79646
document
Randomized clinical trial of tamoxifen plus sequential CMF chemotherapy versus tamoxifen alone in postmenopausal women with advanced breast cancer . Eighty-eight postmenopausal women with metastatic breast cancer , in whom estrogen receptors ( ER ) were positive or unknown , were treated on a controlled trial to determine the effectiveness of tamoxifen and to assess the therapeutic advantage of sequentially adding low-dose cyclophosphamide-methotrexate-5-fluorouracil ( CMF ) chemotherapy in tamoxifen responders . Patients with known ER negative status were not studied . After the initial 12-week treatment with tamoxifen alone , 60 % of ER positive patients achieved complete or partial response as did 35 % in whom ER were unknown . Response status further improved in 18 % randomized to continue tamoxifen alone vs 31 % in whom CMF was added to tamoxifen . There were no statistically significant differences in time to the development of progressive disease or survival between the ER positive and ER unknown patients or between the tamoxifen and tamoxifen plus CMF groups . We conclude that inability to determine ER status should not prejudice against the use of tamoxifen in postmenopausal patients with advanced breast cancer . No benefit has been demonstrated from the addition of CMF chemotherapy in tamoxifen responders .
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Intervention_Pharmacological
tamoxifen
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Intervention_Pharmacological
low-dose cyclophosphamide-methotrexate-5-fluorouracil ( CMF ) chemotherapy in tamoxifen responders
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Intervention_Pharmacological
tamoxifen alone
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Outcome_Other
effectiveness
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Outcome_Other
therapeutic advantage
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Outcome_Other
complete or partial response
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Outcome_Physical
development of progressive disease
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Outcome_Other
or
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Outcome_Mortality
survival
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Participant_Condition
postmenopausal
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Participant_Sex
women
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Participant_Condition
advanced breast cancer
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Participant_Sample-size
Eighty-eight
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Participant_Condition
estrogen receptors ( ER ) were positive or unknown