Key result
Four-drug regimen linked to ~10% higher response rate vs two-drug regimen in metastatic breast cancer.
Why the study?
The efficacy and safety of two combination chemotherapy regimens containing adriamycin for advanced metastatic breast cancer were evaluated.
Does a four-drug chemotherapy regimen improve response rates compared to a two-drug regimen in women with advanced metastatic breast cancer?
Does a four-drug chemotherapy regimen improve response rates compared to a two-drug regimen in women with advanced metastatic breast cancer?
A four-drug chemotherapy regimen including adriamycin showed similar response rates and duration to a two-drug regimen in advanced breast cancer, with longer intervals between adriamycin doses potentially mitigating cardiac toxicity.
Answers are grounded in this paper and cite their sources.
Similar response rates with four- versus two-drug regimens do not support intensified therapy; leaves open whether adriamycin scheduling reduces cardiotoxicity.
Forty-eight women with advanced metastatic carcinoma of the breast were treated with one of two combination chemotherapy regimens: 1) adriamycin and cyclophosphamide or 2) adriamycin, cyclophosphamide, methotrexate and 5-fluorouracil. The response rate in the two-drug treatment group was 50% and in the four-drug treatment group, 55%. The median duration of response was ten months in both treatment groups. Dramatic responses were seen in patients with visceral metastases. Patients who responded to chemotherapy had a significantly longer survival than nonresponders (p less than 0.01). The long interval between adriamycin doses (six weeks) in the four drug regimen did not adversely effect the response rate--an important finding in view of the dose-related cardiac toxicity of this agent.
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Kennealey et al. (1978) studied Advanced metastatic carcinoma of the breast (n=48). Adriamycin, cyclophosphamide, methotrexate and 5-fluorouracil (four-drug regimen) vs. Adriamycin and cyclophosphamide (two-drug regimen) was evaluated on Response rate. A four-drug regimen of adriamycin, cyclophosphamide, methotrexate, and 5-fluorouracil yielded a 55% response rate compared to 50% for a two-drug regimen in advanced metastatic breast cancer.
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