The outcome for 758 consecutive patients who had received one or more
chemotherapy regimens for recurrent or metastatic
breast cancer is presented. The response rate following first line treatment was 34%. Median duration of response was 7.8 months, median time to progression was 3.7 months and median survival was 7.9 months. The only factor predicting for response, of factors recorded at presentation and at initiation of
chemotherapy, was the use of
anthracycline based regimens, though this may reflect the patient selection policy. Initial disease free interval, presence of liver
metastases and use of
anthracyclines were significantly related to time to progression. Several factors related to survival following first
chemotherapy, but
anthracycline usage showed only a very weak correlation. One third of patients (249/758) received two or more
chemotherapy regimens. The response rate (16%) and median time to progression (2.3 months) were significantly worse than for first line treatment. The outcome after third line
chemotherapy was very similar to that observed following second line treatment. Achievement of an objective response with first line
chemotherapy predicted for second response, but with insufficient power to be of use in selecting patients for subsequent
chemotherapy. Time to progression following first line
chemotherapy did not influence that after second line treatment.