Survival in advanced breast cancer Combination chemotherapy improves outlook

BMJ 1994;308:1103 (23 April)

Letters

Survival in advanced breast cancer Combination chemotherapy improves outlook

EDITOR, - I E Smith's editorial on palliative chemotherapy foradvanced non-small cell lung cancer contains a worrying errorof fact.¹ The statement that an average improvement in survivalof around three months after chemotherapy is more than has beenshown for chemotherapy in advanced breast cancer is not correct.

It is true that relatively ineffective protocols - for example,classic cyclophosphamide, methotrexate, and fluorouracil givenover 14 days or mitozantrone, mitomycin C, and methotrexate- often give disappointing results. However, effective combinationchemotherapy given to patients with disseminated breast cancerproduces an overall response rate of between 45% and 80%, witha median duration of response of 5-13 months and a median durationof survival among responders of 15-33 months. This is an internationallyrecognised consensus opinion, so widely accepted that it hasnow been included in standard textbooks of cancer medicine.²Contrary to widespread belief, such protocols can . . . [Full text of this article]