Adjuvant chemotherapy

This is treatment that is given after local treatment of a primary tumour when no metastatic disease is apparent after careful staging, but where there is known to be high incidence of relapse. This relapse is presumed to be due to micrometastases.

For example:

• adjuvant therapy for breast cancer is any treatment given after primary therapy to increase the chance of long-term disease-free survival
  • adjuvant therapy for breast cancer can include chemotherapy, hormonal therapy, the targeted drug trastuzumab (Herceptin®), radiation therapy, or a combination of treatments.
  • primary therapy is the main treatment used to reduce or eliminate the cancer
  • a well-known example of adjuvant chemotherapy is that has been used for women with stage II (axillary node positive) breast cancer in premenopausal women
    • in this sub-group of patients, at least 65% develop metastatic disease, which is incurable. However if this sub-group is given chemotherapy with CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) then the relapse rate is decreased, and there is a reduction is mortality by approximately 20% (1)

Reference:

• Brada M, Robinson MH. Medicine International 1991; 92:3834-8.