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First, second and third line chemotherapy programs in metastatic breast carcinoma
Israel Journal of Medical Sciences
|September 1, 1981
Summary
Sequential chemotherapy regimens, including CMF, CMFVP, and ABVD, offer repeated remission opportunities for metastatic breast carcinoma patients. This approach can prolong survival for responders, demonstrating efficacy in advanced disease management.
Area of Science:
- Oncology
- Medical Oncology
- Pharmacology
Background:
- Metastatic breast carcinoma presents a significant challenge in treatment, often requiring sequential therapeutic approaches.
- Evaluating the efficacy and tolerance of different chemotherapy lines is crucial for optimizing patient outcomes.
Purpose of the Study:
- To report the experience with three distinct chemotherapeutic regimens used sequentially in metastatic breast carcinoma.
- To assess objective remission rates, duration of response, and survival in patients receiving first, second, and third-line treatments.
Main Methods:
- A cohort of 117 previously untreated patients received Cyclophosphamide, Methotrexate, and 5-fluorouracil (CMF).
- 88 patients who progressed on CMF were treated with CMF plus vincristine and prednisone (CMFVP).
- 23 patients refractory to CMFVP received adriamycin, bleomycin, vinblastine, and dimethyl-triazo-imidazole-carboxamide (ABVD) as tertiary chemotherapy.
Main Results:
- CMF achieved 49% objective remission (8% complete) with a median response duration of 16 months.
- CMFVP resulted in 23% objective remission (6% complete) and 28% improvement, with a median response of six months.
- ABVD showed 17% partial remission and 13% improvement, with a median survival of eight months for responders, compared to 4.5 months for non-responders.
Conclusions:
- Sequential chemotherapy administration provides opportunities for repeated remissions in metastatic breast carcinoma.
- This strategy can lead to prolonged survival for patients who respond to treatment.
- The reported regimens were generally well-tolerated, with no observed cardiac or pulmonary toxicity, though fatal septic shock occurred in a small subset.