Important unanswered questions about the use of chemotherapy in advanced breast cancer are outlined below:
- What is the optimal duration of chemotherapy, especially when combined with targeted therapy?
- How would clinical outcomes improve by individualising chemotherapy according to laboratory measures of tumour sensitivity?
- What is the significance of changes in tumour markers and genetic profiling for use of chemotherapy?
- What is the optimal duration of targeted therapy when combined with chemotherapy?
- What evidence is available from clinical trials for treatment of metastatic breast cancer beyond the first-line setting?
- What are the quality of life and symptom control issues associated with the use of chemotherapy?
- How could chemotherapy be used in association with endocrine therapies and supportive therapies?
- When disease progresses, when should targeted therapies be discontinued?