More options, more considerations: how new treatment options influence clinical decision making

Given the fact that the majority of cases of metastatic breast cancer (MBC) are incurable, the primary goal when treating these patients is to prolong overall survival (OS) and palliate symptoms, but not at the expense of quality of life (QoL). The choice of therapy should be made on an individual, patient-by patient basis, taking into account various prognostic or predictive factors (1). Patients with rapidly progressing disease or symptoms may gain the most from combination or more aggressive chemotherapy; a less toxic approach may suit those with more gradual disease progression. It is not a trivial task to achieve the correct balance between efficacy and toxicity when choosing any of the relatively protracted chemotherapeutic regimens that are currently used for MBC.