title: The Duke AFM Program. Intensive induction chemotherapy for metastatic breast cancer.
abstract: Forty-five patients have completed treatment with AFM, an intensive induction chemotherapy regimen composed of Adriamycin (doxorubicin, Adria Laboratories, Columbus, Ohio), 5-fluorouracil, and methotrexate with folinic acid rescue. This regimen was designed to produce rapid and extensive tumor shrinkage prior to high-dose alkylating agent chemotherapy with autologous marrow support. The overall response rate was 91%, and 38% of patients achieved complete clinical responses after a mean of 70 days on treatment. Hematologic and mucosal toxicity were extensive, but no toxic deaths were noted. AFM is a potent remission induction regimen for metastatic breast cancer, but its considerable toxicity suggests caution in its use for routine breast cancer treatment.
authors.affiliation: Duke University Bone Marrow Transplantation Program, Department of Medicine, Durham, North Carolina.
authors.forename: R B
authors.initials: RB
authors.lastname: Jones
authors.forename: E J
authors.initials: EJ
authors.lastname: Shpall
authors.forename: J
authors.initials: J
authors.lastname: Shogan
authors.forename: M L
authors.initials: ML
authors.lastname: Affronti
authors.forename: D
authors.initials: D
authors.lastname: Coniglio
authors.forename: L
authors.initials: L
authors.lastname: Hart
authors.forename: E
authors.initials: E
authors.lastname: Halperin
authors.forename: J D
authors.initials: JD
authors.lastname: Iglehart
authors.forename: J
authors.initials: J
authors.lastname: Moore
authors.forename: J
authors.initials: J
authors.lastname: Gockerman
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects; D012074:Remission Induction
chemical_list: D004317:Doxorubicin; D005472:Fluorouracil; D008727:Methotrexate