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Cohort analysis demonstrates reduced survival in early breast cancer patients with high body surface area due to dose capping, suggesting a need for guideline reevaluation.
In this cohort with consistent dose capping at BSA 2.0 m², patients with high BSA represent an at-risk population with reduced chemotherapy intensity, inferior survival, but good treatment tolerability. Lower rates of blood and lymphatic system disorders and gastrointestinal disorders and fewer dose reductions suggest these patients may have tolerated full weight-based doses. While the contributions of obesity-related prognostic factors and potential underdosing could not be separated, these findings support ASCO guideline recommendations against routine dose capping in curative settings.
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Englisch et al. (2026) studied this question.
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