Abstract
Recently there have been several reports on the effectiveness of combination chemotherapy with 5’-deoxy-5-fluorouridine (51-DFUR) and cyclophosphamide (CPA) for treating recurrent breast cancer. We report a case in which treatment of local recurrence and lung metastases responded was remarkably effective by this combination chemotherapy. A 45-year-old woman underwent modified radical mastectomy for left breast cancer (T2N0M0) three years previously. Involvement of a left supraclavicular lymph node (ScLN) and multiple lung metastases were revealed 2 years and 6 months after the operation. First, we opted for systemic endocrine therapy with local irradiation for the lung metastases and ScLN. However the lung metastases were found to have increased on chest x-ray 2 months after treatment, showing progressive disease (PD). A locally recurrent new lesion sized 2X2 cm had also developed. Thus, we changed the treatment to combination chemotherapy with 51-DFUR 800 mg/body and oral CPA 100 mg/body once a day. The lung metastases had disappeared on chest x-ray and the local recurrence was not palpable after 7 weeks of the new treatment. Thymidine phosphorylase (dThdPase) immunostaining of the primary tumor was strongly positive in almost all cancer cells. We discuss the mechanism of the increased efficacy of combination chemotherapy with 51-DFUR and CPA.
Abbreviations
- 51-DFUR:
-
51-Deoxy-5-fluorouridine
- CPA:
-
Cyclophosphamide
- CR:
-
Complete response
- ScLN:
-
Supraclavicular lymph node
- CT:
-
Computed tomography
- dThdPase:
-
Thymidine phosphorylase
- 5-FU:
-
5-Fluorouracil
- PR:
-
Partial response
- MPA:
-
Medroxyprogesterone acetate
- MTX:
-
Methotrexate
- Epi:
-
Epirubicine
- PD:
-
Progressive disease
References
Miwa M, Ura M, Nishida M,et al: Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumors by enzymes concentrated in human liver and cancer tissue.Eur J Cancer 34:1274–1281, 1998.
Ishikawa T, Fukase Y, Yamamoto T,et al: Antitumor activities of a novel fluoropyrimidine, N4-pentyloxycarbonyl-5’-deoxy-5-fluorocytidine (Capecitabine)Biol Pharm Bull 21(7): 713–717, 1998.
Yoshimoto M, Tada T, Saito M,et al: Treatment of metastatic breast cancer using a combination of two oral drugs of 5’-deoxy-5-fluorouridine and cyclophosphamide.Igakuno Ayumi 184:1013–1014, 1998 (in Japanese).
Koyama H, Nishizawa Y, Noguchi S,et al: A combination therapy with 5’DFUR and MPA as a second line treatment for advanced/recurrent breast cancer.J Jpn Soc Cancer Ther 25:655–661, 1990 (in Japanese).
Tominaga T, Hayashi K, Kitamura M,et al: Effects of single administration of 5’-DFUR and combined treatment of 5’-DFUR with Tamoxifen on advanced breast cancer patients.Oncologia 22:92–99, 1989.
Toi M, Hoshina S, Taniguchi T,et al: Expression of platelet-derived endothelial cell growth factor/thymidine phosphorylase in human breast cancer.Int J Cancer 64:79–82, 1995.
Niitani H, Kimura K, Saito T,et al: Phase II study of 51- deoxy-5-fluorouridine (51-DFUR) on patients with malignant cancer; Multi-institutional cooperative study.Jpn J Cancer Chemother 12:2044–2051, 1985.
Endo M, Ouchi K, Matsumoto T,et al: Efficacy of combination chemotherapy of cyclophosphamide and 5’-deoxy-5-fluorouridine in a mammary tumor xenograft model, MX-1.Jpn J Cancer Chemother 24:1295–1301, 1997 (in Japanese).
Sawada N, Ishikawa T, Fukase Y,et al: Induction of thymidine phosphorylase activity and enhancement of capecitabine efficacy by taxol/taxotere in human cancer xenografts.Clinical Cancer Res 4:1013–1019, 1998.
Author information
Authors and Affiliations
About this article
Cite this article
Iwata, H., Mizutani, M., Iwase, T. et al. A case of metastatic breast cancer achieving complete response by combination therapy with 5’-deoxy-5-fluorouridine and cyclophosphamide. Breast Cancer 7, 83–86 (2000). https://doi.org/10.1007/BF02967194
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02967194