TY - JOUR
T1 - Improved outcome from substituting methotrexate with epirubicin
T2 - results from a randomised comparison of CMF versus CEF in patients with primary breast cancer
AU - Ejlertsen, Bent
AU - Mouridsen, Henning T
AU - Jensen, Maj-Britt
AU - Andersen, Jørn
AU - Cold, Søren
AU - Edlund, Per
AU - Ewertz, Marianne
AU - Jensen, Brita B
AU - Kamby, Claus
AU - Nordenskjold, Bo
AU - Bergh, Jonas
PY - 2007/3
Y1 - 2007/3
N2 - We compared the efficacy of CEF (cyclophosphamide, epirubicin, and fluorouracil) against CMF (cyclophosphamide, methotrexate, and fluorouracil) in moderate or high risk breast cancer patients. We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71-0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66-0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities.
AB - We compared the efficacy of CEF (cyclophosphamide, epirubicin, and fluorouracil) against CMF (cyclophosphamide, methotrexate, and fluorouracil) in moderate or high risk breast cancer patients. We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71-0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66-0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities.
KW - Adult
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols/administration & dosage
KW - Breast Neoplasms/drug therapy
KW - Cyclophosphamide/administration & dosage
KW - Cytarabine/administration & dosage
KW - Epirubicin/administration & dosage
KW - Female
KW - Fluorouracil/administration & dosage
KW - Humans
KW - Methotrexate/administration & dosage
KW - Middle Aged
KW - Treatment Outcome
U2 - 10.1016/j.ejca.2007.01.009
DO - 10.1016/j.ejca.2007.01.009
M3 - Journal article
C2 - 17306974
SN - 0959-8049
VL - 43
SP - 877
EP - 884
JO - European journal of cancer (Oxford, England : 1990)
JF - European journal of cancer (Oxford, England : 1990)
IS - 5
ER -