Cyclical Combination Chemotherapy for Advanced Breast Carcinoma

Abstract

SummaryTwenty-five patients with advanced metastatic breast cancer were treated with the combination of methotrexate 60 mg/M2 and 5-fluorouracil 700 mg/M2 intravenously on the first and eighth days, and cyclophosphamide 100 mg/M2 and prednisone 40 mg/M2 by mouth daily for the first 14 days of a 28-day cycle. The patients had had no previous chemotherapy or extensive radiotherapy and all but two had not responded to hormonal therapy or endocrine ablation. The major metastatic lesions were: lung (12 patients), liver (four patients), bone (four patients), soft tissue (three patients), nodes (two patients). Seventeen of the 25 patients (68oo) responded to treatment with seven complete remissions; these included patients suffering metastatic lesions in the lung, nodes, and soft tissue. The overall median duration of response was nine months (range 6-26 months). Toxicity was primarily haematological, but the group received an average of at least 75% of their calculated dose for each monthly cycle. Haematological toxicity was most pronounced in patients with liver dysfunction and bone marrow involvement. Out of eight nonresponders seven died, with a median survival of six months. Only six of 17 responders died, and the median survival in this group will exceed thirteen months. There was no correlation between the length of the metastasis-free interval after previous treatment and subsequent response to chemotherapy.

Palliative chemotherapy with CMF after the same adjuvant regimen for breast cancer

“…The median duration of objective remissions in our study was 9.5 (range 5-21) months and com pares well with that given for palliative CMF chemotherapy in general [9][10][11][12], There were no statistically significant differ ences in remission rates in different catagories of patients according to the predominant localisa tion of disease, ER-status and menopausal status. However, the subgroups of patients were small.…”

“…Remission rates for CMF in chemotherapy naive patients are reported as 45-53% in litera ture data between 1976 and 1991, covering our w observation time [9][10][11][12].…”

Evolution of systemic treatment for hormone-sensitive breast cancer: from sequential use of single agents to the upfront administration of drug combinations

“…К со-жалению, подобные эффекты почти всегда носили неполный и непродолжительный характер [7,8]. Пер-вые послевоенные десятилетия были отмечены разра-боткой нескольких цитостатических препаратов, показавших многообещающие результаты при лечении РМЖ; опять же, в подавляющем большинстве случаев выраженность ответа опухоли на лечение была уме-ренной, при этом комбинирование нескольких цито-статиков зачастую приводило к значительному увели-чению эффектов [9]. Неудивительно, что сразу после появления лекарственных способов эндокринной абляции опухоли, в частности тамоксифена [10], поя-вились ожидания, что сочетанное назначение антаго-ниста ER и химиопрепаратов приведет к многократ-ному усилению противоопухолевого воздействия.…”

2nd Gordon Hamilton Fairley Lecture

“…Schabel, 1975) that the whole tumour burden, including micrometastases, is reduced progressively by chemotherapy according to first-order kinetics, describes well the responses of some transplanted tumours, and has provided a satisfactory explanation for the treatment protocols which have proved so successful in the cure of a substantial proportion of children with acute lymphoblastic leukaemia (ALL) who require long periods of maintenance treatment after complete remission has been achieved. (Lister et al, 1981 (Canellos et al, 1974). These findings suggest that clinically evident disease can respond better to antiproliferative chemotherapy than residual disease.…”