title: Block sequential adriamycin CMF--optimal non-myeloablative chemotherapy for high risk adjuvant breast cancer?
abstract: After the publication of the 10-year survival data from Milan on the adjuvant use of the block sequential regimen consisting of four cycles of adriamycin followed by eight cycles of intravenous CMF, many centres adopted this as standard of care for high risk, multiple node-positive breast cancer. For this reason it was identified as the standard arm for the Anglo-Celtic adjuvant high-dose chemotherapy trial. This study reports on the experience of this regimen in 329 women with early breast cancer involving at least four axillary nodes, who were treated outside any adjuvant chemotherapy trial. At a median follow-up of 3 years, the overall 5-year disease-free survival is 61%, and the overall survival is 70%. These data confirm the efficacy of this regimen in non-trial patients, and, for the same high risk subgroup, indicate that this approach offers an outcome at least as good as that seen in the CALGB 9344 AC-Taxol arm, and the NCIC days 1 and 8 CEF.
authors.affiliation: Department of Oncology, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, Scotland, UK. David.Cameron@ed.ac.uk
authors.forename: D A
authors.initials: DA
authors.lastname: Cameron
authors.forename: A
authors.initials: A
authors.lastname: Anderson
authors.forename: E
authors.initials: E
authors.lastname: Toy
authors.forename: T R J
authors.initials: TR
authors.lastname: Evans
authors.forename: J H
authors.initials: JH
authors.lastname: Le Vay
authors.forename: I C S
authors.initials: IC
authors.lastname: Kennedy
authors.forename: R J
authors.initials: RJ
authors.lastname: Grieve
authors.forename: T J
authors.initials: TJ
authors.lastname: Perren
authors.forename: A
authors.initials: A
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Mansi
authors.forename: J
authors.initials: J
authors.lastname: Crown
authors.forename: R C F
authors.initials: RC
authors.lastname: Leonard
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate