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document
Comparison of chemotherapy with chemohormonal therapy as first-line therapy for metastatic , hormone-sensitive breast cancer : An Eastern Cooperative Oncology Group study . PURPOSE Although hormonal therapy represents standard therapy for metastatic hormone-sensitive disease , many patients receive initial chemotherapy because of the location , bulk , or aggressiveness of their disease . It is uncertain whether simultaneous hormonal therapy provides additional benefit compared with chemotherapy alone . Eastern Cooperative Oncology Group trial E3186 was initiated to explore this question . PATIENTS AND METHODS Between January 1988 and December 1992 , 231 patients with estrogen receptor ( ER ) -positive or ER-unknown metastatic breast cancer were randomized to receive either chemotherapy ( cyclophosphamide , doxorubicin , and fluorouracil ¿CAF ) or chemohormonal therapy ( CAF plus tamoxifen and Halotestin ¿fluoxymesterone ; Pharmacia-Upjohn , Kalamazoo , MI ¿CAFTH ) as front-line therapy for metastatic breast cancer . Patients who experienced a complete response to induction therapy either received or did not receive maintenance cyclophosphamide , methotrexate , fluorouracil , prednisone , and TH as a secondary randomization . RESULTS The response rates ( complete response and partial response ) of patients who received CAF and CAFTH were similar ( 69.2 % v 68.9 % , respectively ; P =.99 ) . Time to treatment failure ( TTF ) was slightly longer for patients who received chemohormonal therapy compared with chemotherapy alone patients ( 13.4 months v 10.3 months , respectively ; P =.087 ) , and TTF was significantly longer in ER-positive compared with ER-negative patients ( 17.4 months v 10.3 months , respectively ; P =.048 ) . However , ER status had no effect on overall survival ( 30.0 months for CAF v 29.3 months for CAFTH ) . CONCLUSION In patients with potentially hormone-sensitive metastatic breast cancer , chemohormonal therapy prolongs TTF for ER-positive patients without improving overall survival .
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
chemohormonal therapy
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
simultaneous hormonal therapy
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Outcome_Physical
response rates
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Outcome_Physical
Time to treatment failure ( TTF )
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Outcome_Physical
TTF
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Outcome_Mortality
overall survival
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Participant_Condition
metastatic , hormone-sensitive breast cancer
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Participant_Sample-size
231