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The panel noted that the aim of any metastatic breast cancer treatment is to improve overall survival (OS) or to improve quality of life (QoL). Progression free survival (PFS) has been used as the primary end point in many cancer trials. However, this outcome measure is only valid if it is shown to be a surrogate for improved survival or QoL. The AVADO and RIBBON I studies showed no significant improvement in OS, no improvement in QoL, slight improvement in PFS, and increased side effects. These side effects are tolerable in most patients and are comparable to other anti-cancer drugs.
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