EFFECTIVE CONDITIONING REGIMEN FOR PREMENOPAUSAL PATIENTS WITH ADVANCED BREAST-CANCER

The aim of the study was to define an effective regimen as induction t reatment in chemotherapy naive patients with advanced breast cancer as preparation for ablative chemotherapy. Patients and methods: Patients with focally advanced or metastatic breast cancer (AJCC stage IIIB or IV) received 5-fluorouracil, methotrexate with leucovorin rescue and prednisone, alternating with doxorubicin and vincristine for six cycle s. Results One hundred and eleven patients were eligible: All patients were evaluable for toxicity and seventy were evaluable for response. Thirty patients achieved a complete remission (43%) and 24 a partial r emission (34%). Hematological toxicity was acceptable, as in 7% of 602 treatment cycles patients were admitted for neutropenic fever. Patien ts with liver metastases had a higher incidence of leucopenic fever, 3 2% compared to 15% for all patients, and a 25% incidence of cerebellar neuropathy compared to 9% for all patients. Mucositis more severe tha n WHO grade I occurred in 8% of cycles. Nausea and vomiting were not s evere and cardiac or renal toxicity did not occur. Thromboembolic ombo embolic events occurred in 7% of the patients. Conclusions: This induc tion regimen carries a 43% complete and 77% overall remission rate, wh ich is high compared to other conventional and even escalated regimens . The toxicity profile is acceptable except for the higher incidence o f leucopenic fever and the reversible 5-FU cerebellar syndrome in pati ents with liver metastases.