ArticleCancer2026
Initial chemotherapy dose reductions and subsequent treatment delivery in stage I-IIIA breast cancer.
Article in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Interactions of ACEA and WIN 55,212-2 mesylate with temozolomide and cisplatin in neuroblastoma and glioblastoma cell lines: an isobolographic analysis.Pharmacological reports : PR · 2026Article
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Authors and funding
25 authors.
Funding
Abstract
backgroundFor most cytotoxic drugs, guidelines recommend body-surface-area-based dosing, yet some patients start with reduced doses, potentially reflecting tolerability concerns. The relationship between first-cycle dose reductions and subsequent delivery is unclear.
methodsThe authors analyzed data from women with stage I-IIIA breast cancer treated with adjuvant chemotherapy. Sankey diagrams illustrated trajectories from first-cycle dose proportion (FCDP) to average relative dose intensity (ARDI, ratio of received to expected dose intensity across the regimen), and cumulative dose proportion (CDP, ratio of total received to expected dose). Poisson regression estimated adjusted prevalence ratios for reduced FCDP (<95% vs. ≥95%) and three outcomes: ARDI reduction beyond initial FCDP, receiving fewer cycles, and CDP reduction beyond initial FCDP. Analyses assessed effect modification by age, body mass index (BMI), and comorbidities. Dosing was analyzed for cytotoxic and HER2-targeted therapy.
resultsA total of 8772 (90.8%) patients started with FCDP ≥95%; most maintained ARDI ≥95% (65.1%) and CDP ≥95% (79.9%). In multi-variable models, FCDP <95% was not significantly associated with further ARDI or CDP reductions or receipt of fewer cycles. BMI modified these associations (p-interaction = .004 for fewer cycles; p-interaction = .03 for CDP), with positive associations among overweight but not obese or normal-weight patients. FCDP <95% was linked to a lower likelihood of further ARDI reductions for both therapy types and lower likelihood of cumulative dose reduction in HER2-targeted therapy.
conclusionsEarly dosing decisions shaped subsequent chemotherapy delivery. Most patients who began at full dose maintained consistent dosing, whereas early reductions did not stave off subsequent changes, underscoring the need to balance safety with adequate dose intensity.
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