Forty-eight women with advanced metastatic carcinoma of the breast were treated with one of two combination chemotherapy regimens: 1) adriamycin and cyclophosphamide or 2) adriamycin, cyclophosphamide, methotrexate and 5-fluorouracil. The response rate in the two-drug treatment group was 50% and in the four-drug treatment group, 55%. The median duration of response was ten months in both treatment groups. Dramatic responses were seen in patients with visceral metastases. Patients who responded to chemotherapy had a significantly longer survival than nonresponders ( p < 0.01).
The long interval between adriamycin doses (six weeks) in the four drug regimen did not adversely effect the response rate-an important finding in view of the dose-related cardiac toxicity of this agent.
Cancer 42:27-33, 1978.
ARCINOMA OF THE BREAST is the most C common malignancy in women, with an estimated incidence of 90,000 cases in 1977.' Many of these patients will not be cured by surgery and later will become potential candidates for hormonal manipulation and/or chemotherapy. The response of breast cancer to single agent chemotherapy has usually been less than 35% with the anthracycline antibiotic, adriamycin, having perhaps the best response rate.4 The concept of combination chemotherapy, which takes advantage of the different mechanism of action and different toxicity of many of the effective chemotherapeutic agents, was first applied