Effect of c-erbB(2) and estrogen receptor status on survival of women with primary breast cancer treated with adjuvant cyclophosphamide/methotrexate/fluorouracil.

We have investigated the relationship between c-erbB(2) status, estrogen receptor (ER) status and outcome in 274 women with node-positive breast cancer who, following excision and axillary clearance, were randomized to receive either 6 cycles of cyclophosphamide/methotrexate/fluorouracil (CMF) (n = 129) or no such treatment (n = 145). Follow-up data (median 13.3 years) were available on all patients. CMF improved relapse-free and overall survival of all women. The greatest benefit was seen in women with ER-negative tumors; the median overall survival of those given CMF was 11.6 years compared with only 2 years for the control group. For the women with ER-positive tumors the median overall survival of the CMF-treated women was 11.3 years compared with 7.7 years in the control group. When benefit from CMF was examined in relation to c-erbB(2) status, the women with c-erbB(2)-negative tumors who received CMF had a median overall survival of 12.7 years compared with only 7.3 years for the c-erbB(2)-negative women in the control group. The improvement in survival was less marked in the women with c-erbB(2)-positive tumors; median overall survival was 6.1 years for those who received CMF compared with 4.4 years for women in the control group. All women benefited from adjuvant CMF chemotherapy, those with ER-negative tumors benefiting the most. Int. J. Cancer (Pred. Oncol.) 84:354-359, 1999.