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Combination Chemotherapy with FAC (5-FU/Continuous-Infusion ADR/CTX) plus TMX plus Debulking and Consolidation for Metastatic Breast Cancer
Basic Trial Information
Objectives I. Determine whether the administration of adriamycin by continuous infusion decreases cardiotoxicity and therefore can allow continued administration for a longer period. II. Determine whether continuous-infusion adriamycin can increase the response rate from the combination chemotherapy regimen FAC: 5-fluorouracil/adriamycin/cyclophosphamide. III. Determine whether continuing adriamycin as part of the FAC regimen prolongs the remission and survival durations of patients with metastatic breast cancer. IV. Determine the qualitative and quantitative toxicity of this combination. V. Determine whether early changes in systemic therapy in patients with stable and progressive disease prolongs the duration of survival of these two subgroups of patients. Entry Criteria Disease Characteristics: See General Eligibility Criteria Patient Characteristics: See General Eligibility Criteria General Eligibility Criteria: Patients with histologically diagnosed, measurable or evaluable metastatic breast cancer with evidence of progression. Patients showing evidence of resistance to the study agents and those with abnormal electrocardiogram may be excluded. Patients with uncompensated congestive heart failure or uncompensated severe hypertension are excluded. Patients must be ineligible for protocols of higher priority and have adequate bone marrow function. Expected Enrollment 60 patients will be required. Protocol closed. Outline Nonrandomized study. ER-positive or unknown patients enter Regimen A, then switch to Regimen B if disease progresses, or follow Regimen A with Regimen B if disease stabilizes or improves. Patients receive Regimens A and B simultaneously in the presence of life-threatening disease or liver and lymphangitic lung metastases at study entry. Regimen A: Single-agent Antiestrogen Therapy. Tamoxifen, TMX, NSC-180973. Regimen B: Induction: 3-Drug Combination Chemotherapy. FAC: 5-Fluorouracil, 5-FU, NSC-19893; Adriamycin, Doxorubicin, ADR, NSC-123127; Cyclophosphamide, Cytoxan, CTX, NSC-26271. Substitute alternate drug for CTX if hemorrhagic cystitis develops: Melphalan, L-PAM, NSC-8806. Patients enter Regimen C if there is disease progression after 2 courses (or no improvement after 6 courses) of Regimen B. Regimen C: Single-agent Chemotherapy. Vinblastine, VBL, NSC-49842. Patients enter Regimen D upon evidence of cardiac toxicity while responding to therapy. Regimen D: Maintenance: 3-Drug Combination Chemotherapy. CMF: CTX; 5-FU; Methotrexate, MTX, NSC-740. Patients are restaged after 6 courses of Regimen B, and receive debulking surgery concomitant with systemic therapy. Patients achieving CR, or PR in excess of 75 percent, after systemic therapy and/or debulking enter Regimen E concomitantly. Regimen E: Local Consolidation: Radiotherapy, local and involved fields. Trial Lead Organizations M. D. Anderson Cancer Center at University of Texas
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. |
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