Adjuvant therapy The aim of<unk>  as adjuvanted therapy is to eradicate micro metastasis and prolong disease free survival. Vs standard adjuvant therapy The Standard adjuvant therapy is a combination of cyclophosphamide, methotrexate and fluorouracil (CMF). In comparison to this the<unk>  therapy contains fluorouracil/epirubicin/cyclophosphamide (FEC). Three large randomized studies have directly compared the<unk> -containing regimen fluorouracil/epirubicin/cyclophosphamide (FEC) with CMF in the adjuvant setting. Trial one and two contained premenopausal node-positive women with breast cancer, Trial three pre- and postmenopausal women with node-positive or negative breast cancer. It was discovered that FEC is at least as effective as CMF in premenopausal women with node positive- or negative breast cancer and that FEC produced no additional benefit in terms of 5-year relapse-free or overall survival. Dose response Researchers discovered a benefit for<unk>  100 mg (FEC 100) over<unk>  50 mg (FEC 50). Patients with FEC100 treatment of the study were relapse-free and an overall survival rate at 5 years higher as in FEC 50 treatment. They also compared<unk>  90 mg/m2 (EC 90) with<unk>  120 mg/m2 (EC 120). After a mean follow up of 27 months elapse-free survival of patients who received EC 120 was significantly longer than that of patients who received EC 90. The combination of<unk>  and tamoxifen lead to an increase survival in node-positive postmenopausal women with hormone receptor-positive breast tumours. Advanced breast cancer First-line therapy<unk>  monotherapy was shown to be therapeutically equivalent to doxorubicin monotherapy in patients who had to receive previous chemotherapy for advanced breast cancer. There are several Combination therapies: 1. FEC: fluorouracil + cyclophosphamide +<unk> ; 2. FAC: fluorouracil + cyclophosphamide + doxorubicin. The median survival rates markedly better than those achieved with<unk>  monotherapy. Additionally the FEC treatment seems to be less toxic. Second-line therapy Patients with advanced breast cancer who experience disease progression after first-line therapy may respond to subsequent chemotherapy regimens; however, response rates and durations are generally lower than those seen after initial treatment with these regimens (FEC and FAC). Dose escalation A reduced dose intensity leads to reduced response rates . Equimolar doses of<unk>  and doxorubicin have been shown to be therapeutically equivalent in patients with metastatic breast cancer. Additionally the administration of more dose intensive<unk> -containing regimens to patients with metastatic breast cancer has been associated with improved response rates, but not increased overall survival. It is suggested that it is necessary to at least double the dose of chemotherapy to detect a clinically relevant effect.
Epirubicin
Valrubicin
Ifosfamide
Vincristine
Doxorubicin
Daunorubicin
Mitoxantrone
Etoposide