Combination chemoimmunotherapy with FAC‐BCG for metastatic breast cancer: The impact of CMF maintenance chemotherapy

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Abstract
In an attempt to prolong the durations of remission and survival of patients with advanced breast cancer treated with the FAC‐BCG protocol, we modified the CMF maintenance combination by increasing the dose of all three drugs and administering them intravenously. Eighty‐five evaluable patients treated with this new regimen were compared with a recent historical control group of 105 evaluable patients treated with FACBCG and a lower‐dose, oral CMF maintenance program. The overall (70% and 76%) and complete (16% and 19%) response rates were identical in these two groups. The median times to progression for all patients entered were similar too (13 months for both groups). The durations of response were 17 months (PO‐CMF) and 14 months (IV‐CMF), not significantly different (P=.16). The durations of survival of the two treated groups were also very similar. After the administration of intensive FAC induction therapy, a high‐dose, intravenous CMF maintenance program appears no better than a lowdose oral regimen. Other drug combinations consisting entirely of drugs not used in the induction regimen might be better choices for maintenance treatment.