Cytostatic therapy in metastatic breast cancer

Metastasized breast cancer is still incurable. However, improvements in both efficacy and tolerability of systemic cytotoxic therapy led to prolongation of treatment with consecutive improvement of survival. While previous response to chemotherapy is an established predictive factor for expected efficacy of cytotoxic agents in the metastatic setting, the early use of 'new' effective drugs, like taxanes, may compromise the physician's choice of substances. The evaluation of patient compliance before therapy is essential as well as an assessment of the potential representative parameters (lead metastases, tumor markers, symptoms) which help to objectify the treatment effects. In general, due to the incurable situation of metastatic breast cancer, treatment effects and their benefits have to be weighed against toxicity since good quality of life is the major goal in management of this stage of disease.