Does a combination of cyclophosphamide, doxorubicin, and fluorouracil (CAF) improve clinical response compared to cyclophosphamide, methotrexate, and fluorouracil (CMF) in previously untreated patients with advanced metastatic breast cancer?
CAF provides a higher initial clinical response rate than CMF in previously untreated advanced metastatic breast cancer, though with greater hematologic and GI toxicity.
A prospective randomized trial was conducted comparing the clinical response of 78 previously untreated patients with advanced metastatic breast cancer to a combination of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) or to a combination of cyclophosphamide, adriamycin, and 5-fluorouracil (CAF). Sixty-two percent of the patients receiving CMF responded to treatment compared to an 82% response rate for the patients receiving CAF. Although within acceptable limits, hematologic and GI toxicity was greater with CAF. There was no significant difference in the duration of response to the two regimens. Therefore, the therapeutic difference between the two therapies is a higher initial response rate to the adriamycin containing regimen.
Bull et al. (Mon,) studied this question.
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