What are the outcomes of the patients that have ceased chemotherapy at five cycles due to toxicity?

Pinkie Chambers, University College London

Chemotherapy is commonly given into the vein every 2-3 weeks.  The time interval between treatments allows a patients’ body time to recover from side effects.  Usually a patient with breast or ovarian cancer will be given 6 treatments of chemotherapy.  However, sometimes when side effects are getting worse over time, doctors will stop chemotherapy early. This means that the patient will not receive their 6th treatment.  This decision is taken very seriously but some doctors and patients worry that this decision to stop treatment might lead to a cancer returning because it is not treated well enough.  Understanding if stopping that 6th treatment causes a higher chance of a cancer returning (progression) will help communication and understanding for patients and may change the way we treat patients in the future. 

The NHS collects data on the use of chemotherapy nationally.  We aim to use this data to study patients that have had dose reductions or stopped treatment early and how this affects the time period to the cancer returning.  We also can look at the numbers of patients that this happens to around the country to see if there are regional differences. 

When we have our results, we will work with patients, nurses pharmacists and doctors to decide whether changes need to be made to the way we currently give chemotherapy, manage side effects early and the communication we give to patients. This study will have an impact on the NHS and patients.  We understand from our discussions that stopping treatment early can both be stressful and a relief.  When a patient has a cancer progression they will often be given more cancer treatment that can cause more side effects, be more costly to the NHS and be more distressing for themselves and their families. 

Final report available here.