Although this maximum reduction is notably larger than the corresponding above reported reduction due to CMF administration, it steadily decreases afterwards to very low values at the end of the analysed follow-up span.
At that time, the MAM1 trial was promptly designed to evaluate directly, with one of its two factorial comparisons, the superiority of this sequential regimen over the classical CMF and it represents to date the only full report addressing this issue.
We conclude that patients with potentially endocrine responsive node-positive disease who are over 40 years of age can be adequately treated with three rather than six cycles of CMF especially if it is followed by tamoxifen.
It was noted in that study that there was a strong tendency for the older patients to be undertreated, and in a subsequent study from the same group, looking at alternating CMF and adriamycin, it is clear that older women had a poorer outcome than younger women on the same regimen (Bonadonna et al, 1995b).
Kaplan Meier estimates of DFS at 5 years were 0.51 for CMF, 0.56 for CMF → GT, 0.53 for A → CMF and 0.71 for A → CMF → GT.
When we studied the survival of patients with subtype I breast cancer following CMF or CAF adjuvant chemotherapy, it was noticed that both groups had good long-term survival outcome based on the results from a limited number of patients.
We selected the US as the most appropriate comparison population for the overall CMF analyses and we used it as the comparison population for the exposure subgroup analyses for consistency.
At multivariate analysis, HR was 0.86 for CMF → GT, 0.86 for A → CMF and 0.53 for A → CMF → GT as compared to the reference CMF arm.
A survey of a representative sample of nearly 2,000 rural households in AP released on November 16th by the Centre for Microfinance (CMF), an Indian research institute, makes it possible to assess such claims.
