Meta-analysis of adjuvant cyclophosphamide/methotrexate/5-fluorouracil chemotherapy in postmenopausal women with estrogen receptor-positive, node-positive breast cancer

Anne Renee Hartman, Gini F. Fleming, John J. Dillon

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Conflicting results have been published regarding the efficacy of adjuvant cyclophosphamide/methotrexate/5-fluorouracil (CMF)-type chemotherapy in postmenopausal, estrogen receptor (ER)-positive women. The Oxford overview suggests real but limited benefit of any chemotherapy in this group of patients but avoids analyzing smaller subsets. We wished to better quantitate the benefit of adding CMF to tamoxifen in postmenopausal ER-positive women with tumor involvement of axillary lymph nodes. Six randomized studies comparing CMF plus tamoxifen to tamoxifen alone in postmenopausal, ER-positive, node-positive women have been published since 1992. They include 2368 patients. We performed a meta-analysis of 6 endpoints: survival, disease-free survival, locoregional recurrence, distant recurrence, contralateral breast recurrence, and thromboembolic complications. There was a statistically significant increase in disease-free survival from the addition of CMF-type chemotherapy to tamoxifen in this population; the absolute risk of relapse was reduced by 5.5% at 5 years. Effects of loco-regional recurrence were greater than those on overall recurrence. No significant survival benefit was observed.

Original languageEnglish (US)
Pages (from-to)138-143
Number of pages6
JournalClinical breast cancer
Volume2
Issue number2
DOIs
StatePublished - Jul 2001

Keywords

  • CMF
  • Chemotherapy
  • Estrogen receptor
  • Meta-analysis
  • Postmenopausal women
  • Tamoxifren

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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