Combination chemotherapy and high-dose cyclophosphamide intensification for poor prognosis breast cancer. A Southwest Oncology Group Study.

Thirty-seven patients with poor prognosis, metastatic breast cancer were treated with 5-fluorouracil, vinblastine, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (FUVA) induction chemotherapy. All 26 patients (74%) with responsive or stable disease after induction chemotherapy received intensification with high-dose cyclophosphamide (120 mg/kg). Continued responders received additional FUVA as consolidation. The response rate to induction therapy was 54% (with complete response [CR] in 11%). With intensification, three patients (11%) showed improved response (partial response [PR] in one, PR to complete response [CR] in two); however, six patients (23%) progressed within 2 months of cyclophosphamide intensification, three within 1 month. The overall response rate to all three phases of the study was 69%, with CR in 23%. The median survival of all patients entered in this study was 15 months. For cyclophosphamide intensification, major toxicity consisted of leukopenia with fever requiring broad-spectrum antibiotics in 27%. The authors conclude that a single cycle of high-dose cyclophosphamide intensification in metastatic breast cancer does not result in significantly improved responses or prolonged survival.
AuthorsG K Ellis, S Green, S Schulman, B L Tranum, R S Goldberg, R B Livingston
JournalCancer (Cancer) Vol. 64 Issue 12 Pg. 2409-15 (Dec 15 1989) ISSN: 0008-543X [Print] UNITED STATES
PMID2684382 (Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Vinblastine
  • Doxorubicin
  • Cyclophosphamide
  • Fluorouracil
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Bone Neoplasms (secondary)
  • Brain Neoplasms (prevention & control)
  • Breast Neoplasms (drug therapy, mortality, pathology)
  • Clinical Trials as Topic
  • Cyclophosphamide (administration & dosage, therapeutic use)
  • Doxorubicin (administration & dosage)
  • Drug Administration Schedule
  • Fluorouracil (administration & dosage)
  • Humans
  • Neoplasm Recurrence, Local
  • Prognosis
  • Vinblastine (administration & dosage)

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