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Combination versus Sequential Five-Drug Chemotherapy in Metastatic Carcinoma of the Breast¹

Department of Medicine, Section of Medical Oncology, Temple University School of Medicine, Philadelphia 19140 [R. V. S.]; Department of Medicine, Presbyterian Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104 [S. M.]; and Departments of Medicine, Division of Hematology and Oncology [C. M. H.], and of Biometry [A. A. B.], Emory University School of Medicine, Atlanta, Georgia 30322

Patients with metastatic or recurrent adenocarcinoma of the breast were randomized to weekly combination chemotherapy, intermittent combination chemotherapy, or singledrug chemotherapy administered sequentially. Patients receiving weekly combination therapy were more likely to respond than those receiving single-drug therapy (5-fluorouracil). The median survival for either group treated with combination therapy was double that of patients on sequential therapy. One-fourth of the patients had a prolonged survival (>75 weeks), regardless of therapy.

¹ This investigation was supported by the following USPHS Research Grants from the National Cancer Institute to the following institutions: CA03227 and CA11263 to Emory University School of Medicine, Atlanta, Ga.; CA06807 to Medical College of Georgia, Augusta, Ga.; CA05641 to University of Miami School of Medicine, Miami, Fla.; CA12639 to Presbyterian-University of Pennsylvania Medical Center, Philadelphia, Pa.; CA07961 to Temple University School of Medicine, Philadelphia, Pa.; CA03376 to Washington University School of Medicine, St. Louis, Mo.; CA12223 to University of Puerto Rico School of Medicine, San Juan, Puerto Rico; CA13237 to University of Tennessee Memorial Research Center, Knoxville, Tenn.; CA13249 to Veterans Administration Hospital, New Orleans, La.; CA15584 to Case Western Reserve School of Medicine-Veterans Administration Hospital, Cleveland, Ohio; CA17027 to University of Tennessee School of Medicine, Memphis, Tenn; CA17214 to St. Louis University School of Medicine, St. Louis, Mo.; and CA116389 to University of Louisville School of Medicine, Louisville, Ky.

² To whom requests for reprints should be addressed.

³ The following members of the Southeastern Cancer Study Group participated in this study: Evert A. Bruckner, Alfred A. Bartolucci, Yick-Kwong Chan, Charles C. Corley, Jr., Charles M. Huguley, Jr., James W. Keller, John D. Schmale, William Ralph Vogler, and William H. Whaley, Emory University School of Medicine, Atlanta, Ga.; Morton Berenson, Medical College of Georgia, Augusta, Ga.; Howard E. Lessner, University of Miami School of Medicine, Miami, Fla.; Scott Murphy, Presbyterian-University of Pennsylvania Medical Center, Philadelphia, Pa.; Richard V. Smalley, Temple University School of Medicine, Philadelphia, Pa.; Virgil Loeb, Jr., Washington University School of Medicine, St. Louis, Mo.; Antonio Grillo and Enrique Velez-Garcia, University of Puerto Rico School of Medicine, San Juan, Puerto Rico; Stephen Krauss, University of Tennessee Memorial Research Center, Knoxville, Tenn.; Karl Tornyos, Veterans Administration Hospital, New Orleans, La.; Robert Kellermeyer and Anne Rassiga, Case Western Reserve University School of Medicine and Veterans Administration Hospital, Cleveland, Ohio; Stanley Lowenbraun, University School of Medicine, Louisville, Ky.; Charles L. Neely, University of Tennessee School of Medicine, Memphis, Tenn.; and Goronwy O. Broum, Jr., St. Louis University School of Medicine, St. Louis, Mo.

(for the Southeastern Cancer Study Group)

Received 4/16/76. Accepted 7/15/76.