Actual 5-year survival of patients with stage IIIB breast carcinoma: PhaseII trial of methotrexate, vinblastine, adriamycin, cisplatin, and folinic acid

Patients with stage IIIB br east carcinoma represent only a small proportio n of women with breast cancer in western countries but may constitute up to 50% of cases in underdeveloped countries. The prognosis remains pool despi te aggressive treatment. Nineteen patients (11 with inflammatory breast car cinoma) received at least three courses of neoadjuvant chemotherapy of meth otrexate, vinblastine, adriamycin, cisplatin, and folinic acid (MVAC/FA) fo llowed by mastectomy. Six months of cyclophosphamide, methotrexate, and 5-f luorouracil were given after surgery. Radiation therapy followed chemothera py. Seventy percent of patients achieved complete and 14% partial response after MVAC/FA chemotherapy alone. Eleven patients (58%) survived 5 years, a nd 30% survived at least 8 years. The addition of cisplatin in combination chemotherapy used as first-line treatment for stage IIIB breast carcinoma w as well tolerated, resulted in higher response rates, and appeared to have an effect on overall survival.