Phase II Evaluation of Methotrexate, Vinblastine, Doxorubicin, and Cisplatin (M-VAC) in Advanced, Measurable Breast Carcinoma

The purpose of this study was to determine whether methotrexate, vinblastine, doxorubicin, and cisplatin, each individually active in metastatic breast cancer (MBC), could, in combination, produce an overall response rate, median survival, and long-term survival sufficiently promising to merit its consideration for phase 111 trials in MBC and as induction therapy prior to autologous bone marrow transplant. From July 1986 through February 1990,30patients with stage IV, measurable breast carcinoma received M-VAC: methotrexate–30 mglm days 1,15, 22; vinblastine–3 mg/m2 days 2, 15, 22; doxorubicin–30 mglm day 2; cisplatin–70 mglm day 2. Cycles were repeated at 4-week intervals for up to six courses. Median age was 53 years (range 34–64 years). Prior treatment included adjuvant cyclophosphamide, methotrexate, and 5-Fluorouracil in 12 patients, radiotherapy in 13 patients, and hormonal therapy in 14 patients. Eleven patients were ER (+) at the time of initial diagnosis. Five patients had disease restricted to b...