FILM (5-fluorouracil, ifosfamide, leucovorin and mitomycin C), an alternative chemotherapy regimen suitable for the treatment of advanced breast cancer in the 'out-patient' setting

FILM, a combination of 5-fluorouracil (5-FU) 750 mg/m(2), ifosfamide 1 g/m( 2) leucovorin 200 mg/m(2) and mitomycin C 6 mg/m(2) (alternate cycles), was administered to 24 chemo naive patients with inoperable disease, locally a dvanced or metastatic. Up to 6 x 3-weekly cycles of FILM were administered on an outpatient basis. Responses included 8 patients in complete remission (CR) and 12 showing a partial response (PR) (83%). Following analysis of t hese results, the FILM regimen was introduced as a standard out-patient pro tocol at the North Middlesex Hospital, United Kingdom. A further 66 patient s have been treated in this setting. Retrospective analysis of these data c onfirm the trial results and allow conclusions regarding tolerability, toxi city, duration of response and survival to be drawn from a total cohort of 90 patients. A total of 524 cycles have been administered. Nineteen cycles (4%) were delayed owing to slow recovery of white blood cells (WBC), but no dose reductions were necessary. Five blood transfusions were required for anaemia. The most frequent non-haematological toxicities included nausea, v omiting and fatigue. Of 80 patients treated for inoperable or locally advan ced disease, 56 (70%) remain in remission, and 69 (86%) remain alive after 5 years.