Cyclophosphamide therapy in patients with advancing breast cancer following adrenalectomy and 5-fluorouracil.

Abstract

Seven of 21 patients with advanced breast cancer previously treated with a combination of adrenalectomy and 5-fluorouracil responded to cyclophosphamide administered when disease relapsed after response to the combination. Four women who failed to benefit from adrenalectomy and 5-fluorouracil also did not respond to cyclophosphamide. Neither time from primary therapy to appearance of first metastases (free interval) nor time from adrenalectomy to cyclophosphamide therapy predicted response. Patients with dominant soft tissue disease appeared to have a greater chance of response than those with predominantly visceral or bony disease. Mild-to-moderate gastrointestinal and hematologic toxicity was seen in the majority of patients, but transient adrenal insufficiency was noted in only two women. There were no deaths due to toxicity, and increased maintenance corticoid dosage was not required. Cyclophosphamide is a useful palliative agent in advanced breast cancer patients who have relapsed after response to adrenalectomy, even when 5-fluorouracil was combined with the procedure.