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[Chemo-endocrine therapy including mitomycin C and medroxyprogesterone acetate in doxorubicin-refractory advanced
Y Nomura1, H Tashiro, M Shirouzu
1Dept. of Breast Surgery, National Kyushu Cancer Center, Japan.
Abstract:
In the management of doxorubicin (ADR)-refractory advanced breast cancer, combination chemotherapies including mitomycin C (MMC) have been widely acknowledged to have definitive therapeutic effects. A randomized comparative study was performed estimating the efficacy and toxicity of MMV chemotherapy (MMC+methotrexate+vincristine), MMVM (MMV+medroxyprogesterone acetate (MPA), and MMVP (MMV+predo-nisolone (P). A total of 108 patients with advanced breast cancer resistant to ADR or relapsed after response were randomized, and 102 were evaluable. Response rates of 9.5% (2/21) in MMV, 37.5% (15/40) in MMVM, and 29.2% (12/41) in MMVP were obtained; with a significant difference between MMV and MMVM (p = 0.021). The time to progression of patients treated with MMVM and MMVP was shown to be longer than MMV patients. Thrombocytopenia was less appeared by adding MPA, making the dose escalation of MMV agents. It was concluded also from reviewing the references that MMVM is an effective 2nd-line therapy of advanced breast cancer after ADR treatment.