title: Ifosfamide, methotrexate, and 5-fluorouracil: effective combination in resistant breast cancer.
abstract: Ifosfamide has definite efficacy in many malignant tumours, including breast cancer. In the present study we substituted cyclophosphamide with ifosfamide in the combination CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) regimen in 25 patients with breast cancer whose disease was refractory to CMF or who had relapsed after previous response. Ifosfamide was given in an i.v. infusion at a dose of 1.2 g/m2 daily for 5 days, together with mesna as a uroprotector (at 20% of the ifosfamide dose). Methotrexate was given at a dose of 40 mg/m2 and 5-fluorouracil was given at 600 mg/m2, both by i.v. push. Courses were repeated every 21 days. The 24 evaluable patients received 3-12 courses (average, 5 courses); results included a complete remission in 3 patients (12.5%) and a partial remission in 3 (12.5%). Among the remaining patients, improvement was seen in 4 (16.6%); stable disease, in 7; and progressive disease, in 7 (29.2%). The complete responses lasted for 11+, 13+, and 15+ months, and partial remissions, for 2, 6, and 9 months. The responses were detected in soft-tissue as well as visceral lesions, but not in bony lesions. The responders remain under follow-up. This study shows the efficacy of ifosfamide-containing chemotherapy in breast cancer. As toxicities were tolerable, higher doses of ifosfamide could safely be used in these patients. Use of this combination as first-line therapy in breast cancer could be considered for a future study.
authors.affiliation: National Cancer Institute Fom-El-Khalig, Cairo, Egypt.
authors.forename: N
authors.initials: N
authors.lastname: Gad-el-Mawla
authors.forename: M R
authors.initials: MR
authors.lastname: Hamza
authors.forename: Z K
authors.initials: ZK
authors.lastname: Zikri
authors.forename: M
authors.initials: M
authors.lastname: Elserafi
authors.forename: A
authors.initials: A
authors.lastname: el-Khodari
authors.forename: H
authors.initials: H
authors.lastname: Khaled
authors.forename: R
authors.initials: R
authors.lastname: Gafaar
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D005472:Fluorouracil; D007069:Ifosfamide; D008727:Methotrexate