Premium
Five‐drug therapy in advanced breast cancer. Factors Influencing Toxicity and Response
Author(s) -
Davis Hugh L.,
Ramirez Guillermo,
Ellerby Richard A.,
Ansfield Fred J.
Publication year - 1974
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197408)34:2<239::aid-cncr2820340202>3.0.co;2-e
Subject(s) - medicine , cyclophosphamide , combination therapy , breast cancer , toxicity , fluorouracil , chemotherapy , cancer , methotrexate , prednisone , vincristine , surgery , oncology , gastroenterology
Seventy‐four women with advanced breast cancer were treated with a combination of continuous oral prednisone (45 mg/day × 2 wks, 30 mg/day × 2 wks, then 15 mg/day) and cyclophosphamide (100 mg/day), and weekly injections of 5‐fluorouracil, 500 mg; methotrexate, 25 mg; and vincristine, 1 mg. Thirtyone of 74 showed an objective response to therapy for a median length of 5 months. The responses were seen in soft tissue and visceral metastases. Definite recalcification of lytic bone lesions was seen in only 1 patient. Prior therapy decreased the number of responses to five‐drug therapy. With no prior cytotoxic therapy, 11/16 responded; with prior 5‐FU therapy 13/25 responded; with both prior 5‐FU and alkylating agent therapy, 7/33 responded. The median length of response was similar regardless of prior therapy. Toxicity was moderately severe; dosage modifications were necessary in the majority of patients, and there were seven drug contributory deaths during therapy. After failure of this combination, only 5/28 responded briefly to a variety of therapeutic measures. Comparable survival from first recurrence was seen whether response or failure occurred on five‐drug therapy. Trials of sequential vs. combination therapy will be necessary to define the role of combination therapy in advanced breast cancer.