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Mitoxantrone, 5‐fluorouracil and high‐dose leucovorin (NFL) in the treatment of metastatic breast cancer: randomized comparison to cyclophosphamide, methotrexate and 5‐fluorouracil (CMF) and attempts to improve efficacy by adding paclitaxel
Author(s) -
HAINSWORTH JOHN D.
Publication year - 1997
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.1997.tb00318.x
Subject(s) - medicine , mitoxantrone , regimen , metastatic breast cancer , cyclophosphamide , fluorouracil , breast cancer , chemotherapy , oncology , paclitaxel , methotrexate , gastroenterology , surgery , cancer
The combination of mitoxantrone (12 mg/m 2 i.v., day 1) 5‐fluorouracil (350 mg/m 2 i.v. days 1–3) and leucovorin (300 mg i.v. days 1–3) is an active and well‐tolerated regimen for metastatic breast cancer. We compared this regimen to a standard CMF regimen (cyclophosphamide 600 mg/m 2 i.v. day 1; methotrexate 40 mg/m 2 day 1; 5FU 600 mg/m 2 i.v. day I) in a randomized, phase II study. One hundred and twenty‐eight women receiving first‐line chemotherapy for metastatic breast cancer were treated. NFL produced lugher response rates (45% vs. 26%) and longer remissions (9 months vs. 6 months) than did CMF; overall survival was not different (19 months vs. 16 months). Both regimens were well tolerated. In an attempt to improve efficacy, we added paclitaxel(l35 mg/m 2 i.v. 1‐h infusion) to the NFL regimen. Although this regimen was active (51 % response rate in first‐second‐line treatment], myelosuppression was greater than expected. These results confirm the utility of NFL as an active, well‐tolerated regimen for the palliative treatment of metastatic breast cancer.