Clinical cooperative trials of the national cancer institute of Canada clinical trials group breast cancer site group

Abstract

For more than 10 years, the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) Breast Cancer Site Group has focused primarily on trials of adjuvant therapy and of investigational new drugs (JND). Four trials of adjuvant therapy in node‐positive women have been completed, are active, or are about to begin. Investigational new drug (IND) studies have included Phase II trials of intravenous and oral menagaril, 10‐EDAM (eda‐trexate), taxotere, and mifepristone (RU‐486) as well as a Phase 1/11 trial of 5‐fluorouracil (5‐FU), doxorubicin, and vinorelbine (FAN): a Phase 1/11 trial of 5‐FU, leucovorin, doxorubicin, and vinorelbine (super‐FAN), all as first‐line therapy for metastatic disease; and a Phase III study of vinorelbine plus doxorubicin versus doxorubicin alone as first‐ or second‐line metastatic therapy. A proposed study with the European Organization for Research and Treatment of Cancer in locally advanced breast cancer will compare a standard NCIC CTG regimen of cyclophosphamide, epirubicin, and 5‐FU (CEF) with epirubicin and cyclophosphamide granulocyte colony‐stimulating factor (G‐CSF), a more dose‐intensive regimen. In addition, NCIC CTG is preparing a pilot of CEF with G‐CSF to examine whether a substantially more intensive dosage can be given without added toxicity. NCIC CTG will also enter patients into a currently active Cancer and Leukemia Group B/Southwest Oncology Group randomized trial of intensive therapy versus more intensive therapy with bone marrow support in women younger than age 60 with 10 or more positive nodes. It is believed that optimizing the combination and timing of adjuvant hormonal and chemotherapy, exploring dose intensive approaches, developing investigational new drugs, studying the role of biologics, and tumor banking in conjunction with clinical trials remain important approaches for the future.

Efficacy and Safety of Oral Anticoagulation in Patients with Cancer

“…Venous thromboembolism is a frequent complication in patients with cancer and can even precede the diagnosis of cancerby months or years (1). The pathogenetic mechanisms arc complex and multifactorial but certain risk factors such as treatment with chemotherapy (2,3) and surgery appear to increase the risk of venous thrombosis. Prophylaxis with low molecular weight heparin (4) or sodium warfarin (5) can reduce the risk of venous thrombosis in certain clinical sihrations.…”