Increasing the dose intensity of chemotherapy by more frequent administration or sequential scheduling: a patient-level meta-analysis of 37 298 women with early breast cancer in 26 randomised trials.

The proportional reductions in recurrence with dose-intense chemotherapy were similar and highly significant (p<0·0001) in oestrogen receptor (ER)-positive and ER-negative disease and did not differ significantly by other patient or tumour characteristics.

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There was borderline significant (p=0·012) heterogeneity between results of the 26 trials for recurrence ( figure 1 ).

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Unexpectedly, the 10-year risk of death without recurrence appeared to be somewhat lower in the dose-intense arms than in the standard-schedule arms (4·1% vs 4·6%; figure 4C ), although this difference was only of borderline significance (RR 0·88, 95% CI 0·78–0·99; p=0·034).

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