Feasibility of a dose-intensive CMF regimen with granulocyte colony-stimulating factor as adjuvant therapy in premenopausal patients with node-positive breast cancer

Our aim was to study the feasibility of an intensified intravenous CMF (cyc lophosphamide, methotrexate and 5-fluorouracil) schedule with the aim to es calate dose intensity (DI). Twenty-three premenopausal breast cancer patien ts received 6 cycles of adjuvant CMF intravenously on days 1. and 8 every 3 weeks and granulocyte colony-stimulating factor days 9-18. Endpoints were DI and toxicity. Twenty-one out of 23 patients (91%) received the projected total dose and reached greater than or equal to 85% of the projected Dl, C ompared to 'classical' CMF, all patients reached greater than or equal to 1 11% DI. Nine patients received the planned schedule without delay. Thirteen patients (57%) were treated for infection and four patients (17%) were hos pitalized for febrile neutropenia. Twelve patients received red blood cell transfusions (52%). Radiation therapy (n = 6) had no adverse impact on dose intensity or haematological toxicity. This dose-intensified CMF schedule w as accompanied by enhanced haematological toxicity with clinical sequelae, namely fever, intravenous antibiotics and red blood cell transfusions, but allows a high dose intensity in a majority of patients. (C) 2000 Cancer Res earch Campaign.