Combination chemotherapy with adriamycin and cyclophosphamide for advanced breast cancer.

Fifty-five consecutive women with advanced breast cancer were treated with a combination of adriamycin (40 mg/m2 administered intravenously on day 1) and cyclophosphamide (200 mg/m2/day given orally in divided doses for 4 days on days 3-6). Courses were repeated at 21-28-day intervals. The mean age for the 55 patients was 55 years (range, 37-77 years); 20% of the patients were 65 years or older. All patients were evaluable. Objective response (at least a 50% decrease in the size of all measurable lesions lasting for at least 1 month) was noted in 40 (80%) of the 50 patients who received an adequate trial of chemotherapy (a minimum of two courses). Six of the 40 responses observed were complete. The median duration of response was 10 months. Actuarial survival for the entire group of 55 patients was 80% at 6 months after initiating chemotherapy and 70% at 12 months. Survival for the 40 responding patients was 95% at 6 months and 80% at 12 months. Response rates by site of involvement were: soft tissue, 20/25 (80%); lymph node, 15/19 (79%); bone, 21/25 (84%); lung, 15/18 (83%); pleural effusion, 6/8 (75%); and liver, 7/10 (70%). Eighty-three percent of the responses were apparent after two courses of treatment and 98% were apparent after four courses. Toxicity was acceptable and included nausea, myelosuppression, alopecia, and reversible congestive heart failure (in 2 patients who received 550 mg/m2 of adriamycin). Chemotherapy with adriamycin and cyclophosphamide proved to be safe and effective for out-patient treatment of advanced breast cancer.