The chemical therapy of breast cancer.

Abstract

0 F ALL THE MAJOR solid tumor types, adenocarcinoma of the breast is one of the most responsive to a chemotherapeutic approach. A wide range of chemicals with different mechanisms of action can induce a shrinkage of measurable tumor by greater than 50% (standard definition of objective regression) in a significant number of patients with advanced disease. This results in palliation and prolonged survival for the patient but not in cure. Recently, combinations of drugs have produced tumor regressions in advanced disease in more than half the women treated, and breast cancer has become a prime target for a combined modality approach to primary therapy with the hope of increasing the cure rate for this feared tumor. Within the Division of Cancer Treatment of the National Cancer Institute, the concept of combined modalities is an essential part of the therapeutic strategy aimed at increasing cure rates in all solid tumors. The Division’s main thrust in the combined modality area will be with chetnotherapy plus surgery and/or radiotherapy and/or immunotherapy. This is logical both from the standpoint of the long-established DCT expertise in chemotherapy and from the fact that chemotherapy is the only modality of unquestionable effectiveness in killing tumor cells anywhere in the body. Chemotherapy, either with drugs alone or in combination, can cure some patients with at least eight different kinds of cancer.’ The philosophic basis of the combined modality approach is the recognition that both surgery and radiotherapy have reached a plateau in their ability to cure solid tumors. They are local modalities that kill tumor cells only where they are applied,