Fifteen randomised controlled trials were included in the review: eight studies of breast cancer (early-stage breast cancer 3,453 participants and advanced breast cancer 377 participants), four studies of non-Hodgkin lymphoma (2,001 participants) and three studies of patients with non-small cell lung cancer (333 participants).
Early or node-positive breast cancer: One of four trials that evaluated overall survival reported statistically significant benefits at four years with dose-dense treatment (RR 0.69, 95% CI 0.50 to 0.93; 2,005 participants). One trial (150 participants) assessed progression-free survival but no differences between standard and dose-dense regimens were found. There were no differences in response rates between regimens in two trials.
Advanced or metastatic cancer: No differences were observed in overall survival (three trials) or progression-free survival (three trials) between dose-dense treatment groups and standard treatment groups. Two of four trials (256 participants) that reported response rates found significantly higher complete response rates with dose-dense treatment schedules.
Non-Hodgkin lymphoma: Two of four trials that evaluated overall survival found significant benefits with dose-dense schedules compared to standard treatment schedules (1,697 participants). All four trials provided data on response rates that generally favoured dose-dense schedules, although significant benefits in complete response were found in one trial (831 participants).
Non-small cell lung cancer: One trial (100 participants) showed improved median survival (57 weeks compared to 37.7 weeks, p=0.036) and improved median progression-free survival (23.7 compared to 13.9 weeks) with dose-dense treatment. Rates of complete responses were low in all the trials and no differences in complete or partial response were observed.