Treatment of Early Breast Cancer With Adriamycin-Cyclophosphamide With or Without Radiation Therapy: Initial Results of a Brief and Effective Adjuvant Program
We initiated study of the combination of adriamycin and cyclophosphamide (A–C) for advanced breast cancer at the University of Arizona in 1973 . That study was based on evidence that both agents were quite active individually, had different mechanisms of action, and were useful in relatively low growth fraction solid tumors. Results of our initial study plus those obtained simultaneously by workers at the Southern Research Institute  suggested that the A–C combination was synergistic or potentiating. We observed an overall objective response rate of 78% in 51 patients with advanced breast cancer who had not recceived prior chemotherapy . A number of subsequent trails in advanced breast cancer using A–C plus other drugs (e.g., 5-fluorouracil) have yielded almost identical results [2, 8], suggesting that A–C is the active component of these regimens. The high response rate, acceptable toxicity, and ease of administration to advanced breast cancer patients encouraged us to initiate a surgical adjuvant breast cancer program with this regimen. We reasoned that a relatively brief adjuvant program could be formulated with both drugs administered intensively to eradicate a minimum number of occult micrometastases. Furthermore, we believed that the duration of therapy could be related to the tumor stage as defined by pathologic staging (e.g., more treatment for more advanced stages). The kinetic considerations applied in design of this trial are summarized elsewhere . Thus, in mid-1974 we initiated the Arizona Breast Cancer Adjuvant Program [9, 11, 14]. This report summarizes the updated preliminary results as of May 1978.
KeywordsToxicity Adenocarcinoma Anemia Methotrexate Melphalan
Unable to display preview. Download preview PDF.
- 1.Bonadonna, G., Rossi, A., Valagussa, P. et al.: Adjuvant chemotherapy with CMF in breast cancer with positive axillary nodes. In: Adjuvant therapy of cancer. Salmon, S., Jones, S. (eds.), pp. 83-94. Amsterdam: Elsevier/North Holland 1977.Google Scholar
- 8.Gutterman, J. V., Cardenas, J. O., Blumenschein, G. R. et al.: Chemoimmunotherapy of advanced breast cancer: Prolongation of remission and survival with BCG. Br. Med. J. 1976 II, 1222-1225.Google Scholar
- 9.Hammond, N., Jones, S., Salmon, S. et al.: Adjuvant treatment of breast cancer with Adriamycin-Cyclophosphamide with or without radiation therapy. In: Adjuvant therapy of cancer. Salmon, S., Jones, S. (eds.), pp. 153-160. Amsterdam: Elsevier/North Holland 1977.Google Scholar
- 15.Salmon, S. E.: Kinetic rationale for adjuvant chemotherapy of cancer. In: adjuvant therapy of cancer. Salmon, S., Jones, S. (eds.), pp. 3-14. Amsterdam: Elsevier/North Holland 1977.Google Scholar
- 16.Salmon, S. E.: Kinetics of minimal residual disease. In: Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease I. Bonadonna, G., Mathé, G., Salmon, S. E. (eds.), RRCR 67, pp. 5-15. Berlin, Heidelberg, New York: Springer 1979.Google Scholar