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Query: UMLS:C0027627 (
metastases
)
103,950
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
One hundred thirty-one premenopausal women with metastatic breast cancer who had received no prior systemic treatment for
metastases
were entered on study. Patients without prior chemotherapy with estrogen receptor (ER)-positive and ER-unknown disease were randomized to receive cyclophosphamide, Adriamycin (Adria Laboratories, Columbus, OH), and 5-fluorouracil (
CAF
) or surgical oophorectomy followed directly by
CAF
(O +
CAF
). ER-negative patients without prior chemotherapy were directly assigned to treatment with
CAF
. Among randomized patients 83% have responded, and 37% have achieved a complete remission. Among ER-negative patients the complete response rate was 38%, and the complete plus partial response rate was 70%. Characteristics significantly associated with a longer time to treatment failure were age 45 or over, one or two organ sites, and performance status O. The median survival time of ER-positive patients treated with
CAF
is 29 months, and with O +
CAF
it has not yet been reached, whereas for ER-unknown patients the equivalent survival times are 41 months and 43 months respectively. For ER-negative patients treated with
CAF
the median survival time is 17 months. Characteristics associated with significantly longer survival among randomized patients were age 35 or over (P = .009) and only one or two organ sites involved (P = .02). Neither treatment (P = .33) nor ER status (P = .70) was significant.
...
PMID:Treatment of metastatic breast cancer in premenopausal women using CAF with or without oophorectomy: an Eastern Cooperative Oncology Group Study. 358 44
In a prospective, randomized trial Cancer and Leukemia Group B (CALGB) evaluated
CAF
chemotherapy (cyclophosphamide + doxorubicin + 5-fluorouracil [5-FU]) v
CAF
plus tamoxifen (TCAF) in advanced breast cancer. Patients were stratified by estrogen receptor (ER) status, dominant site of
metastatic disease
, menopausal status, and prior adjuvant therapy. Regardless of ER status or menopausal status, the addition of tamoxifen conferred no significant advantage in response rate, response duration, time to treatment failure (TTF) or survival over
CAF
alone. A secondary objective was to compare the response to
CAF
of ER positive (ER+) and ER negative (ER-) patients to determine if there was a differential response to cytotoxic chemotherapy. Response rates of ER+ and ER- patients to
CAF
were identical (56%), but the response duration, time to treatment failure, and survival of ER+ patients were significantly longer than ER- patients. This lack of differential response implies that chemotherapy and hormonal therapy may compete for the same pool of ER+ cells. It also suggests that chemotherapy kills breast cancer cells indiscriminately, regardless of ER status.
...
PMID:Chemohormonal therapy in advanced carcinoma of the breast: Cancer and Leukemia Group B protocol 8081. 365 56
Data on 162 women (90 premenopausal and 72 postmenopausal) with metastatic breast cancer randomized to receive cyclophosphamide, Adriamycin (doxorubicin) and 5-fluorouracil (
CAF
) on two Eastern Cooperative Oncology Group (ECOG) protocols were analyzed. Twenty-three percent had complete remission; 39% had partial remission; 28% had no change; and 3% had disease progression. Of those patients in whom receptors were known, response rates were 65% for estrogen (ER)-receptor positive and 70% for ER-negative patients. The median duration of response was 11.4 months. The median survival time from the start of
CAF
was 20.2 months. The response rate, time to treatment failure (TTF), and median survival time were superior in the premenopausal women. These differences ceased, however, to be statistically significant in logistic models. Factors significantly associated with longer TTF and longer survival were as follows: one or two organs with
metastases
(TTF, P less than 0.0001; survival, P less than 0.0001); dominant site other than soft tissue (TTF, P less than 0.0001; survival, P = 0.05); and an initial good performance status (TTF, P = 0.007; survival, P = 0.02). Patients with ER-positive disease had a significantly longer median survival time (P = 0.003).
...
PMID:The Eastern Cooperative Oncology Group experience with cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) in patients with metastatic breast cancer. 383 57
One hundred fifty-five eligible women with metastatic breast cancer were randomly allocated to receive monthly cycles of either CMFP (cyclophosphamide, methotrexate, 5-fluorouracil, prednisone) or
CAF
(cyclophosphamide, doxorubicin, 5-fluorouracil), and 12 patients were studied to evaluate the effects of additional Corynebacterium parvum immunotherapy. Overall response rates of 53% were seen with CMFP and
CAF
.
CAF
was associated with significantly more complete responses than CMFP (17% v 5%). However,
CAF
therapy was administered for eight months and CMFP for six months. Only 13% of the
CAF
patients had a complete response during the first six months of chemotherapy, and this was not significantly different from the complete response rate on CMFP. The median response durations (CMFP, 6.3 months;
CAF
, 11.0 months), times to treatment failure (CMFP, 5.7 months;
CAF
, 7.8 months), and survival times (CMFP, 15.8 months;
CAF
, 18.6 months) were not statistically different. Other investigators who have compared
CAF
to CMF-containing regimens have reported a large advantage in
CAF
therapy among patients with "good risk" sites of
metastases
(local-regional recurrence, bone, lung nodules). Such a finding was not confirmed by our study: in multivariate analyses the groups associated with an advantage for
CAF
tended to have a poorer prognosis than the groups associated with an advantage for CMFP. There was significantly more nausea and vomiting after
CAF
treatment, and CMFP treatment was associated with significantly more edema, Cushingoid features, fever, and eye symptoms.
...
PMID:Comparison of CAF versus CMFP in metastatic breast cancer: analysis of prognostic factors. 389 87
From January 1980 to August 1982 the Cancer and Leukemia Group B conducted a prospective randomized trial comparing chemoendocrine therapy with T-
CAF
(cyclophosphamide, adriamycin, and 5-fluorouracil plus tamoxifen) to
CAF
alone in postmenopausal women with advanced breast cancer. The patients were stratified by estrogen receptor (ER) status into three groups: ER-negative, ER-positive, ER-unknown. They were also stratified by dominant site of
metastatic disease
: visceral and other (osseous and/or soft tissue). A total of 246 eligible patients were enrolled in the study; 232 were evaluable and constitute the basis for this report. The study revealed that there was no difference in overall response frequency or response duration between T-
CAF
and
CAF
; there was no difference in response between T-
CAF
and
CAF
in ER-positive or in ER-negative patients; and there was no difference in response between T-
CAF
and
CAF
by dominant site of
metastatic disease
. The expected advantage of T-
CAF
over
CAF
, especially for ER-positive patients, was not observed.
...
PMID:Chemoendocrine therapy vs chemotherapy alone for advanced breast cancer in postmenopausal women: preliminary report of a randomized study. 636 9
Fourteen patients with advanced carcinoma of the breast were treated with
CAP
combination therapy. An objective therapeutic response (partial remissions with a mean duration of 6.3 months) was achieved in 6 of 13 evaluated patients. This response was observed in soft tissue
metastases
. Nausea and vomiting were found to be the most frequent undesirable side effects in all patients and could not be avoided by administration of antiemetics. In 2 patients mild nephrotoxicity was found without any effects on further therapy. The results of this study were considered as promising; a definitive assessment of the
CAP
regimen is expected to come from a randomized study which started in the CMEA countries in 1983.
...
PMID:CAP (cyclophosphamide, adriamycin, cisplatinum) in the treatment of advanced breast cancer. 654 99
During the past 10 years, the Southeastern Cancer Study Group (SECSG) has been engaged in one major adjuvant study and three major advanced disease studies for patients with adenocarcinoma of the breast. The adjuvant study is demonstrating that six months of adjuvant CMF is the therapeutic equivalent of 12 months and that post-operative irradiation is of no added therapeutic benefit. In patients with advanced disease, a low dose 5 drug combination of CMFVP induces more objective responses than single agent 5FU, but improves survival only for those patients with liver metastases when compared to the sequential use of the same 5 single agents. The three drug combination,
CAF
, utilizing doxorubicin, induces more objective responses than low dose CMFVP, but it does not improve overall survival. The subsets of patients with bone-only
metastases
, with local chest wall recurrence and with nodular lung metastases benefit from
CAF
in terms of a longer duration of disease control and longer duration of unmaintained remission, but have only a marginal improvement in survival. The addition of a phase active combination, CAMELEON, (i.e., sequentially alternating therapy) to
CAF
has not improved the duration of disease control and survival for patients with liver metastases, lymphangitic and nodular lung metastases compared to
CAF
. Aggressive combination chemotherapeutic approaches to patients with advanced disease provide better and longer disease and tumor control but only marginal improvements in overall survival. Adding additional agents to a maximally tolerable regimen has not improved the therapeutic outcome.
...
PMID:Southeastern Cancer Study Group: breast cancer studies 1972-1982. 660 45
Twenty-one patients, presenting with
metastases
only to bone from a primary adenocarcinoma of the breast having previously undergone mastectomy, tolerated aggressive cytotoxic chemotherapy (
CAF
--cyclophosphamide 500 mg/m2, Adriamycin 50 mg/m2, 5-fluorouracil 500 mg/m2 q 3 weeks) without significant clinical morbidity. Sixteen of the 21 achieved total clinical symptomatic improvement (pain, performance status). Eleven of these 16 patients tolerated and received between 75% and 100% of the original prescribed dose every 3 weeks, completing a total cumulative course dose of 450 mg/m2 of Adriamycin within 36 weeks, and remained clinically free of disease for an average of 26 months despite cessation of therapy. Their median survival is greater than 3 1/2 years. Those patients tolerating and receiving a dose of 50% or less developed early progression and had a relatively short survival. In general, patients with
metastatic disease
limited to bone have a relatively good prognosis and are tolerant of and benefit from aggressive cytotoxic therapy. In these patients an excellent clinical response can be achieved with a prolonged disease-free treatment-free period of life.
...
PMID:Advanced breast cancer with bone-only metastases: a chemotherapeutically responsive pattern of metastases. 709 Oct 41
In recent years, the incidence of endometrial cancer has tended to increase gradually in Japan. Most cases (early cancer of stage I and II) are treated by hysterectomy alone, and the prognosis has been relatively good. From analysis of the poor prognostic factors in endometrial cancer, we understood that additional therapy is necessary for patients who have the following factors: degree of differentiation: G3; invasion to > 1/2 myometrium;
metastases
to pelvic or para-aortic lymph node, isthumus-cervix extension; surgical stage III and more. However, for patients with advanced inoperable and recurrent cancer, a radiotherapy, is not so sensitive to endometrial cancer has been used. A first line establish a chemotherapy has not been established either. Various attempts have been made to establish a chemotherapy for endometrial cancer. As a result, adriamycin (ADR) and cisplatin (CDDP) have proved effective as single agents. For patients with early cancer who have the poor prognostic factors mentional above, irradiation and polychemotherapy regimens (
CAP
and AP) are effective. Since the progression of endometrial cancer is dependent on sex steroid hormones, antitumor effects of Medroxyprogesterone acetate (MPA) are expected to be effective for patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer, or with well-differentiated adenocarcinoma (G1 type) histologically. Although several forms of therapy are capable of inducing objective remission as adjuvant treatment, all treatment for advanced and recurrent disease remains palliative, and responses and survival for patients treated with irradiation and chemotherapy remain short. Furthermore, we should examine new methods such as new drug application of key drugs like ADR and Pt pharmaceutical preparation, improvement of Dose intensity of the key drugs and Biochemical modulation, CPT-11, Taxol and assembly of key drugs, along with the Circadian approach in the light of Biochronology.
...
PMID:[Chemotherapy of uterine endometrial cancer]. 766 68
One hundred patients with metastatic breast cancer were randomly selected to receive combined chemotherapy treatment with adriamycin (50 mg/m2) or mitoxantrone (12 mg/m2) associated with 5-fluorouracil (600 mg/m2) and cyclophosphamide (600 mg/m2) administered intravenously every 21 days with a maximum of ten cycles. All patients included in this study were under 75 years of age and had ECOG performance status of less than 4. They had not been treated previously with chemotherapy for
metastatic disease
. Patients treated with adjuvant chemotherapy, which could not have included anthracyclines, had to have relapsed at least 12 months after the completion of therapy. There were no statistically significant differences in pretreatment characteristics or
metastatic disease
location between the two groups. Ninety-four patients were assessable for response. No differences were observed in response rate or in survival between the groups. The response rate (complete response (CR) and partial response (PR)) was 68% (13% CR and 55% PR for
CAF
; 0% CR and 68% PR for CNF). Median survival for all patients was 19 months (18 months with
CAF
and 19 months with CNF). All patients were assessable for toxicity. There were no differences in gastrointestinal and cardiac toxicity. More grade I-II hematologic toxicity episodes (p < 0.001) and treatment delays (p = 0.05) due to leucopenia were observed with the CNF group, and more grade III alopecia (p < 0.001) was observed with the
CAF
group. Patients received further therapeutic manoeuvres after finishing the study with a sequential treatment consisting of hormonal therapy and chemotherapy with mitomycin (M) -vinblastine (Vbl) (M 10 mg/m2 day 1, Vbl 5 mg/m2 days 1, 15 and 29; maximum 5 cycles). This chemotherapy treatment was received by 32 patients, with a response rate of 34% and grade III-IV hematologic toxicity of 37%. Treatment with CNF can be considered a good alternative to
CAF
for first-line treatment of metastatic breast cancer. M-Vbl treatment is useful as second-line treatment in patients with prior adriamycin exposure.
...
PMID:A phase III randomized trial of cyclophosphamide, mitoxantrone, and 5-fluorouracil (CNF) versus cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) in patients with metastatic breast cancer. 774 56
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