Improved outcome from substituting methotrexate with epirubicin: Results from a randomised comparison of CMF versus CEF in patients with primary breast cancer
Abstract We compared the efficacy of CEF (cyclophosphamide, epirubicin, and fluorouracil) against CMF (cyclophosphamide, methotrexate, and fluorouracil) in moderate or high risk breast cancer patients. We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive ni...
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| Veröffentlicht in: | European journal of cancer (1990) 2007-03, Vol.43 (5), p.877-884 |
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| container_title | European journal of cancer (1990) |
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| creator | Ejlertsen, Bent Mouridsen, Henning T Jensen, Maj-Britt Andersen, Jørn Cold, Søren Edlund, Per Ewertz, Marianne Jensen, Brita B Kamby, Claus Nordenskjold, Bo Bergh, Jonas |
| description | Abstract We compared the efficacy of CEF (cyclophosphamide, epirubicin, and fluorouracil) against CMF (cyclophosphamide, methotrexate, and fluorouracil) in moderate or high risk breast cancer patients. We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71–0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66–0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities. |
| doi_str_mv | 10.1016/j.ejca.2007.01.009 |
| format | Article |
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We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71–0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66–0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities.</description><identifier>ISSN: 0959-8049</identifier><identifier>ISSN: 1879-0852</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2007.01.009</identifier><identifier>PMID: 17306974</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject><![CDATA[Adult ; Aged ; Antineoplastic combined chemotherapy protocols ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage/therapeutic use ; Biological and medical sciences ; Breast neoplasms ; Breast Neoplasms - drug therapy ; Cyclophosphamide ; Cyclophosphamide - administration & dosage ; Cytarabine - administration & dosage ; Epirubicin ; Epirubicin - administration & dosage ; Female ; Fluorouracil ; Fluorouracil - administration & dosage ; Hematology, Oncology and Palliative Medicine ; Humans ; Medical sciences ; MEDICIN ; Medicin och hälsovetenskap ; MEDICINE ; Methotrexate ; Methotrexate - administration & dosage ; Middle Aged ; Pharmacology. Drug treatments ; Proportional hazards models ; Randomised controlled trials ; Survival analysis ; Treatment Outcome ; Tumors]]></subject><ispartof>European journal of cancer (1990), 2007-03, Vol.43 (5), p.877-884</ispartof><rights>Elsevier Ltd</rights><rights>2007 Elsevier Ltd</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c598t-2ac61762d2ab1e66da2ab9348833128efed248b38b8bd9475380c6335521ea3b3</citedby><cites>FETCH-LOGICAL-c598t-2ac61762d2ab1e66da2ab9348833128efed248b38b8bd9475380c6335521ea3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejca.2007.01.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18626638$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17306974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-49977$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-15230$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:1928185$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Ejlertsen, Bent</creatorcontrib><creatorcontrib>Mouridsen, Henning T</creatorcontrib><creatorcontrib>Jensen, Maj-Britt</creatorcontrib><creatorcontrib>Andersen, Jørn</creatorcontrib><creatorcontrib>Cold, Søren</creatorcontrib><creatorcontrib>Edlund, Per</creatorcontrib><creatorcontrib>Ewertz, Marianne</creatorcontrib><creatorcontrib>Jensen, Brita B</creatorcontrib><creatorcontrib>Kamby, Claus</creatorcontrib><creatorcontrib>Nordenskjold, Bo</creatorcontrib><creatorcontrib>Bergh, Jonas</creatorcontrib><title>Improved outcome from substituting methotrexate with epirubicin: Results from a randomised comparison of CMF versus CEF in patients with primary breast cancer</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Abstract We compared the efficacy of CEF (cyclophosphamide, epirubicin, and fluorouracil) against CMF (cyclophosphamide, methotrexate, and fluorouracil) in moderate or high risk breast cancer patients. We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71–0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66–0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic combined chemotherapy protocols</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Antineoplastic Combined Chemotherapy Protocols/administration & dosage/therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Breast neoplasms</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Cyclophosphamide</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Cytarabine - administration & dosage</subject><subject>Epirubicin</subject><subject>Epirubicin - administration & dosage</subject><subject>Female</subject><subject>Fluorouracil</subject><subject>Fluorouracil - administration & dosage</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>MEDICIN</subject><subject>Medicin och hälsovetenskap</subject><subject>MEDICINE</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Proportional hazards models</subject><subject>Randomised controlled trials</subject><subject>Survival analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0959-8049</issn><issn>1879-0852</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl1rFDEUhgdR7Fr9A15IbrzSWfMxM0mkCGXtaqEi-HUbMpkzbbY7kyEfW_tn_K1m3dUFoQqBhPA854SctyieEjwnmDSvVnNYGT2nGPM5JnOM5b1iRgSXJRY1vV_MsKxlKXAlj4pHIaxwBkWFHxZHhDPcSF7Nih_nw-TdBjrkUjRuANR7N6CQ2hBtTNGOl2iAeOWih-86Arqx8QrBZH1qrbHja_QJQlrHsPM08nrs3GBDrpjLTdrb4EbkerT4sEQb8CEFtDhbIjuiSUcLY1Z_1Zy8HbS_Ra0HHSIyejTgHxcPer0O8GS_Hxdfl2dfFu_Li4_vzhenF6WppYgl1aYhvKEd1S2Bpul0PkhWCcEYoQJ66GglWiZa0Xay4jUT2DSM1TUloFnLjotyVzfcwJRatX-Mctqq_dV1PoGqOckr8_xOPv9nd5B-i0RSQUSdzRd3mm_tt1Pl_KVKSZGaMpzpl_-n1zapSkrOM053uPEuBA_9H4Fgtc2MWqltZtQ2MwoTlTOTpWc7KTcYoDso-5Bk4Pke0MHodZ9HbGw4cKKhTcNE5k52HORJbSx4FUwesIHOejBRdc7--x1v_tLN2o42d7yGWwgrl_yYM6CIClRh9Xmb7m24Mc_BJhVnPwHLpfod</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Ejlertsen, Bent</creator><creator>Mouridsen, Henning T</creator><creator>Jensen, Maj-Britt</creator><creator>Andersen, Jørn</creator><creator>Cold, Søren</creator><creator>Edlund, Per</creator><creator>Ewertz, Marianne</creator><creator>Jensen, Brita B</creator><creator>Kamby, Claus</creator><creator>Nordenskjold, Bo</creator><creator>Bergh, Jonas</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG8</scope><scope>DF2</scope></search><sort><creationdate>20070301</creationdate><title>Improved outcome from substituting methotrexate with epirubicin: Results from a randomised comparison of CMF versus CEF in patients with primary breast cancer</title><author>Ejlertsen, Bent ; Mouridsen, Henning T ; Jensen, Maj-Britt ; Andersen, Jørn ; Cold, Søren ; Edlund, Per ; Ewertz, Marianne ; Jensen, Brita B ; Kamby, Claus ; Nordenskjold, Bo ; Bergh, Jonas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c598t-2ac61762d2ab1e66da2ab9348833128efed248b38b8bd9475380c6335521ea3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic combined chemotherapy protocols</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Antineoplastic Combined Chemotherapy Protocols/administration & dosage/therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Breast neoplasms</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Cyclophosphamide</topic><topic>Cyclophosphamide - administration & dosage</topic><topic>Cytarabine - administration & dosage</topic><topic>Epirubicin</topic><topic>Epirubicin - administration & dosage</topic><topic>Female</topic><topic>Fluorouracil</topic><topic>Fluorouracil - administration & dosage</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>MEDICIN</topic><topic>Medicin och hälsovetenskap</topic><topic>MEDICINE</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Middle Aged</topic><topic>Pharmacology. 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We randomly assigned 1224 patients with completely resected unilateral breast cancer to receive nine cycles of three-weekly intravenous CMF or CEF. Patients were encouraged to take part in a parallel trial comparing oral pamidronate 150 mg twice daily for 4 years versus control (data not shown). Substitution of methotrexate with epirubicin significantly reduced the unadjusted hazard for disease-free survival (DFS) by 16% (hazard ratio 0.84; 95% CI; 0.71–0.99) and for overall survival by 21% (hazard ratio 0.79; 95% CI; 0.66–0.94). The risk of secondary leukaemia and congestive heart failure was similar in the two groups. Overall CEF was superior over CMF in terms of DFS and OS in patients with operable breast cancer without subsequent increase in late toxicities.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>17306974</pmid><doi>10.1016/j.ejca.2007.01.009</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0959-8049 |
| ispartof | European journal of cancer (1990), 2007-03, Vol.43 (5), p.877-884 |
| issn | 0959-8049 1879-0852 1879-0852 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Aged Antineoplastic combined chemotherapy protocols Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Antineoplastic Combined Chemotherapy Protocols/administration & dosage/therapeutic use Biological and medical sciences Breast neoplasms Breast Neoplasms - drug therapy Cyclophosphamide Cyclophosphamide - administration & dosage Cytarabine - administration & dosage Epirubicin Epirubicin - administration & dosage Female Fluorouracil Fluorouracil - administration & dosage Hematology, Oncology and Palliative Medicine Humans Medical sciences MEDICIN Medicin och hälsovetenskap MEDICINE Methotrexate Methotrexate - administration & dosage Middle Aged Pharmacology. Drug treatments Proportional hazards models Randomised controlled trials Survival analysis Treatment Outcome Tumors |
| title | Improved outcome from substituting methotrexate with epirubicin: Results from a randomised comparison of CMF versus CEF in patients with primary breast cancer |
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