Weekly adriamycin versus VAC in advanced breast cancer. A randomized trial

In a prospective randomised study 128 patients with advanced breast cancer were treated either with Adriamycin (20 mg/week) or vincristine, Adriamycin and cyclophosphamide (VAC). An objective response was obtained in 31 and 35% of patients in the two groups. There was no significant difference with regard to duration of response or survival. Weekly low dose Adriamycin was well tolerated. When subjective side effects occurred, they were usually slight and transient. In approx. 40% of the patients no side-effects at all were observed. Eight per cent had alopecia requiring a wig. Only slight myelosuppression could be seen in a few patients and this had no practical implications. Most or all of VAC patients experienced severe toxicity with regard to nausea, vomiting and alopecia. Also myelosuppression was more pronounced among VAC patients. It is concluded that weekly doses of Adriamycin as single agent therapy for advanced breast cancer is as effective as the VAC combination delivered every third week, with considerably less toxicity.