Current treatment of locally advanced and metastatic breast cancer in the Asia-Pacific region: Challenges and limitations

Abstract

Over the past decade, the management of breast cancer has improved substantially with advances in understanding the tumor biology and the introduction of several new, more effective agents. As a result, the performance of breast-conservation surgery has increased, and the use of neoadjuvant therapy to downstage locally advanced breast cancer has become more common in the Asia-Pacific region. For patients with metastatic breast cancer, treatment typically follows Western clinical experience, but the use of specific drugs and regimens is variable throughout the region. Anthracycline-based and/or taxane-based regimens are commonly used for the first-line treatment of locally advanced and metastatic breast cancer. However, a number of challenges and barriers have emerged that are unique to the treatment of patients with breast cancer in the Asia-Pacific region. These include differences in the safety and tolerability profiles of standard chemotherapeutic agents between Asian-Pacific and Western women; the variable availability of, and cost of anticancer agents; the high prevalence of Chinese herbal medicines and alternative therapies used by women with breast cancer, and the prohibitive costs of conducting clinical trials in some countries in the region. © 2008 The Authors Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.