The expanding role of epirubicin in the treatment of breast cancer.

Adjuvant treatment of early breast cancer has experienced major changes in the last 25 years. Since the mid 1970s, when cyclophosphamide, methotrexate and fluorouracil (CMF) resulted in statistically significant and clinically meaningful improvements in disease-free and overall survival, the use of adjuvant chemotherapy has become common practice worldwide. Anthracyclines are considered to be among the most active available agents to treat breast cancer and have become core components of adjuvant regimens. Anthracycline-containing polychemotherapy regimens provide a significant benefit over CMF. Regimens containing epirubicin are generally associated with prolongation in relapse-free and overall survival rates compared with standard therapies including CMF. Epirubicin-taxane combinations are active in treating metastatic breast cancer and do not appear to be associated with any pharmacokinetic interactions. Ongoing research is focusing on combining anthracyclines with taxanes in an effort to continue to improve outcomes following adjuvant therapy.