A study recently published in the British Journal of Cancer suggests that the multi-agent chemotherapy regimen consisting of 5-fluorouracil, leucovorin and cyclophosphamide is well tolerated and effective in treating metastatic breast cancer that has stopped responding to treatment consisting of an anthracycline and taxane.
Metastatic breast cancer occurs when cancer that has started in the breast has spread to distant locations in the body such as the liver, lungs, bones or other sites. Patients who do not respond to initial chemotherapy treatment or progress may elect to be treated with salvage therapy. Salvage therapy is treatment following a cancer recurrence, often without intent to cure. The purpose of salvage therapy may be to improve symptoms through local control of the cancer or to prolong a patient’s survival. Since cancer can become resistant to chemotherapy agents over time, few of the available treatment options are effective for patients with recurrent, metastatic breast cancer and many cause severe side effects.
This study enrolled 41 patients with metastatic breast cancer that had stopped responding to anthracyclines (epirubicin or doxorubicin) and taxanes (paclitaxel or docetaxel), chemotherapy agents commonly used as initial therapy for metastatic breast cancer. Patients were treated with high doses of the chemotherapy agents 5-fluorouracil and leucovorin in combination with conventional doses of cyclophosphamide. Cyclophosphamide and 5-fluorouracil are chemotherapy agents that may be used in standard treatment regimens for metastatic breast cancer. In this trial, 5-fluorouacil was administered with high doses of leucovorin, a chemotherapy agent used for other types of cancer that increases the ability of 5-fluorouracil to concentrate in tumor tissue.
The results of the treatment regimen were promising. Overall, 19 patients achieved an anti-cancer response to treatment. The average duration of response was 8 months and the majority of patients did not experience disease progression until 9.5 months after treatment. The average survival time was 13 months and 51% of patients were alive one year following treatment. Only nine patients experienced severe neutropenia (decrease in neutrophils) and four patients experienced severe thrombocytopenia (decrease in blood platelets). There were no deaths or hospital stays due to treatment side effects.
Results from this study suggest that a multi-agent chemotherapy regimen combining 5-fluorouracil, leucovorin and cyclophosphamide is safe and effective as salvage treatment for metastatic breast cancer that has stopped responding to anthracyclines and taxanes. Patients with metastatic breast cancer may wish to speak with their physician about the risks and benefits of this salvage chemotherapy regimen or about participating in a clinical trial further evaluating this issue or novel therapeutic options. Two sources of information regarding ongoing clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (British Journal of Cancer, Vol. 85, No. 6, pp. 798-802, 2001)