These observations have been used as a rationale for a series of induction-maintenance clinical trials, in which patients are initially treated with more potent regimens and then later switched to a better tolerated, less potent regimen.
Neoadjuvant chemotherapy (NAC) with taxanes followed by fluorouracil, epirubicin, and cyclophosphamide (FEC), and concurrent trastuzumab is a potent regimen for HER2 over-expressing breast cancer.
aResulting in an intensification of the immunosuppressive therapy (> 50mg prednisone-equivalent added, or switch of the therapy regimen to a more potent regimen, such as cyclophosphamide).
The majority of patients who relapsed after initial high-risk treatment in this series received EP/EMA, which has previously been shown to be a potent regimen in GTN (Newlands et al, 2000).
Also, peptides 9, 15, 55, 151, and 164 induced weaker, but definite, positive vaccine-elicited responses (Fig. 2C), which may not have been detected using a less potent regimen (10, 22).
Maintenance treatment: a standard and potent regimen with highly toxic drugs is discontinued and replaced by a less potent maintenance regimen with less toxic drugs, which usually comprises a first-line drug and another drug or targeted agent with no cross-resistance to first-line treatment.
