Treatment of advanced breast cancer with two doxorubicin-containing regimens

The Georgetown University Hospital experience in the treatment of advanced breast cancer using either a combination of doxorubicin (adriamycin) and vincristine (AV) or adriamycin and mitomycin-C (AM) is presented. Of 74 previously treated patients with advanced breast cancer, 50 patients were given AV and 24 patients were given AM. Both groups were comparable in regard to number of disease sites, age, prior radiation therapy, disease-free interval after mastectomy, duration of treatment, and estrogen-receptor status. The response rates were 32% and 25% with AV and AM combinations, respectively. Achievement of response was not related to menopausal or estrogen-receptor status. Median time to disease progression was 7.0 and 9.6 months for AV and AM, respectively. Median survivals were not statistically different (9.7 months for AV and 11.1 months for AM). Life-table analysis for responders versus nonresponders within each regimen and between responders in either regimen revealed no statistical differences. Duration of response for each regimen was also equivalent. Toxicity was mild and similar to previous reports using these drugs. However, myelosuppression was significantly greater for premenopausal than postmenopausal patients in the AV group. The possible reasons for this are discussed. Both AM and AV are well-tolerated regimens which provide equivalent but limited response rates, duration of response, and median survival in previously treated women with advanced breast cancer.