Adjuvant chemohormonal therapy with cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP) or CMFP plus tamoxifen compared with CMF for premenopausal breast cancer patients

Article Abstract:

The addition of hormonal treatment to regular chemotherapeutic regimens has become an accepted part of chemotherapy for breast cancer. It is important to evaluate the performance of similar regimens in an adjuvant capacity; that is, when extended chemotherapy is used postoperatively to improve the results which might be expected following surgery alone. In order to make this evaluation, 553 breast cancer patients were divided into three groups. All the patients had cancer that had spread to the lymph nodes on the side where the tumor was removed. One hundred eighty-eight patients received cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); 183 received CMF plus prednisone (CMFP), and 182 received CMFPT, which was CMF with both prednisone and tamoxifen, a potent anti-estrogen compound. Patients were followed for an average of 7.7 years. There were no significant differences among the groups in time to relapse, nor were there any significant differences in survival. In addition, there were no differences in the patterns of observed relapse among the groups. Toxicity was increased by both the addition of prednisone and the addition of tamoxifen. The CMFP regimen has previously been shown to be superior to CMF in the chemotherapeutic treatment of metastatic breast cancer. It is not known why a similar significant effect was not seen in these patients when the same treatment was used in an adjuvant capacity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Tamoxifen

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Efficacy of adjuvant chemotherapy in high-risk node-negative breast cancer: an intergroup study

Article Abstract:

Adjuvant therapy is required in the treatment of primary breast cancer when the cancer has spread to lymph nodes near the breast. High cancer recurrence and death rates in women whose breast cancer is node-negative led researchers to assess the effectiveness of adjuvant chemotherapy for these patients. After radical or modified mastectomy, patients were observed or were administered short-term intensive chemotherapy, using cyclophosphamide, methotrexate, fluorouracil, and prednisone. These node-negative patients had either a tumor of any size without estrogen receptors or a tumor greater than or equal to three centimeters with estrogen receptors. The disease-free survival rate among patients treated with adjuvant chemotherapy was 84 percent and 69 percent for the patients who were observed. Severe toxicity occurred in 33 percent of the treated patients. The chemotherapy regimen used improves disease-free survival among high-risk patients who have node-negative operable breast cancer.

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Epirubicin and cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy for early breast cancer

Article Abstract:

The National Epirubicin Adjuvant Trial (NEAT) and the BR9601 trial were designed jointly by English and Scottish investigators in 1994 and 1995 to determine the value of anthracyclines in the adjuvant treatment of early breast cancer. Adjuvant treatment of early breast cancer with epirubicin plus CMF was significantly superior over CMF alone in terms of relapse free survival and overall survival, and hence epirubicin plus CMF as an option for anthracycline-based adjuvant chemotherapy in women with early breast cancer was recommended.

Drug therapy, Epirubicin

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