Cyclophosphamide breast cancer

Clinical trials showed therapeutic efficacy in a broad spectrum of tumors these include SCLC, testicular tumors, sarcomas, breast cancer, renal cell cancer, pancreatic tumors and lymphomas. Ifosfamide is less myelosuppressive than cyclophosphamide but is more toxic to the bladder. Therefore it is recommended that ifosfamide is coadministered with the thiol compound mesna to avoid hemorrhagic cystitis and to reduce the risk of developing bladder cancer. Other side effects include neurotoxicity and myelosuppression. 

Thiotepa is chemically less reactive than the nitrogen mustards. It has antineoplastic activity against ovarian and breast cancers as well as lymphomas. However, it has been largely supplanted by cyclophosphamide and other nitrogen mustards. 

Cytotoxic drugs that have been used alone and in combination as adjuvant therapy in breast cancer include doxorubicin, epirubicin, cyclophosphamide, methotrexate, fluorouracil,... 

CMF regimen is a combination of cyclophosphamide, MTX, and 5-FU, and represents one of the treatments of choice for women with non-metastatic breast cancer, significantly increasing disease-free and overall survival. A recent report in a... 

Maloisel F, Dufour P, Bergerat JP, et al. Results of initial doxorubicin, 5-fluorouracil, and cyclophosphamide combination chemotherapy for inflammatory carcinoma of the breast. Cancer 1990 65 851-855. 

Dhingra K, Esparza-Guerra L, Valero V, et al. A Phase III Randomized Trial of Dose-Intensive, Neoadjuvant 5FU, Doxorubicin, Cyclophosphamide (FAC) with G-CSF (filgrastim) in Locally Advanced Breast Cancer (LABC)-Efficacy and Safety Data (Meeting abstract). ProcAnnu Meet Am Soc Clin Oncol 1999 18 A278. 

Cyclophosphamide is a component of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) and other drug combinations used in the treatment of breast cancer. Cyclophosphamide in combination may produce complete remissions in some patients with ovarian cancer and oat cell (small cell) lung cancer. Other tumors in which benehcial results have been reported include non-oat cell lung cancers, various sarcomas, neuroblastoma, and carcinomas of the testes, cervix, and bladder. Cyclophosphamide also can be employed as an alternative to azathioprine in suppressing immunological rejection of transplant organs. 

The major indications for melphalan are in the palliative therapy of multiple myeloma and cancers of the breast or ovary. Because it does not produce alopecia, melphalan is occasionally substituted for cyclophosphamide in the CMF regimen for breast cancer. 

G. Other applications Herceptin has been combined with cisplatin in the treatment of heavily pretreated metastatic breast cancer. Treatment of patients with ovarian cancer is under investigation. A recent study demonstrated that Herceptin increased the clinical benefits of first-line chemotherapy—doxorubicin (or epiru-bicin) and cyclophosphamide or pacli-taxel—in metastatic breast cancer that overexpressed HER2. 

Cyclophosphamide Same as above Breast cancer, ovarian cancer, non-Flodgkin s lymphoma, CLL, soft tissue sarcoma, neuroblastoma, Wilms tumor, rhabdomyosarcoma Nausea and vomiting ... 

Several trials were performed on breast cancer patients treated with cyclophosphamide. Little local toxicity was found, and an antibody response was evidenced. Partial clinical responses and disease stabilizations were obtained. [200-202]. Adluri et al. [203] compared vaccines using Detox or QS-21 in an adjuvant therapy for colorectal cancer patients. Toxicity was mostly local. An antibody response was... 

A phase II trial was performed on metastatic breast cancer patients with or without cyclophosphamide [204]. The results showed a local toxicity. Cyclophosphamide was not efficient. An antibody response was evidenced. No complete remission was obtained. 

In another study involving patients with metastatic breast, colorectal and ovarian cancer, increased anti-sTn titers were correlated with better survival. Even if before treatment, elevated titers of antibodies against the mucin MUC1, were correlated with a poor response to immunotherapy, CTL precursors to the MUC1 were detected in carcinoma patients [208], A vaccine using 10 pg/ml MUC1-KLH mixed with Detox was injected s.c. in breast cancer patients treated with cyclophosphamide. A weak antibody response, and an ex vivo CTL response against HLA-matched adenocarcinoma cell lines were seen. No correlation with the clinical outcome was available [209],... 

Advantage is taken of the properties of antimctabolitcs in chemotherapy. In cancer chemotherapy, several antimetabolites are used. These include methotrexate, 6-mercaptopunne, 6-thioguanine, 5-fluorouracil, and cystine arabinoside. In the chemotherapy of metastatic breast cancer, 5-fluorouracil and methotrexate, in combination with cyclophosphamide, have been used. Antimetabolites, sometimes along with corticosteroids, are used in the therapy of various autoimmune diseases, such as thrombocytenic purpura, thyroiditis, Goodpasture s syndrome, among others. 

Issac C, Robert NJ, Bailey FA, Schuster MW, et al. 1997. Randomized placebo-controlled study of recombinant human interleukin 11 to prevent chemotherapy induced thrombocytopenia in patients with breast cancer receiving dose-intensive cyclophosphamide and doxorubicin. J Clin Oncol. 15 3368-3377. 

Distante V, Bolognesi A, Aldrighetti D, Farris A. Cyclophosphamide, methotrexate, and fluorouracil versus tamoxifen plus ovarian suppression as adjuvant treatment of estrogen receptor-positive pre-/perimenopausal breast cancer patients results of the Italian Breast Cancer Adjuvant Study Group 02 randomized trial. J Clin Oncol 2000 18(14) 2718-27. 

CMF Cyclophosphamide (Cytoxan), methotrexate, 5-fluorouracil Breast cancer... 

FAC 5-Fluorouracil, doxorubicin (Adriamycin), cyclophosphamide (Cytoxan) Breast cancer... 

Cyclophosphamide (Cytoxan and Endoxan) is used in the treatment of Hodgkin s disease, lymphosarcoma, and other lymphomas. It is employed as a secondary drug in patients with acute leukemia and in combination with doxorubicin in women with breast cancer. A drug combination effective in the treatment of breast cancer is cyclophosphamide, methotrexate, fluorouracil, and prednisone (CMFP). Cyclophosphamide is also an immunosuppressive agent. The toxicity of cyclophosphamide causes alopecia, bone marrow depression, nausea and vomiting, and hemorrhagic cystitis. 

All patients had stage IV breast cancer receiving first-line chemotherapy, either AC (doxorubicin or epirubicin plus cyclophosphamide) or T (paclitaxel). Data from Slamon et al. (250). 

Taylor CW, Dalton WS, Mosley K, et al. Combination chemotherapy with cyclophosphamide, vincristine, adriamycin, and dexamethasone (CVAD) plus oral quinine and verapamil in patients with advanced breast cancer. Breast Cancer Res Treat 1997 42(1) 7-14. 

Modlich O, Prisack HB, Munnes M, Audretsch W, Bojar H. Predictors of primary breast cancers responsiveness to preoperative epirubicin/cyclophosphamide-based chemotherapy Translation of microarray data into clinically useful predictive signatures. J Transl Med 2005 3 32. 

Ayers M, Symmans WF, Stec J, Damokosh Al, Clark E, Hess K, et al. Gene expression profiles predict complete pathologic response to neoadjuvant paclitaxel and fluorouraril, doxorubicin, and cyclophosphamide chemotherapy in breast cancer. J Clin Oncol 2004 22(12)2284-2293. 

Knoop AS, Knudsen H, Balslev E, Rasmussen BB, Overgaard J, Nielsen KV, et al. retrospective analysis of topoisomerase lla amplifications and deletions as predictive markers in primary breast cancer patients randomlyassignedtocyclophosphamide, methotrexate, andfluorouracilor cyclophosphamide, epirubicin, and fluorouracil Danish Breast Cancer Cooperative Group. J Clin Oncol 2005 23(30) 7483-90. 

Therapeutic applications These agents have a broad clinical spectrum, being used either singly or as part of a regimen in treatment of a wide variety of neoplastic diseases, for example, Burkitt s lymphoma and breast cancer. Non-neoplastic disease entities, such as nephrotic syndrome and intractable rheumatoid arthritis, are also effectively treated with cyclophosphamide. 

Batist, G., Ramakrishnan, G., and Rao, C. S. (2001), Reduced cardiotoxicity and preserved antitumor efficacy of liposome-encapsulated doxorubicin and cyclophosphamide compared with conventional doxorubicin and cyclophosphamide in a randomized, multicenter trial of metastatic breast cancer,/. Clin. Oncol., 19,1444-1454. 

Chan, S., Davidson, N., Juozaityte, E., Erdkamp, F., Pluzanska, A., Azarnia, N., and Lee, L. W. (2004), Phase III trial of liposomal doxorubicin and cyclophosphamide compared with epirubicin and cyclophosphamide as first line therapy for metastatic breast cancer, Ann. Oncol., 15,1527-1534. 

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