Block sequential adriamycin CMF – optimal non-myeloablative chemotherapy for high risk adjuvant breast cancer?

Cameron, David; Anderson, A.; Toy, Elizabeth; Evans, T.R. Jeffry; Vay, J H Le; Kennedy, Ian; Grieve, Robert; Perren, Timothy J.; Jones, Andrew; Mansi, Janine; Crown, John; Leonard, Robert

doi:10.1038/sj.bjc.6600660

Cited by 5 publications

(2 citation statements)

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“…It was noted in that study that there was a strong tendency for the older patients to be undertreated, and in a subsequent study from the same group, looking at alternating CMF and adriamycin, it is clear that older women had a poorer outcome than younger women on the same regimen (Bonadonna et al, 1995b). Interestingly, in a recent audit of over 300 patients treated with that same adriamycin-CMF regimen in 11 centres in UK, Ireland and New Zealand, there was no difference in outcome for older patients (Cameron et al, 2002). These data, together with the observation from the meta-analysis that the benefit of adjuvant chemotherapy appears to diminish with increasing age, led us to hypothesise that it may be a failure to deliver drug dose and/or dose intensity in the older adjuvant breast cancer patient that results in its apparent reduced efficacy.…”

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confidence: 98%

Moderate neutropenia with adjuvant CMF confers improved survival in early breast cancer

et al. 2003

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Despite the extensive literature clearly demonstrating the survival benefit for adjuvant chemotherapy in women with operable breast cancer, there are few data confirming this in routine practice. Some studies have suggested that not all women gain to the same extent, with older women showing a smaller benefit and lower doses achieving poorer outcomes. We therefore reviewed the case notes of 750 women treated over a 15-year period at The Edinburgh Cancer Centre with the same intravenous CMF (cyclophosphamide, methotrexate and 5-fluorouracil) regimen, to identify patient-and treatment-related factors influencing outcome in routine practice.The actuarial 10-year survival for these women was 59.3%, with the anticipated poorer outcome for those with more involved ipsilateral axillary nodes, higher grade and ER-negative tumours. There was no evidence that a lower delivered dose intensity or older age at presentation resulted in a poorer survival. Of particular interest was the observation that 45% of patients who had grade 2/3 neutropenia had a 10% absolute survival advantage over those with no neutropenia (Po0.001). This strongly suggests that some degree of neutropenia has more influence on outcome than age or delivered dose intensity.

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Moderate neutropenia with adjuvant CMF confers improved survival in early breast cancer

et al. 2003

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“…Regulation and disturbance of the cancer cell cycle is a therapeutic target for development of new anticancer drugs. [ 14 ] Apoptosis has been defined as counterbalance for cell proliferation in maintaining normal tissue homeostasis. [ 15 ] In this study, it could be found that n-butyl-β-D-fructofuranoside was likely to suppress the Bel-7402 cells not only by interfering the cell cycle but also by inducing apoptosis.…”

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Antiproliferative effects of n-butyl-β-D-fructofuranoside from Kangaisan on Bel-7402 cells

Lou

et al. 2014

Indian J Pharmacol

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Aims:Kangaisan is a powdered compound prescription of Traditional Chinese Medicine which has been used in cancers for many years in Hubei province, China. The purpose of this study was to investigate the antitumor effects of Kangaisan and screen bioactive components.Materials and Methods:3-(4,5-Dimethythiazol-2-yl)-2,5 diphenyl-tetrazolium bromide (MTT) assay, flow cytometry, DNA (Deoxyribonucleic acid) fragmentation assay, Western blot, and real time-polymerase chain reaction were used to investigate the antiproliferation effect of n-butyl-β-D-fructofuranoside on Bel-7402 cells.Statistical Analysis:All experiments were performed in triplicate and the results were expressed as mean ± standard deviation. Statistical analysis was performed with analysis of variance using Origin 8.0 software.Results:It was illustrated that treatment of Bel-7402 cells with various concentrations of n-butyl-β-D-fructofuranoside resulted in growth inhibition in both a dose-dependent and time-dependent manner. The arrest of G0/G1 phase was also induced (P < 0.05). The increasing of sub-G1 cell population indicated the apoplectic characteristic (P < 0.05). Furthermore, the emerging of DNA fragmentation and the increase of Bax/Bcl-2 ratio and p53 expression suggested the possible mitochondrial apoptotic pathway (P < 0.05).Conclusions:The results illustrate that Kangaisan showed anticancer effects and n-butyl-β-D-fructofuranoside extracted from Kangaisan can suppress Bel-7402 cells via interfering cell cycle and by inducing apoptosis.

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Meeting Highlights: International Expert Consensus on the Primary Therapy of Early Breast Cancer 2005

et al. 2005

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The ninth St Gallen (Switzerland) expert consensus meeting in January 2005 made a fundamental change in the algorithm for selection of adjuvant systemic therapy for early breast cancer. Rather than the earlier approach commencing with risk assessment, the Panel affirmed that the first consideration was endocrine responsiveness. Three categories were acknowledged: endocrine responsive, endocrine non-responsive and tumors of uncertain endocrine responsiveness. The three categories were further divided according to menopausal status. Only then did the Panel divide patients into low-, intermediate- and high-risk categories. It agreed that axillary lymph node involvement did not automatically define high risk. Intermediate risk included both node-negative disease (if some features of the primary tumor indicated elevated risk) and patients with one to three involved lymph nodes without additional high-risk features such as HER 2/neu gene overexpression. The Panel recommended that patients be offered chemotherapy for endocrine non-responsive disease; endocrine therapy as the primary therapy for endocrine responsive disease, adding chemotherapy for some intermediate- and all high-risk groups in this category; and both chemotherapy and endocrine therapy for all patients in the uncertain endocrine response category except those in the low-risk group.

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Block sequential adriamycin CMF – optimal non-myeloablative chemotherapy for high risk adjuvant breast cancer?

Cited by 5 publications

References 8 publications

Moderate neutropenia with adjuvant CMF confers improved survival in early breast cancer

Moderate neutropenia with adjuvant CMF confers improved survival in early breast cancer

Antiproliferative effects of n-butyl-β-D-fructofuranoside from Kangaisan on Bel-7402 cells

Meeting Highlights: International Expert Consensus on the Primary Therapy of Early Breast Cancer 2005

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