Chemotherapy versus combination of chemotherapy and endocrine therapy in advanced breast cancer. A prospective randomized study

G. Cocconi, V. de Lisi, C. Boni, P. Mori, P. Malacarne, D. Amadori, E. Giovanelli

Research output: Contribution to journalArticle

Abstract

One hundred-forty-five postmenopausal women with metastatic breast cancer entered a prospective randomized trial comparing treatment A (cyclophosphamide, methotrexate, and 5-fluorouracil; CMF) with treatment B (the same chemotherapy plus tamoxifen; CMF plus T). Patients on treatment A had T added to CMF at the time of progression or relapse (second-line CMF plus T). One hundred thirty-three cases were evaluable. Considering response rate to first-line treatment, CMF plus T appeared to be significantly superior to CMF alone (74 versus 51%, respectively; P <0.01). Median time to failure to first-line treatments, considering all patients, was longer in CMF plus T than in CMF arm (48 and 24 weeks, respectively; P = 0.06). Considering patients showing objective remission, median duration of response to CMF was similar to that of CMF plus T (47 and 51 weeks, respectively). Twelve of 39 evaluable women treated with second-line CMF plus T showed objective responses (31%). Median time to failure to treatment procedures scheduled in arm A (CMF → CMF + T) was longer than that to treatment in arm B (CMF plus T) (56 and 48 weeks, respectively; P = 0.08). Median survival was longer in patients randomized to treatment A (111 weeks) than in patients randomized to treatment B (78 weeks), but this difference was not statistically significant (P = 0.25). It can be concluded from this study that a combination of endocrine therapy and chemotherapy is significantly more active than chemotherapy alone in inducing an objective remission. This strategy of treatment is advisable in situations urgently requiring a clinical response. However, as a sequence of chemical and endocrine therapy induced a longer time to development of progressive disease and a better survival, sequential therapy is advisable for common clinical use.

Original languageEnglish
Pages (from-to)581-588
Number of pages8
JournalCancer
Volume51
Issue number4
Publication statusPublished - 1983

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Cocconi, G., de Lisi, V., Boni, C., Mori, P., Malacarne, P., Amadori, D., & Giovanelli, E. (1983). Chemotherapy versus combination of chemotherapy and endocrine therapy in advanced breast cancer. A prospective randomized study. Cancer, 51(4), 581-588.