A three-drug chemotherapy combination that includes epirubicin appears to significantly improve disease-free survival and overall survival for premenopausal patients with lymph node-positive breast cancer, according to French researchers.

The researchers reported in the Journal of Clinical Oncology on a study conducted between 1986 and 1990 in which 621 patients with operable breast cancer were randomly assigned to receive various combinations and doses of the chemotherapy drugs fluorouracil, epirubicin, and cyclophosphamide.

After a median followup of almost 11 years, the researchers found that the 10-year disease-free survival was 53.4 percent for those receiving the three chemotherapy drugs every 21 days for six cycles (FEC 50); 42.5 percent for those receiving the combination for three cycles; and 43.6 percent for those receiving the same combination but with a stronger dose of epirubicin for three cycles.

The 10-year overall survival for those receiving the combination for six cycles was 64.3 percent; for those receiving the combination for three cycles 56.6 percent; and for those in the stronger epirubicin group 59.7 percent

"After a long-term follow-up in an adjuvant setting, the benefit of six cycles of FEC 50 compared with three cycles, whatever the dose, is highly significant in terms of disease free survival," the researchers concluded. "s regards overall survival, the group receiving six cycles of FEC 50 has significantly better results than the group receiving three cycles of FEC 50."

Other sources: Journal of Clinical Oncology