Research Article

Chemoimmunotherapy of advanced breast cancer: prolongation of remission and survival with BCG.

Br Med J 1976; 2 doi: https://doi.org/10.1136/bmj.2.6046.1222 (Published 20 November 1976) Cite this as: Br Med J 1976;2:1222
  1. J U Gutterman,
  2. J O Cardenas,
  3. G R Blumenschein,
  4. G Hortobagyi,
  5. M A Burgess,
  6. R B Livingston,
  7. G M Mavligit,
  8. E J Freireich,
  9. J A Gottlieb,
  10. E M Hersh

    Abstract

    Forty-five patients with disseminated breast cancer were given a trial of combination chemotherapy consisting of fluorouracil, adriamycin, and cyclophosphamide (FAC) and immunotherapy with BCG given by scarification. The results were compared with those in a comparable group of 44 patients treated with FAC alone immediately before the chemoimmunotherapy study. The remission rates (73% and 76% for FAC and FAC-BCG respectively) were similar in both studies. The durations of remission for patients on FAC-BCG (medium 12 months) were longer than remissions achieved for patients given FAC alone (median 8 months) (P = 0.068). The most notable effect of BCG was on survival. Thus 21 out of 34 patients achieving remission on FAC-BCG were alive at the time of the last follow-up examination (median over 22 months) compared with 11 out of 32 patients achieving remission on FAC (median 15 months) (P = 0.01). Twenty-six of the 45 patients given FAC-BCG were alive at the time of the last follow-up examination (median over 22 months) compared with 12 of the 44 patients given FAC (median 15 months) (P = 0.005). Although the apparent benefit of BCG could be explained by a maldistribution of some prognostic factors, the data suggest that further trial of chemoimmunotherapy of breast cancer should be carried out.