Cyclophosphamide, Adriamycin and Platinum (CAP) Combination Chemotherapy, A New Effective Approach in the Treatment of Disseminated Breast Cancer. Preliminary Report

Abstract

The prospective controlled Phase III clinical trial tested the therapeutic value of the cis-platinum-adriamycin-cyclophosphamide combination (CAP), compared with the combination including cyclophosphamide, methotrexate, 5-fluorouracil, vincristine and prednisolone (CMFVP), in untreated metastatic breast cancer. One hundred and twenty-three patients (greater than 2 cycles) were evaluated: 61 on the CAP, and 62 on the CMFVP schedule. An objective response (CR + PR) to CAP combination chemotherapy was achieved in 72% of patients (43/61), with a high rate (36%) of complete remissions. In terms of metastatic site, the response rate appeared to be particularly high in soft tissue and visceral organ (lung, liver) metastases. In the CMFVP group, an objective response was noted in 26 of 62 patients (42%), with 16% complete remissions. The difference in overall therapeutic response - and in the complete remission rate as well - was statistically significant to the advantage of the CAP regimen (P less than 0.01). The duration of remissions was 6-28 + months (means = 14) for the CAP, and 4-15 + months (mean = 9) for the CMFVP schedule. Toxic side effects were more pronounced in the CAP group, particularly myelosuppression, with anemia prevailing. Side effects of CMFVP treatment were moderate. In 39 CMFVP previously treated cases, CAP was administered as second-line treatment, and an objective response was observed in 51% of cases (20/39). Results of this controlled trial showed the advantage of the CAP combination chemotherapy in the treatment of metastatic breast cancer.

Do old drugs still have a place in cancer treatment?

“…Cependant, quelques études ont montré une efficacité notable en première ligne de traitement, parfois supérieure aux traitements de référence. Ainsi, dans une étude publiée en 1985 [10], il était montré que l'association CDDP/Doxo/CPM chez des patientes métastatiques en 1 re ligne de traitement donnait un taux de RO de 72 % dont la moitié en état de RC. Avec une durée moyenne de durée de la réponse de 14 mois (6 à 28).…”

Cisplatin and 5-fluorouracil in refractory breast cancer patients: A phase II study

“…Phase II studies of CDDP alone in pretreated patients have shown conflicting results: some authors failed to demonstrate activity of CDDP therapy [1], while others observed a response rate ranging from 12 to 20% [2][3][4]. More interesting results were obtained in untreated patients, both with CDDP alone [5,6], and in combination therapy [7].…”