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Annals of Oncology Advance Access originally published online on November 15, 2007
Annals of Oncology 2008 19(2):212-222; doi:10.1093/annonc/mdm285
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© 2007 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

reviews

Effective oral chemotherapy for breast cancer: pillars of strength

M. Findlay1,*, G. von Minckwitz2 and A. Wardley3

1 Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
2 German Breast Group, Neu-Isenburg/Frankfurt, Germany
3 Christie Hospital and South Manchester University Hospital, Manchester, UK

* Correspondence to: Prof. M. Findlay, Professor of Oncology/Director of Cancer Trials New Zealand, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. Tel: +64 9 373 7599 ext 82005/84927; Fax: +64 9 373 7927; E-mail: mp.findlay{at}auckland.ac.nz

Traditionally, anticancer therapy has been dominated by intravenous drug therapy. However, oral agents provide an attractive approach to chemotherapy and use of oral treatments is increasing. We discuss the benefits and challenges of oral chemotherapy from the perspectives of patients, healthcare providers and healthcare funders. Important issues include patient preference, efficacy, compliance, bioavailability, reimbursement, use in special patient populations, financial and staff time savings and flexibility of dosing. We review data for traditional oral agents (e.g. cyclophosphamide, methotrexate), newer oral chemotherapies (e.g. capecitabine), oral formulations of traditionally intravenous agents (e.g. vinorelbine, idarubicin) and new biologic agents under evaluation in breast cancer (e.g. tyrosine kinase inhibitors). Lastly, we review studies of all-oral combination regimens. The wealth of data available and the increasing use of oral agents in breast cancer suggest that many of the concerns and perceptions about oral therapy, including efficacy and bioavailability, have been overcome, and that oral therapy will play a major role in breast cancer management in the future in both the metastatic and adjuvant settings.

Key words: breast cancer, capecitabine, oral chemotherapy, vinorelbine

Received for publication December 14, 2006. Revision received May 14, 2007. Accepted for publication May 15, 2007.


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