.94, P = .005) than those on the conventional schedule. No benefit was observed in patients with hormone receptor-positive tumors. Seven trials enrolling 8652 patients compared dose-dense chemotherapy with regimens that use standard intervals but with different agents and/or dosages in the treatment arms. Similar results were obtained for these trials with respect to overall survival (HR of death = 0.85, 95% CI = 0.75 to 0.96, P = .01) and disease-free survival (HR of recurrence or death = 0.81, 95% CI = 0.73 to 0.88, P < .001). The rate of nonhematological adverse events was higher in the dose-dense chemotherapy arms than in the conventional chemotherapy arms.

Conclusion: Dose-dense chemotherapy results in better overall and disease-free survival, particularly in women with hormone receptor-negative breast cancer. However, additional data from randomized controlled trials are needed before dose-dense chemotherapy can be considered as the standard of care.

Sequential dose-dense doxorubicin, paclitaxel, and cyclophosphamide for resectable high-risk breast cancer: feasibility and efficacy.
C Hudis, A Seidman, +12 authors, L Norton.
J Clin Oncol, 1999 Aug 24; 17(1). PMID: 10458222
Dose-dense therapy in the treatment of early-stage breast cancer: an overview of the data.
Heather L McArthur, Clifford A Hudis.
Clin Breast Cancer, 2008 Feb 20; 8 Suppl 1. PMID: 18282369
Dose-dense chemotherapy for primary breast cancer.
Sherko Kümmel, Mahdi Rezai, Rainer Kimmig, Peter Schmid.
Curr Opin Obstet Gynecol, 2007 Jan 16; 19(1). PMID: 17218856
Doxorubicin with cyclophosphamide followed by docetaxel every 21 days compared with doxorubicin and docetaxel every 14 days as preoperative treatment in operable breast cancer: the GEPARDUO study of the German Breast Group.
Gunter von Minckwitz, Günter Raab, +11 authors, Manfred Kaufmann.
J Clin Oncol, 2005 Apr 20; 23(12). PMID: 15837982
A Gompertzian model of human breast cancer growth.
L Norton.
Cancer Res, 1988 Dec 15; 48(24 Pt 1). PMID: 3191483
Highly Cited.
Phase III comparison of standard doxorubicin and cyclophosphamide versus weekly doxorubicin and daily oral cyclophosphamide plus granulocyte colony-stimulating factor as neoadjuvant therapy for inflammatory and locally advanced breast cancer: SWOG 0012.
Georgiana K Ellis, William E Barlow, +6 authors, Robert B Livingston.
J Clin Oncol, 2011 Jan 12; 29(8). PMID: 21220618    Free PMC article.
Operating characteristics of a rank correlation test for publication bias.
C B Begg, M Mazumdar.
Biometrics, 1994 Dec 01; 50(4). PMID: 7786990
Highly Cited.
Decline in pulmonary function in patients with breast cancer receiving dose-dense chemotherapy: a prospective study.
R Yerushalmi, M R Kramer, +5 authors, S M Stemmer.
Ann Oncol, 2009 Jan 14; 20(3). PMID: 19139179
Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints.
M K Parmar, V Torri, L Stewart.
Stat Med, 1999 Jan 28; 17(24). PMID: 9921604
Highly Cited.
Average relative dose intensity and the impact on design of clinical trials.
W M Hryniuk.
Semin Oncol, 1987 Mar 01; 14(1). PMID: 3823917
Meta-analysis in clinical trials.
R DerSimonian, N Laird.
Control Clin Trials, 1986 Sep 01; 7(3). PMID: 3802833
Highly Cited.
Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer.
A D Seidman, C A Hudis, +9 authors, L Norton.
J Clin Oncol, 1998 Oct 21; 16(10). PMID: 9779712
Accelerated versus standard cyclophosphamide, epirubicin and 5-fluorouracil or cyclophosphamide, methotrexate and 5-fluorouracil: a randomized phase III trial in locally advanced breast cancer.
E Baldini, G Gardin, +9 authors, P F Conte.
Ann Oncol, 2003 Feb 04; 14(2). PMID: 12562649
Dose-dense adjuvant chemotherapy in early breast cancer patients: results from a randomized trial.
Marco Venturini, Lucia Del Mastro, +11 authors, Paolo Bruzzi.
J Natl Cancer Inst, 2005 Dec 08; 97(23). PMID: 16333028
Cost-effectiveness of adding granulocyte colony-stimulating factor to primary prophylaxis with antibiotics in small-cell lung cancer.
Johanna N H Timmer-Bonte, Eddy M M Adang, +5 authors, Vivianne C G Tjan-Heijnen.
J Clin Oncol, 2006 May 10; 24(19). PMID: 16682725
The bigger the better? ... or what we know and what we still need to learn about anthracycline dose per course, dose density and cumulative dose in the treatment of breast cancer.
L Biganzoli, M J Piccart.
Ann Oncol, 1998 Mar 13; 8(12). PMID: 9496381
Statistical aspects of the analysis of data from retrospective studies of disease.
J Natl Cancer Inst, 1959 Apr 01; 22(4). PMID: 13655060
Highly Cited.
Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741.
Marc L Citron, Donald A Berry, +18 authors, Larry Norton.
J Clin Oncol, 2003 Apr 02; 21(8). PMID: 12668651
Highly Cited.
Economic evaluation of prophylactic granulocyte colony stimulating factor during chemotherapy in elderly patients with aggressive non-Hodgkin's lymphoma.
Jeanette K Doorduijn, Ivon Buijt, +3 authors, Carin A Uyl-de Groot.
Haematologica, 2004 Sep 21; 89(9). PMID: 15377472
Bias in meta-analysis detected by a simple, graphical test.
M Egger, G Davey Smith, M Schneider, C Minder.
BMJ, 1997 Oct 06; 315(7109). PMID: 9310563    Free PMC article.
Highly Cited.
Final results of a randomized phase III trial comparing cyclophosphamide, epirubicin, and fluorouracil with a dose-intensified epirubicin and cyclophosphamide + filgrastim as neoadjuvant treatment in locally advanced breast cancer: an EORTC-NCIC-SAKK multicenter study.
P Therasse, L Mauriac, +8 authors, EORTC.
J Clin Oncol, 2003 Mar 01; 21(5). PMID: 12610183
Sequenced compared with simultaneous anthracycline and cyclophosphamide in high-risk stage I and II breast cancer: final analysis from INT-0137 (S9313).
Hannah M Linden, Charles M Haskell, +8 authors, Silvana Martino.
J Clin Oncol, 2007 Feb 20; 25(6). PMID: 17308269
Cyclophosphamide, epirubicin, and Fluorouracil versus dose-dense epirubicin and cyclophosphamide followed by Paclitaxel versus Doxorubicin and cyclophosphamide followed by Paclitaxel in node-positive or high-risk node-negative breast cancer.
Margot Burnell, Mark N Levine, +11 authors, Lois E Shepherd.
J Clin Oncol, 2009 Nov 11; 28(1). PMID: 19901117    Free PMC article.
PREPARE trial: a randomized phase III trial comparing preoperative, dose-dense, dose-intensified chemotherapy with epirubicin, paclitaxel and CMF versus a standard-dosed epirubicin/cyclophosphamide followed by paclitaxel ± darbepoetin alfa in primary breast cancer--results at the time of surgery.
M Untch, P A Fasching, +20 authors, Arbeitsgemeinschaft Gynäkologische Onkologie PREPARE investigators.
Ann Oncol, 2011 Mar 10; 22(9). PMID: 21385882
Intensive dose-dense compared with conventionally scheduled preoperative chemotherapy for high-risk primary breast cancer.
Michael Untch, Volker Möbus, +17 authors, Gottfried E Konecny.
J Clin Oncol, 2009 Apr 15; 27(18). PMID: 19364964
Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG).
Lancet, 2005 May 17; 365(9472). PMID: 15894097
Highly Cited.
Randomised trial: survival benefit and safety of adjuvant dose-dense chemotherapy for node-positive breast cancer.
S Kümmel, J Krocker, +5 authors, D Elling.
Br J Cancer, 2006 Apr 20; 94(9). PMID: 16622463    Free PMC article.
Accelerated BEP: a phase I trial of dose-dense BEP for intermediate and poor prognosis metastatic germ cell tumour.
Y Rimmer, J Chester, +9 authors, M V Williams.
Br J Cancer, 2011 Aug 19; 105(6). PMID: 21847130    Free PMC article.
Phase III randomized trial of dose intensive neoadjuvant chemotherapy with or without G-CSF in locally advanced breast cancer: long-term results.
Banu K Arun, Kapil Dhinghra, +16 authors, Gabriel N Hortobagyi.
Oncologist, 2011 Nov 02; 16(11). PMID: 22042783    Free PMC article.
Uptake and economic impact of first-cycle colony-stimulating factor use during adjuvant treatment of breast cancer.
Dawn L Hershman, Elizabeth T Wilde, +4 authors, Alfred I Neugut.
J Clin Oncol, 2012 Feb 09; 30(8). PMID: 22312106    Free PMC article.
A way forward on the medically appropriate use of white cell growth factors.
Thomas J Smith, Bruce E Hillner.
J Clin Oncol, 2012 Mar 01; 30(14). PMID: 22370327    Free PMC article.
Increased efficacy of a dose-dense regimen of neoadjuvant chemotherapy in breast carcinoma: a retrospective analysis.
Bohuslav Melichar, Helena Hornychová, +7 authors, Aleš Ryška.
Med Oncol, 2012 Mar 07; 29(4). PMID: 22392196
Being Pregnant and Diagnosed with Breast Cancer.
Sibylle Loibl, Sileny N Han, Frederic Amant.
Breast Care (Basel), 2012 Aug 09; 7(3). PMID: 22872793    Free PMC article.
Is it time for a new paradigm for systemic cancer treatment? Lessons from a century of cancer chemotherapy.
Sarah Crawford.
Front Pharmacol, 2013 Jun 28; 4. PMID: 23805101    Free PMC article.
Treatment of breast cancer in young women: do we need more aggressive therapies?
Giuseppe Cancello, Emilia Montagna.
J Thorac Dis, 2013 Jul 03; 5 Suppl 1. PMID: 23819027    Free PMC article.
Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study.
József Zsiros, Laurence Brugieres, +17 authors, International Childhood Liver Tumours Strategy Group (SIOPEL).
Lancet Oncol, 2013 Jul 09; 14(9). PMID: 23831416    Free PMC article.
Reply to E.J. Moylan et al.
Sandra M Swain, Gong Tang, Charles E Geyer.
J Clin Oncol, 2014 Jan 15; 32(6). PMID: 24419136    Free PMC article.
Long-term survival of advanced triple-negative breast cancers with a dose-intense cyclophosphamide/anthracycline neoadjuvant regimen.
S Giacchetti, R Porcher, +12 authors, M Espié.
Br J Cancer, 2014 Feb 27; 110(6). PMID: 24569467    Free PMC article.
Model-based meta-analysis for quantifying Paclitaxel dose response in cancer patients.
D Lu, A Joshi, +5 authors, J Y Jin.
CPT Pharmacometrics Syst Pharmacol, 2014 May 23; 3. PMID: 24850445    Free PMC article.
Neutropenia and relative dose intensity on adjuvant FOLFOX chemotherapy are not associated with survival for resected colon cancer.
Martin Smoragiewicz, Khodadad R Javaheri, Yaling Yin, Sharlene Gill.
J Gastrointest Cancer, 2014 Jul 12; 45(4). PMID: 25012517
Organizing medical oncology care at a regional level and its subsequent impact on the quality of early breast cancer management: a before-after study.
Aline Voidey, Xavier Pivot, +4 authors, Samuel Limat.
BMC Health Serv Res, 2014 Jul 30; 14. PMID: 25070624    Free PMC article.
Adjuvant chemotherapy in breast cancer: To use or not to use, the anthracyclines.
Jennifer A Crozier, Abhisek Swaika, Alvaro Moreno-Aspitia.
World J Clin Oncol, 2014 Aug 13; 5(3). PMID: 25114866    Free PMC article.
Chemotherapy in early breast cancer: when, how and which one?
Marcus Schmidt.
Breast Care (Basel), 2014 Sep 02; 9(3). PMID: 25177256    Free PMC article.
Granulocyte colony-stimulating factors as prophylaxis against febrile neutropenia.
Sol Cortés de Miguel, Miguel Ángel Calleja-Hernández, Salomón Menjón-Beltrán, Inmaculada Vallejo-Rodríguez.
Support Care Cancer, 2014 Oct 07; 23(2). PMID: 25284722
Update on adjuvant chemotherapy for early breast cancer.
Murtuza M Rampurwala, Gabrielle B Rocque, Mark E Burkard.
Breast Cancer (Auckl), 2014 Oct 23; 8. PMID: 25336961    Free PMC article.
Breast cancer under age 40: a different approach.
D Ribnikar, J M Ribeiro, +6 authors, F Cardoso.
Curr Treat Options Oncol, 2015 Mar 23; 16(4). PMID: 25796377
Optimal approach in early breast cancer: Adjuvant and neoadjuvant treatment.
J Ribeiro, B Sousa, F Cardoso.
EJC Suppl, 2013 Sep 01; 11(2). PMID: 26217109    Free PMC article.
Progress in adjuvant chemotherapy for breast cancer: an overview.
Jesus Anampa, Della Makower, Joseph A Sparano.
BMC Med, 2015 Aug 19; 13. PMID: 26278220    Free PMC article.
Highly Cited. Review.
Triple negative breast cancer: looking for the missing link between biology and treatments.
Giuseppe Palma, Giuseppe Frasci, +7 authors, Massimiliano D'Aiuto.
Oncotarget, 2015 Sep 21; 6(29). PMID: 26387133    Free PMC article.
Highly Cited. Review.
A genome-wide association study identifies WT1 variant with better response to 5-fluorouracil, pirarubicin and cyclophosphamide neoadjuvant chemotherapy in breast cancer patients.
Lina Wu, Lu Yao, +8 authors, Yuntao Xie.
Oncotarget, 2015 Nov 18; 7(4). PMID: 26573232    Free PMC article.
A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities.
Jean E Abraham, Louise Hiller, +11 authors, Helena M Earl.
BMC Med, 2015 Dec 31; 13. PMID: 26715442    Free PMC article.
If Chemotherapy Is Indicated, Give the Optimal Regimen!
Volker Möbus.
Breast Care (Basel), 2016 Apr 07; 11(1). PMID: 27051388    Free PMC article.
Adjuvant Dose-Dense Chemotherapy in Breast Cancer: Standard of Care in High-Risk Patients.
Volker Möbus.
Breast Care (Basel), 2016 Apr 07; 11(1). PMID: 27051389    Free PMC article.
Multidisciplinary Management of Breast Cancer During Pregnancy.
Shlomit Strulov Shachar, Kristalyn Gallagher, +5 authors, Carey K Anders.
Oncologist, 2017 Feb 25; 22(3). PMID: 28232597    Free PMC article.
Adjuvant Capecitabine in Combination With Docetaxel, Epirubicin, and Cyclophosphamide for Early Breast Cancer: The Randomized Clinical FinXX Trial.
Heikki Joensuu, Pirkko-Liisa Kellokumpu-Lehtinen, +15 authors, Henrik Lindman.
JAMA Oncol, 2017 Mar 03; 3(6). PMID: 28253390    Free PMC article.
Neoadjuvant Therapy for Breast Cancer: Established Concepts and Emerging Strategies.
Tessa G Steenbruggen, Mette S van Ramshorst, +3 authors, Gabe S Sonke.
Drugs, 2017 Jun 16; 77(12). PMID: 28616845
Assessing the Clinical Benefit of Systemic Adjuvant Therapies for Early Breast Cancer.
Volker Möbus, Susanne Hell, Marcus Schmidt.
Geburtshilfe Frauenheilkd, 2017 Nov 03; 77(10). PMID: 29093601    Free PMC article.
Efficacy, safety and proper dose analysis of PEGylated granulocyte colony-stimulating factor as support for dose-dense adjuvant chemotherapy in node positive Chinese breast cancer patients.
Fan Zhang, RuiXia LingHu, +5 authors, Junlan Yang.
Oncotarget, 2017 Nov 08; 8(45). PMID: 29108384    Free PMC article.
How to mathematically optimize drug regimens using optimal control.
Helen Moore.
J Pharmacokinet Pharmacodyn, 2018 Feb 08; 45(1). PMID: 29411198    Free PMC article.
Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences.
Fedro Alessandro Peccatori, Matteo Lambertini, +2 authors, Giovanni Codacci-Pisanelli.
Cancer Biol Med, 2018 Mar 17; 15(1). PMID: 29545964    Free PMC article.
Anthracycline Use for Early Stage Breast Cancer in the Modern Era: a Review.
Sakshi Jasra, Jesus Anampa.
Curr Treat Options Oncol, 2018 May 13; 19(6). PMID: 29752560
Neoadjuvant chemotherapy in breast cancer: a dose-dense schedule in real life and putative role of PIK3CA mutations.
Valentina Cocciolone, Katia Cannita, +16 authors, Corrado Ficorella.
Oncotarget, 2018 Jun 26; 9(44). PMID: 29937992    Free PMC article.
Survival benefit of pure dose-dense chemotherapy in breast cancer: a meta-analysis of randomized controlled trials.
Wenqi Zhou, Shizhe Chen, Faliang Xu, Xiaohua Zeng.
World J Surg Oncol, 2018 Jul 17; 16(1). PMID: 30007402    Free PMC article.
Protocol for the P3BEP trial (ANZUP 1302): an international randomised phase 3 trial of accelerated versus standard BEP chemotherapy for adult and paediatric male and female patients with intermediate and poor-risk metastatic germ cell tumours.
Nicola J Lawrence, Howard Chan, +14 authors, ANZUP.
BMC Cancer, 2018 Aug 31; 18(1). PMID: 30157803    Free PMC article.
Breast Cancer during Pregnancy-Current Paradigms, Paths to Explore.
Ayelet Alfasi, Irit Ben-Aharon.
Cancers (Basel), 2019 Oct 31; 11(11). PMID: 31661803    Free PMC article.
Synchronous versus sequential chemo-radiotherapy in patients with early stage breast cancer (SECRAB): A randomised, phase III, trial.
Indrajit N Fernando, Sarah J Bowden, +18 authors, SECRAB Investigators.
Radiother Oncol, 2019 Dec 02; 142. PMID: 31785830    Free PMC article.
Does chemotherapy improve survival in patients with nodal positive luminal A breast cancer? A retrospective Multicenter Study.
Daniel Herr, Manfred Wischnewsky, +10 authors, Achim Wöckel.
PLoS One, 2019 Jul 10; 14(7). PMID: 31283775    Free PMC article.
Specific, reversible G1 arrest by UCN-01 in vivo provides cytostatic protection of normal cells against cytotoxic chemotherapy in breast cancer.
Benjamin B Mull, J Andrew Livingston, +3 authors, Khandan Keyomarsi.
Br J Cancer, 2020 Jan 17; 122(6). PMID: 31942030    Free PMC article.
Skeletal muscle mass loss and dose-limiting toxicities in metastatic colorectal cancer patients.
Sophie Kurk, Petra Peeters, +14 authors, Anne May.
J Cachexia Sarcopenia Muscle, 2019 May 17; 10(4). PMID: 31094083    Free PMC article.
Updated Survival Analysis after a Median Follow-up of 12 Years of an Anthracycline-Containing Adjuvant Prospective Multicentre, Randomised Phase III Trial on Dose-Dense Chemotherapy in Primary Node-Positive, High-Risk Breast Cancer Patients.
Mattea Reinisch, Oleg Gluz, +10 authors, Sherko Kümmel.
Breast Care (Basel), 2019 Jul 19; 14(3). PMID: 31316314    Free PMC article.
Trends in utilization of sentinel node biopsy and adjuvant radiation in women ≥ 70.
Jinny Gunn, Riccardo Lemini, +6 authors, Emmanuel Gabriel.
Breast J, 2020 Jan 08; 26(7). PMID: 31908095    Free PMC article.
Avoiding Peg-Filgrastim Prophylaxis During the Paclitaxel Portion of the Dose-Dense Doxorubicin-Cyclophosphamide and Paclitaxel Regimen: A Prospective Study.
Ines Vaz-Luis, Romualdo Barroso-Sousa, +18 authors, Nancy U Lin.
J Clin Oncol, 2020 Apr 25; 38(21). PMID: 32330102    Free PMC article.
Early stage triple negative breast cancer: Management and future directions.
Lubna N Chaudhary.
Semin Oncol, 2020 Jun 09; 47(4). PMID: 32507668    Free PMC article.
Application of the ESMO-Magnitude of Clinical Benefit Scale (V.1.1) to the field of early breast cancer therapies.
Shani Paluch-Shimon, Nathan I Cherny, +4 authors, Fatima Cardoso.
ESMO Open, 2020 Sep 08; 5(5). PMID: 32893189    Free PMC article.
Adjuvant Dose-Dense Chemotherapy for Breast Cancer: Available Evidence and Recent Updates.
Fernando Kude de Almeida, Daniela Dornelles Rosa.
Breast Care (Basel), 2019 Feb 26; 13(6). PMID: 30800040    Free PMC article.
Effects of Chemotherapy on Serum Lipids in Chinese Postoperative Breast Cancer Patients.
Qi Lu, Xian Wu, +10 authors, Xiaoan Liu.
Cancer Manag Res, 2020 Sep 29; 12. PMID: 32982433    Free PMC article.
Landmark trials in the medical oncology management of early stage breast cancer.
Whitney Hensing, Cesar A Santa-Maria, Lindsay L Peterson, Jennifer Y Sheng.
Semin Oncol, 2020 Sep 17; 47(5). PMID: 32933761    Free PMC article.
Adjuvant continuous metronomic adriamycin + cyclophosphamide followed by weekly nab-paclitaxel for high-risk early-stage breast cancer.
Eunpi Cho, Qian Wu, +5 authors, Georgiana Ellis.
Breast J, 2018 Mar 14; 24(4). PMID: 29532546    Free PMC article.
Real-world use of granulocyte colony-stimulating factor in ambulatory breast cancer patients: a cross-sectional study.
Florence Van Ryckeghem, Chloë Haverbeke, +5 authors, Simon Van Belle.
Support Care Cancer, 2018 Aug 14; 27(3). PMID: 30099601
Taxane & cyclophosphamide vs anthracycline & taxane-based chemotherapy as adjuvant treatment for breast cancer: a pooled analysis of randomized controlled trials by the Hellenic Academy of Oncology.
Panagiotis Ntellas, Nikolaos Spathas, +2 authors, Emmanouil Saloustros.
Oncotarget, 2019 Mar 07; 10(11). PMID: 30838092    Free PMC article.
Long-term patient reported outcomes and hematologic toxicity among patients who received Granulocyte-Colony Stimulating Factors during chemotherapy for early breast cancer.
Pietro Lapidari, Arnauld Gbenou, +17 authors, Antonio Di Meglio.
Breast, 2021 Mar 13; 57. PMID: 33711699    Free PMC article.
Triple-negative breast cancer: new treatment strategies in the era of precision medicine.
Song-Yang Wu, Hai Wang, Zhi-Ming Shao, Yi-Zhou Jiang.
Sci China Life Sci, 2020 Aug 18; 64(3). PMID: 32803712