CMF IV: It is the consensus opinion of the oncology reference committee that this protocol is not considered best practice for this patient population.
Treatment schedule summary
Frequency: Every 3 weeks
"Classical CMF" (oral cyclophosphamide D1-14, IV fluorouracil and methotrexate D1 and 8, Q 4/52) has been compared with "modified" intravenous CMF (all drugs given IV d1 Q 3/52) in a randomised controlled trial in postmenopausal women with advanced breast cancer. The response rate was significantly better in favour of the classical CMF arm (48% vs 29%, p=0.003), and overall survival was also superior for classical CMF (17 months vs 12 months, p=0.016). This trial is the only one directly comparing the two CMF regimens. The results are consistent with classical CMF being a superior regimen, probably explained by the higher dose intensity achieved.r
Based on the results of this study confirming inferiority of the intravenous CMF regimen, it is recommended that IV CMF be considered a superseded regimen, to be replaced by "classical CMF" as the preferred CMF regimen.