Abstract
Weekly chemotherapy with cyclophosphamide 80 mg m-2 day-1 p.o. continuously, methotrexate 35 mg m-2 week-1 i.v., 5-fluorouracil 500 mg m-2 week-1 i.v., vincristine 1.4 mg m-2 i.v. every two weeks and prednisolone 20 mg m-2 day-1 p.o. continuously (CMFVP) was prospectively studied in 45 previously untreated outpatients with advanced breast cancer to determine the feasibility of delivering a dose-intense regimen. Of 40 evaluable patients, complete response (CR) occurred in one patient, partial response (PR) in 20 (CR + PR 53%), stable in eight, progression in 11 and five were unevaluable for response. The median relapse-free survival for responders was 25 weeks and median survival for all patients was 31 weeks. The mean dose intensity relative to the Cooper regimen fell from 1.02 to 0.6 within the first 4 weeks of treatment and the median dose intensity achieved for all patients on study was only 0.52. Eighty-seven per cent of patients had treatment delays with a mean of 3.9 delays per patient and 71% had dose reductions. Neutropenia was the major toxicity with WHO grade 3 or 4 neutropenia (less than 1.0 x 10(9) l-1) in 62% of patients and three septic deaths while neutropenic. Dose-intense weekly CMFVP in this schedule cannot be delivered to previously untreated outpatients with advanced breast cancer.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Coates A., Gebski V., Bishop J. F., Jeal P. N., Woods R. L., Snyder R., Tattersall M. H., Byrne M., Harvey V., Gill G. Improving the quality of life during chemotherapy for advanced breast cancer. A comparison of intermittent and continuous treatment strategies. N Engl J Med. 1987 Dec 10;317(24):1490–1495. doi: 10.1056/NEJM198712103172402. [DOI] [PubMed] [Google Scholar]
- Cooper R. G., Holland J. F., Glidewell O. Adjuvant chemotherapy of breast cancer. Cancer. 1979 Sep;44(3):793–798. doi: 10.1002/1097-0142(197909)44:3<793::aid-cncr2820440302>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
- Eder J. P., Antman K., Peters W., Henner W. D., Elias A., Shea T., Schryber S., Andersen J., Come S., Schnipper L. High-dose combination alkylating agent chemotherapy with autologous bone marrow support for metastatic breast cancer. J Clin Oncol. 1986 Nov;4(11):1592–1597. doi: 10.1200/JCO.1986.4.11.1592. [DOI] [PubMed] [Google Scholar]
- Hortobagyi G. N., Buzdar A. U., Bodey G. P., Kau S., Rodriguez V., Legha S. S., Yap H. Y., Blumenschein G. R. High-dose induction chemotherapy of metastatic breast cancer in protected environment: a prospective randomized study. J Clin Oncol. 1987 Feb;5(2):178–184. doi: 10.1200/JCO.1987.5.2.178. [DOI] [PubMed] [Google Scholar]
- Hryniuk W., Bush H. The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol. 1984 Nov;2(11):1281–1288. doi: 10.1200/JCO.1984.2.11.1281. [DOI] [PubMed] [Google Scholar]
- Jones R. B., Holland J. F., Bhardwaj S., Norton L., Wilfinger C., Strashun A. A phase I-II study of intensive-dose adriamycin for advanced breast cancer. J Clin Oncol. 1987 Feb;5(2):172–177. doi: 10.1200/JCO.1987.5.2.172. [DOI] [PubMed] [Google Scholar]
- Miller A. B., Hoogstraten B., Staquet M., Winkler A. Reporting results of cancer treatment. Cancer. 1981 Jan 1;47(1):207–214. doi: 10.1002/1097-0142(19810101)47:1<207::aid-cncr2820470134>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
- Muss H. B., White D. R., Cooper M. R., Richards F., 2nd, Spurr C. L. Combination chemotherapy in advanced breast cancer.: a randomized trial comparing a three-vs a five-drug program. Arch Intern Med. 1977 Dec;137(12):1711–1714. [PubMed] [Google Scholar]
- Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smalley R. V., Lefante J., Bartolucci A., Carpenter J., Vogel C., Krauss S. A comparison of cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) and cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone (CMFVP) in patients with advanced breast cancer. Breast Cancer Res Treat. 1983;3(2):209–220. doi: 10.1007/BF01803563. [DOI] [PubMed] [Google Scholar]
- Smalley R. V., Murphy S., Huguley C. M., Jr, Bartolucci A. A. Combination versus sequential five-drug chemotherapy in metastatic carcinoma of the breast. Cancer Res. 1976 Nov;36(11 Pt 1):3911–3916. [PubMed] [Google Scholar]
- Tormey D. C., Gelman R., Band P. R., Sears M., Rosenthal S. N., DeWys W., Perlia C., Rice M. A. Comparison of induction chemotherapies for metastatic breast cancer. An Eastern Cooperative Oncology Group Trial. Cancer. 1982 Oct 1;50(7):1235–1244. doi: 10.1002/1097-0142(19821001)50:7<1235::aid-cncr2820500703>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
