Do different Adriamycin-based combination regimens (FAC, AC, A+COMFP) yield different response rates and survival in patients with previously untreated metastatic breast cancer?
Three Adriamycin-based combination chemotherapy regimens demonstrated similar response rates and overall survival in patients with previously untreated metastatic breast cancer, though FAC was associated with more leukopenia.
The Southwest Oncology Group tested three combinations of drugs with Adriamycin to identify a best regimen for treatment of advanced breast cancer. Adriamycin, cyclophosphamide, and 5-fluorouracil (5FU)(FAC); Adriamycin and cyclosphosphamide (AC); and Adriamycin followed by cyclophosphamide, vincristine, methotrexate, 5FU, and prednisone (A + COMFP) were used in a prospective randomized study of 497 patients with previously untreated metastatic breast cancer. The complete response (CR) plus partial response (PR) was (57/140) 44% with AC, (77/160) 48% with FAC, and (78/148) 46% with A + COMFP. The median length of response was 29, 52, and 37 weeks respectively, with AC, FAC and A + COMFP. The median survival of all patients was 79 weeks; 89 weeks AC, 84 weeks FAC, and 76 weeks with A + COMFP. Toxicity was similar in all three regimens except that leukopenia was more common with FAC.
Tranum et al. (1982) studied this question.