THE AIM OF THIS STUDY was to investigate the relative induction efficiency of dibromodulcitol + adriamycin + vincristine (DAV) as compared to cyclophosphamide + adriamycin + 5-fluorouracil (CAF) in patients with metastatic breast cancer. A further aim was to explore the possible benefits of a fixed cross-over of two non-cross-resistant chemotherapy regimens in comparison to continuous administration of one regimen in patients with metastatic breast cancer.
One hundred patients with metastatic breast cancer were prospectively randomized to receive CAF or DAV, the latter being cycled with cyclophosphamide + methotrexate + 5-fluorouracil (CMF). The patient and disease discriminants were comparable for both treatment options. The side effects encountered (nausea and vomiting, depression of hemogram, and alopecia) were similar for patients in both treatment arms. The response rate for CAF was 67.4% and for DAV/CMF was 77.1%. This difference was not statistically significant (p > 0.20). The duration of response was similar for both treatment regimens. Analysis of the results of this study show that DAV alone was at least equivalent to CAF in the treatment of metastalie breast cancer and suggests that the addition of CMF to DAV provided no additional therapeutic effect. As CMF had previously been shown to be inferior to CAF, it is not clear whether the failure to gain signifieantly from the drug cycling was due to the addition of an inferior regimen, or to the pharmacological principle of drug cycling as such not being applicable to the treatment of metastatic breast cancer.