A comparison of continuation versus late intensification followed by discontinuation of chemotherapy in advanced breast cancer. A prospective randomized trial of the Italian Oncology Group for Clinical Research (G.O.I.R.C.)

Cocconi, Giorgio; Bisagni, Giancarlo; Bacchi, M.; Buzzi, Franco; Canaletti, R; Carpi, A.; Ceci, Guido; Colozza, A.; Lisi, Vincenzo De; Lottici, Renata; Passalacqua, Rodolfo; Peracchia, Giuseppe

doi:10.1093/oxfordjournals.annonc.a057671

Cited by 22 publications

(3 citation statements)

References 19 publications

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“…Time to progression was statistically signi cantly better in 4 studies using continuous therapy:increased number of courses (154,193,194,196). Furthermore, in the Italian study, intensi cation therapy and immediate switch to an anthracycline -CMF rotating regimen for six more courses (46 evaluable patients) was not signi cantly better than continuous CMF (49 evaluable patients) therapy followed by an anthracycline as second line therapy, as regards time to progression (p ¾ 0.47) and survival (p¾ 0.55) (131). In the small British study of only 43 patients no difference could be detected (195).…”

Section: Duration Of Therapymentioning

confidence: 93%

A Systematic Overview of Chemotherapy Effects in Breast Cancer

Bergh¹,

Jönsson²,

Glimelius³

et al. 2001

Acta Oncologica

150

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A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scientific literature are described separately (Acta Oncol 2001; 40: 155-65). This synthesis of the literature on chemotherapy for breast cancer is based on 233 randomised studies, 9 meta-analysis of randomised studies, a population-based cohort study and 18 overviews/retrospective analyses including a total of 155,243 patients. The conclusions reached can be summarised into the following points: Adjuvant treatment-- There is solid scientific support from randomised studies that adjuvant polychemotherapy at 10 years will result in an absolute mortality reduction for patients younger than 50 years by 12% for node positive (34% relative mortality reduction corresponding to an estimated median survival prolongation of several years) and 6% for node negative patients. For women aged 50 to 69 years, the corresponding figures for node positive and node negative patients are 6% and 2%, respectively (approximately 11% relative mortality reduction). Anthracycline-containing combinations result in an absolute survival benefit at five years of 3%, compared with non-anthracycline based polychemotherapy. There are indications that the taxane paclitaxel may further improve the survival compared with anthracyclines. However, the limited data preclude conclusions for the routine care. The addition of tamoxifen to chemotherapy further enhances the survival benefit for receptor positive subgroups. The roles of more dose-intensive regimens, including high-dose therapy with stem cell support, are presently studied in randomised investigations. The data presented so far are conflicting but they do not in general support high-dose therapy. Quality of life, based on analyses of randomised studies, demonstrate that adjuvant polychemotherapy has an initial detrimental effect, but long-term follow-up of treated patients demonstrates no impairment of quality of life compared with untreated patients. Polychemotherapy in standard doses should be offered to premenopausal node positive patients, and the corresponding postmenopausal group with a receptor-negative breast cancer and to node negative patients with high risk factors. Polychemotherapy should be combined with tamoxifen to all patients with receptor-positive tumours. Due to a need of more knowledge in this field, patients should be included in investigational protocols. Locally advanced breast cancer-- Based on current knowledge, treatment of patients with locally advanced breast cancer should include neoadjuvant/preoperative polychemotherapy since there is evidence from controlled studies that such therapy will statistically significantly increase the number of patients who can be offered breast-conserving surgery. Indirect comparisons also demonstrate survival improvements, but the scientific support is equivocal. Metastatic breast cancer-- The median survival for patients with metastatic disea...

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Section: Duration Of Therapymentioning

confidence: 93%

A Systematic Overview of Chemotherapy Effects in Breast Cancer

Bergh¹,

Jönsson²,

Glimelius³

et al. 2001

Acta Oncologica

150

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“…The CMFEV regimen used in the current trial is an innovative schedule aimed at administering five partially or totally noncross‐resistant cytotoxic agents, first designed and tested by our group as a means of late intensification after CMF in metastatic disease,14 and whose rotational strategy is different from that of alternating or sequential schemes. All five agents are administered at full dose, but, to avoid excessive toxicity and consequent dose reductions, each cycle involves the administration of only four drugs, always including vincristine, and is organized in such a way that only three among the four potentially myelotoxic drugs (C, M, F, E) are rotatively included (CMFV, CMEV, CFEV, MFEV); the planned dosages of C, M, F, and E in each cycle were therefore either 100% or 0%.…”

Section: Discussionmentioning

confidence: 99%

Preparation of soluble poly(amide imide) derivatives with metal salts and phosphorous compounds

Jeon¹

2002

J of Applied Polymer Sci

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Soluble poly(amide imide) derivatives were prepared through the direct polycondensation of 1,2,4-benzenetricarboxylic acid and three diamines-bis[4-(3-aminophenoxy)phenyl]sulfone, bis(4-aminophenyl)-1,4-diisopropylbenzene, and 4,4Ј-oxydianilne-in the presence of metal salts and phosphorous compounds. Phosphonium salt, which was used as the initiating species and was prepared by the reaction of the metal salts and phosphorous compounds, reacted with 1,2,4-benzenetricarboxylic acid to form acyloxy phosphonium salt, and then the salt was reacted with a diamine for the preparation of the prepolymers. The prepolymers were converted into the corresponding poly(amide imide)s in a homogeneous solution state at 180°C. The poly(amide imide)s showed good thermal and mechanical properties. Glass-transition temperatures were observed from 240 to 270°C in differential scanning calorimetry traces. A melting endotherm was not observed for the polymers with differential scanning calorimetry. The initial decomposition occurred around 400°C according to thermogravimetric analysis, and major weight loss was observed from 610 to 680°C. The poly(amide imide)s had comparatively good solubility in aprotic polar solvents at concentrations high enough (ϳ30%) for the fabrication of various forms.

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“…It was first designed and tested by our Group as a means of late intensification after CMF in metastatic breast carcinoma [9] and then in the neoadjuvant setting of operable breast carcinoma [10,11]. Its rotational strategy is different from that of alternating or sequential schemes as the five agents are administered at full dose but, in order to avoid excessive toxicity and consequent dose reductions, each cycle involves the administration of only four drugs, always including vincristine (V) and epirubicin (E).…”

Section: Introductionmentioning

confidence: 99%