New Zealand Formulary
Menu Close Menu

Fewer cancers.
Better survival.
Equity for all.

Systemic Anti-Cancer Therapy Regimen Library

Home > BR Adjuvant - CMF classical IV [CYCLOPHOSPHamide, metHOTREXATe and fluorouracil]

BR Adjuvant - CMF classical IV [CYCLOPHOSPHamide, metHOTREXATe and fluorouracil]

Treatment Overview

Cycles 1 to 6 - 28 days

Cycle length:
28

Cycle details

Cycles 1 to 6 - 28 days

Medication Dose Route Days Max Duration
dexamethasone * 8 mg oral administration 1, 2, 3,
8, 9, 10
ondansetron 8 mg oral administration 1, 8
fluorouracil * 600 mg/m² intravenous 1, 8 15 minutes
metHOTREXATe 40 mg/m² intravenous 1, 8 5 minutes
CYCLOPHOSPHamide 600 mg/m² intravenous 1, 8 60 minutes
ondansetron 8 mg oral administration 1, 8
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

Full details

Cycles 1 to 6 - 28 days

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
fluorouracil * 600 mg/m² intravenous 15 minutes
metHOTREXATe 40 mg/m² intravenous 5 minutes
CYCLOPHOSPHamide 600 mg/m² intravenous 60 minutes
ondansetron 8 mg oral administration
Instructions:
EIGHT hours after chemotherapy OR before bed.
domperidone 10 mg Three times daily oral administration
Instructions:
When required for nausea and/or vomiting. The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.

Day: 3

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.

Day: 8

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
fluorouracil * 600 mg/m² intravenous 15 minutes
metHOTREXATe 40 mg/m² intravenous 5 minutes
CYCLOPHOSPHamide 600 mg/m² intravenous 60 minutes
ondansetron 8 mg oral administration
Instructions:
EIGHT hours after chemotherapy OR before bed.

Day: 9

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.

Day: 10

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Medium

References

Bonadonna, G., P. Valagussa, A. Moliterni, et al. 1995. "Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up." N.Engl.J.Med. 332(14):901-906., PMID: 7877646

Bonadonna, G., A. Moliterni, M. Zambetti, et al. 2005. "30 years' follow up of randomised studies of adjuvant CMF in operable breast cancer: cohort study." BMJ 330(7485):217., PMID: 15649903

Bishop, J. F., J. Dewar, G. C. Toner, et al. 1999. "Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer." J Clin Oncol 17(8):2355-2364., PMID: 10561297

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.