The CAF regimen is well established in both the metastatic and adjuvant settings in breast cancer. It is one of several standrd therapies in common use in the metastatic disease, although it does suffer from a disadvantage of not containing taxanes, probably the most active class of drugs for breast cancer. The Southeastern Cancer Study Group, in a recent prospectively randomized study of patients with advanced breast cancer, compared a low dose intermittently administered five-drug regimen including cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone (CMFVP) with an aggressively administered three-drug regimen including cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF). CAF induced more responses and more complete responses and a longer duration of disease control. However, only a marginal difference was demonstrated in overall survival between the two regimens.
In general, the approach to metastatic breast cancer has shifted toward sequential use of single agents with teh goal of long-term control at least price in terms of txicity. However, combination therapy remains an acceptable option.
Richard V. Smalley et al, A comparison of cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) and cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone (CMFVP) in patients with advanced breast cancer
Journal Breast Cancer Research and Treatment Volume 3, Number 2 / June, 1983
von Minckwitz, G (Mar 2007). “Docetaxel/anthracycline combinations for breast cancer treatment”. Expert Opinion on Pharmacotherapy 8 (4): 485–495.
nccn.org, breast cancer