Breast cancer

Updated 20 November 2017

Low-dose chemo may keep breast cancer under control

Using lower amounts of medication may work better to keep tumours under control than bombarding breast cancer cells with large doses of chemotherapy.

Rather than try to wipe out cancer with powerful doses of chemotherapy, researchers said Wednesday an experimental approach using lower amounts of medication may work better to keep tumours under control.

Toxic effects

The study was done on mice with breast cancer, according to the report in Science Translational Medicine, and is part of a growing movement in oncology to explore alternatives to high-dose chemo and its often toxic side effects.

"Our results suggest that this adaptive therapeutic strategy... can result in prolonged progression-free survival in breast cancer," said the study, authored by Pedro Enriquez-Navas and colleagues at the H. Lee Moffitt Cancer Centre and Research Institute in Tampa, Florida.

Read: Nipple-sparing mastectomy as good as full surgery

Some researchers question the use of standard chemotherapy because it rarely wipes out cancer entirely, and leaves behind drug-resistant cells that can take over and lead to an explosion in tumour growth.

The new approach delivers continuous low-dose chemotherapy – in this case paclitaxel – that stabilises the tumour by "maintaining a small population of drug-sensitive tumour cells to suppress the growth of resistant cells," said the study.

Standard doses of paclitaxel in mice shrunk breast tumours, but these tumours grew back once the treatment ended.

Read: Breast self-examination

"Another treatment regimen that skips doses whenever the tumour shrinks also inevitably resulted in tumour progression," said the study.

"In contrast, adaptive therapy consisting of high initial drug doses followed by progressively lower doses as the tumour responded was more effective in controlling tumour growth than either standard therapy or dose skipping."

Read: New breast cancer drug shows 'unprecedented' results

The study found that 60 to 80 percent of the mice treated by adaptive therapy could be "weaned off the drug completely without relapsing for an extended period of time".

More research is needed before the approach can be recommended for use in people. However, the research offers "a very good possibility for future therapies", Giannoula Klement, of the Tufts University School of Medicine in Boston, wrote in an accompanying editorial.

"More and more oncologists are engaging some version of this approach." 

Read more: 

What is breast cancer? 

Symptoms of breast cancer  

Preventing breast cancer  


Ask the Expert

Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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