A controlled study in the use of combined drug therapy for metastatic breast cancer

Abstract

Three prospectively planned and controlled cooperative clinical studies in the use of combination drug therapy for metastatic breast cancer are reported. Each study contained two drug regimen arms. A total of 326 evaluable patients was treated with one of the five various drug combinations employed. As the number of drugs used in each regimen was increased from two to five, a concommitant increase in remission rates from 50% to 75% was observed. Remission duration of approximately 8 months and survival from the onset of treatment, however, remained relatively constant at 13 to 16 months in all drug regimens. Patients achieving tumor remission survived an average of three times longer than those with progressive disease under therapy. The results are correlated to patient age and predominant metastatic type. Subjective improvement was definitely related to objective tumor regression or stabilization. Treatment was relatively well tolerated and well applicable to outpatient care. Dosage adjustments were often necessary during the initial phases of therapy. Combined cystostatic drug therapy is highly effective in the prognostically worst forms of metastatic breast cancer, and is the treatment of choice for younger patients with visceral type metastases.Comer 36:120&1219, 1975. REAST CANCER IS THE MOST COMMON MALIC-B nancy in women. It develops in approximately every 20th woman and is unique in its markedly variable course. Metastases frequently first appear 5 to 10 years after the initial diagnosis and treatment.2JJ Considering the number of primarily inoperable cases, as well as the number of relapses occurring beyond the commonly used 5-year observation

A Pilot Study of Sequential Combination Chemotherapy with Adriamycin and Cyclophosphamide, and Methotrexate, 5‐Fluorouracil and Prednisolone in Advanced Breast Cancer

“…Since the number of patients is so small, the widely scattered survivals are difficult to evaluate. The survival appears similar to other series 1,3,4 . However, direct comparison may not be possible, since our patients may have more advanced disease, with a median length of history of disease of 34 months at the commencement of chemotherapy (Fig 3).…”

“…The duration of response is disappointingly less than in the originally reported adriamycin and cyclophosphamide study, 10 and cyclophosphamide, methotrexate, 5‐fluorouracil and prednisolone trials 4 . Although a similar duration of response has been reported in some recent studies, 3,5 , it is less than in most reports 1,9 . Since the number of patients is so small, the widely scattered survivals are difficult to evaluate.…”

Quadruple chemotherapy for advanced malignant disease

“…Deemarskyand Chernomordikova(l970) using a combination of 5-fluorouracil and an alkylating agent reported 22 remissions in 31 patients with advanced breast disease. More recent reports have been equally encouraging (Brunner et al, 1975;Fisher et al, 1975).…”

“…The validity of this approach has been demonstrated in animals and in humans with childhood and adult acute leukaemia (Freireich et al, 1964;Thompson et al, 1965) and metastatic cancer of the testis (Li et al, 1959(Li et al, , 1960. Combination chemotherapy has now been applied to a wide variety of advanced malignant disease and the initial reports have been encouraging (Costanzi and Coltman, 1969;Price and Goldie, 1971 ;Priestman and Hanham, 1972), particularly in regard to breast cancer (Deemarsky and Chernomordikova, 1970;Livingstone and Carter, 1970;Hanham et al, 1971;Shingleton et al, 1971;Davis et al, 1974;Brunner et al, 1975).…”