Adjuvant cyclophosphamide, methotrexate, and fluorouracil versus fluorouracil, epirubicin, and cyclophosphamide chemotherapy in premenopausal women with axillary node-positive operable breast cancer: results of a randomized trial. The International Collaborative Cancer Group.

Coombes, R. C.; Bliss, Judith; Wils, J.; Morvan, F.; Espié, Marc; Amadori, Dino; Gambrosier, P; Richards, MA; Aapro, Matti; Villar-Grimalt, A; McArdle, C. S.; Pérez-López, F.R.; Vassilopoulos, P.; Ferreira, E. Pinto; Chilvers, C. E. D.; Coombes, Gill; Woods, E.; Marty, M.

doi:10.1200/jco.1996.14.1.35

Cited by 151 publications

(43 citation statements)

References 18 publications

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“…The FASG-01 conducted in premenopausal, node-positive breast cancer patients showed that six cycles of FEC 50 were significantly better than three cycles of FEC 50 or FEC 75 in terms of 10-year DFS (14). The FEC regimen remains widely accepted in Europe, while four cycles of the AC regimen (doxorubicin and cyclophosphamide) is commonly used in the USA, based on the NSABP B-15 trial which showed results similar to those obtained using six cycles of CMF (cyclophosphamide, methotrexate, and fluorouracil) (15). AC was preferable since, following total mastectomy, AC was completed on day 63 versus day 154 for conventional CMF; patients visited health professionals three times as often for conventional CMF as for AC; and nausea-control medication was given for about 84 days to conventional CMF patients versus for about 12 days to patients on AC.…”

Section: Role Of Anthracyclinessupporting

confidence: 49%

Chemotherapy for breast cancer (Review)

Hassan¹

2010

Oncol Rep

158

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Abstract. The use of cytotoxic chemotherapy in both advanced and early stage breast cancer has made significant progress in the last 10 years with several landmark studies identifying clear survival benefits for newer therapies. In spite of these developments the optimal approach for any specific patient can not be determined from a literature review or decision-making algorithm alone. Treatment choices are predominantly based on practice determined by individual or collective experience and the historical development of treatment within a locality. The improvement in the understanding of the molecular biological basis of breast cancer provides possible targets for novel therapies. Personalised therapies for breast cancer based on the molecular characteristics of the tumour could improve the risk:benefit ratio of current therapies. Increased improvements in the use of a panel of biomarkers will thus not only move us towards tailored therapies but will also spare a group of patients that do not benefit from adjuvant chemotherapy. At the same time a better understanding of tumour biology will also streamline the development of new regimens for those who are unlikely to benefit from existing drugs. This review will focus on the evidence for the use of chemotherapy and highlight advances in chemotherapy treatments with the addition of new and novel drugs marching into our clinics as standard treatments based on evidence from clinical trials and from a better understanding of tumour biology that has transformed the outlook in breast cancer in both the adjuvant and metastatic setting.

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Section: Role Of Anthracyclinessupporting

confidence: 49%

Chemotherapy for breast cancer (Review)

Hassan¹

2010

Oncol Rep

158

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“…CMF reported by Coombes et al, 30 one case of nonfatal cardiomyopathy thought to be related to FEC was observed. The study by Martin et al 35 reported a 1.5% incidence of grade 1-2 cardiac toxicity and a 0.6% incidence of grade 3-4 cardiac toxicity after FAC, compared with a 0.2% incidence of grade 1-2 cardiac toxicity after i.v.…”

Section: Cardiotoxicitymentioning

confidence: 98%

“…CMF. 25,28,[30][31][32]35,46 The NSABP B-15 trial also showed that the AC (doxorubicin and cyclophosphamide) regimen was associated with more prolonged and, in some cases, intractable, vomiting than either oral or i.v. CMF 25 but that oral CMF was associated with greater nausea than either i.v.…”

Section: Acute Toxicitiesmentioning

confidence: 99%

“…CMF with at least 90% of women receiving an anthracycline experiencing at least grade 2 alopecia. 25,28,[30][31][32]34,46 Piccart and colleagues reported that full-dose anthracycline therapy was associated with a higher incidence of alopecia and asthenia than oral CMF. 34 The taxanes also cause alopecia, although this has not been reported in the studies that are currently published.…”

Section: Acute Toxicitiesmentioning

confidence: 99%

“…5 Since the 1998 overview, the results of several of the studies included have been updated and an additional trial has been reported. Thus, CMF has now been compared with anthracycline-containing regimens in a total of 12 randomized trials [25][26][27][28][29][30][31][32][33][34][35][36] published between 1990 and 2003 ( Table 1), 11 of which were included in the 1998 overview. The most recent addition to the trials, presented at the 2003 American Society of Clinical Oncology (ASCO) meeting, was a combined analysis of two UK trials that added four cycles of epirubicin to CMF, in 2391 patients.…”

Section: Cmf Versus Other Regimens: Activity Anthracycline-containingmentioning

confidence: 99%

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Adjuvant chemotherapy for early breast cancer: Is cyclophosphamide, methotrexate and 5‐fluorouracil still the standard?

Stuart-Harris

Odell

Sturgiss

2005

Asia-Pac J Clncl Oncology

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Background : Oral cyclophosphamide, methotrexate and 5-fluorouracil (CMF) was one of the first combination chemotherapy regimens used as adjuvant chemotherapy for early breast cancer. The value of CMF in reducing both recurrence and mortality from early breast cancer has been firmly established by the overviews of randomized trials of polychemotherapy, which have used CMF as their standard. The purpose of this review is to review the usage of oral CMF and the variants of CMF and to compare both the activity and side-effects of CMF with more modern adjuvant chemotherapy regimens. Results : There are many variants of CMF but oral (or classical) CMF is probably more effective than intravenous (i.v.) CMF, at least in metastatic disease. When oral CMF is used in early breast cancer it reduces the annual hazard of recurrence by 24% and the annual hazard of mortality by 14% overall, although it appears more effective in younger patients. Anthracycline-based regimens are more effective for reduction of recurrence and mortality than CMF but are associated with more severe acute toxicities and potentially greater risks of long-term toxicities. Taxane-based regimens have not been compared with CMF directly; however, in comparison with anthracycline-based regimens, the early information suggests that taxane-based regimens may be even more effective. The acute toxicities of taxane-based regimens are probably less severe than anthracycline-based regimens, but their long-term toxicities are less well defined. Conclusion : Oral CMF as adjuvant chemotherapy for early breast cancer is the standard by which newer regimens are compared. Although newer regimens appear more effective than CMF, they may be associated with greater acute and potentially greater long-term toxicities than CMF. Thus, CMF remains the standard by which future regimens should be judged, either directly or indirectly.

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Impact of a Clinical Guidelines Program for Breast and Colon Cancer in a French Cancer Center

Ray‐Coquard

Philip²,

Lehmann³

et al. 1997

JAMA

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Adjuvant cyclophosphamide, methotrexate, and fluorouracil versus fluorouracil, epirubicin, and cyclophosphamide chemotherapy in premenopausal women with axillary node-positive operable breast cancer: results of a randomized trial. The International Collaborative Cancer Group.

Abstract: We conclude that the FEC2 regimen, in which epirubicin replaced the methotrexate in CMF, is the preferable adjuvant chemotherapy regimen for premenopausal patients with operable axillary node-positive breast cancer.

Cited by 151 publications

References 18 publications

Chemotherapy for breast cancer (Review)

Chemotherapy for breast cancer (Review)

Adjuvant chemotherapy for early breast cancer: Is cyclophosphamide, methotrexate and 5‐fluorouracil still the standard?

Impact of a Clinical Guidelines Program for Breast and Colon Cancer in a French Cancer Center

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