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According to a recent study published in the Journal of Clinical Oncology, a combination of chemotherapy agents consisting of vinorelbine and protracted (extended) infusion of fluorouracil (5-FU) may extend survival time and improve the quality of life for patients with metastatic breast cancer who have stopped responding to standard chemotherapy.

Breast cancer is a common malignancy occurring in women in the United States with almost 200,000 new cases diagnosed each year. Breast cancer is characterized by the presence of cancer cells in the tissues or ducts of the breast. Metastatic breast cancer refers to cancer that has spread outside the breast to distant locations in the body.

Treatment for breast cancer is dependent on many factors. One of the main considerations in making a treatment choice is the stage, or extent of the cancer. Currently, treatment options for patients with metastatic breast cancer are aimed at improving the quality of life by alleviating symptoms caused by advanced cancer, including pain, extreme weight loss and fatigue, and extending survival time (palliative care). Initial chemotherapy for women with advanced breast cancer typically consists of combinations that include an anthracycline drug such as doxorubicin or epirubicin. However, most women ultimately stop responding to initial therapy and experience a return of their cancer. Therefore, different chemotherapy combinations are continually being evaluated in an attempt to produce the greatest survival time coupled with improved quality of life for patients with this disease.

In a recent clinical study, the combination of vinorelbine plus protracted 5-FU was evaluated in 83 patients with metastatic breast cancer who were no longer responding to initial chemotherapy. Each patient had central venous access, meaning a small tube had been surgically placed in a large vein near the heart, so chemotherapy could be administered on an outpatient basis. Vinorelbine was only administered twice a month, while 5-FU was continually being infused through a pump for a period of time lasting between 2 and 6 months. Following treatment, over 60% of patients showed a partial or complete disappearance of their cancer. For these patients, the average duration of survival following treatment was almost 2 years. Adverse side effects caused by this chemotherapy combination were generally mild.

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These results indicate the effectiveness and tolerability of the chemotherapy combination of vinorelbine and protracted 5-FU infusion for palliative treatment in women with metastatic breast cancer. The overall response rate observed in this clinical trial is among the highest reported. Patients with advanced breast cancer who no longer are responding to their initial chemotherapy combination may wish to speak with their physician about receiving this chemotherapy combination or about the risks and benefits of participating in a clinical trial utilizing other promising new strategies. Two sources of information on ongoing trials that can be discussed with a doctor include comprehensive, easy-to-use listing services provided by the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients. (Journal of Clinical Oncology, Vol 18, No 19, pp 3370-3377, 2000)

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