• Phase III study of 4,894 patients showed that the addition of G to DD AC → P did not improve outcomes; no significant differences in efficacy between DD AC → P and TAC.
• Toxicity: DD: neuropathy and anemia; TAC: diarrhea, febrile neutropenia.

On a blustery winter morning in 2001, I found myself sitting in the office of Memorial’s Dr Larry Norton preparing to interview him about the soon-to-be-presented CALGB-9741 adjuvant trial evaluating dose-dense (DD) chemotherapy, and during our chat Dr Norton described in detail the mathematical calculations related to cell kill and dose that were the underpinnings of DD treatment. More than a decade later, while this adjuvant treatment is perhaps the most commonly used anthracycline/taxane regimen in practice, the underlying tumor biology is still being debated. In fact, many oncologists currently use weekly rather than q2wk DD paclitaxel with growth factors with likely the same effect. This raises the question of whether the benefit seen in CALGB-9741 was the result of complex mathematics or basic pharmacology. Unfortunately, by the time Dr Sandra Swain presented B-38, much of the interest in it had given way to other paradigms and hypotheses. In the end, both regimens demonstrated about the same efficacy and tolerability and are now considered acceptable options.