A study conducted by the Cancer and Leukemia Group B (CALGB) and presented at the 25th Annual San Antonio Breast Cancer Symposium assessed the effectiveness of reducing the interval between successive doses of a commonly used chemotherapy regimen to improve survival rates in breast cancer// women. This study was conducted as follow-up of a mathematical model which was developed in the 1980s that suggested the value of increased dose density.

Researchers tested both dose dense and conventional chemotherapy regimens in 1,973 women with node-positive primary breast cancer and no other metastases. Following surgical removal of their tumors, the women were assigned to one of four treatment regimens involving the standard chemotherapy drugs doxorubicin (A), paclitaxel (T), and cyclophosphamide (C):

Sequential administration (A followed by T, followed by C) in three-week intervals (conventional)

Sequential administration in two-week intervals, with filgrastim (dose dense)

Concurrent administration (A and C together, followed by T) in three-week intervals

Concurrent administration in two-week intervals, with filgrastim (dose dense)

The dose dense regimen was made tolerable to patients with the drug filgrastim, which helps prevent neutropenia, a serious complication of chemotherapy. In neutropenia there is a decline in the number of a certain type of white blood cells which hampers the immune system of the body. Filgrastim, also known as the granulocyte-colony stimulating factor (G-CSF), helps prevent neutropenia by stimulating the formation of white blood cells called neutrophils. Without it, chemotherapy dosing frequency is limited to longer intervals.

The researchers found that the disease-free survival was 82 per cent after four years compared to 75 percent for those who received conventional therapy. This difference corresponded to a 26 percent overall reduction in the risk of cancer recurre
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