SAN ANTONIOA 10-year update of Canada’s MA.5 trial has found a continuing survival advantage for node-positive premenopausal breast cancer patients treated with adjuvant cyclophosphamide(Drug information on cyclophosphamide)/epirubicin (Ellence)/fluorouracil (5-FU) (CEF) vs those given classic cyclophosphamide/methotrexate/5-FU (CMF).
Kathleen I. Pritchard, MD, head of Clinical Trials and Epidemiology at Toronto-Sunnybrook Regional Cancer Centre, reported the 10-year results at the 25th Annual San Antonio Breast Cancer Symposium (abstract 17).
The National Cancer Institute of Canada Clinical Trials Group MA.5 trial, which began in 1989, involves 710 pre- or perimenopausal women with early-stage breast cancer who had undergone radical mastectomy or lumpectomy with axillary dissection and who had one or more positive nodes.
The patients were randomized to classic CMF (cyclophosphamide, 100 mg/m2 orally days 1 to 14; methotrexate(Drug information on methotrexate), 40 mg/m2 IV days 1 and 8; and 5-FU, 600 mg/m2 IV days 1 and 8) or CEF (cyclophosphamide, 75 mg/m2 orally days 1 to 14; epirubicin(Drug information on epirubicin), 60 mg/m2 IV days 1 and 8; and 5-FU, 500 mg/m2 IV days 1 and 8). The CEF arm included antibiotic prophylaxis with daily cotrimoxazole. Both regimens were administered over six 4-week cycles.
Patients who had undergone lumpec-tomy received breast irradiation at the completion of chemotherapy; locore-gional radiation was not permitted. Tamoxifen(Drug information on tamoxifen) (Nolvadex) was not part of the study protocol, Dr. Pritchard said, and the vast majority of patients did not receive it.