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Meta-Analysis
. 2010 Nov 10;2010(11):CD003368.
doi: 10.1002/14651858.CD003368.pub3.

Addition of drug/s to a chemotherapy regimen for metastatic breast cancer

Daria J Butters  1 , Davina Ghersi, Nicholas Wilcken, Steven J Kirk, Peter T Mallon
Affiliations
Meta-Analysis

Addition of drug/s to a chemotherapy regimen for metastatic breast cancer

Daria J Butters et al. Cochrane Database Syst Rev. .

Abstract

Background: The addition of a chemotherapy drug or drugs to an established regimen is one method used to increase the dose and intensity of treatment for metastatic breast cancer.

Objectives: To assess the effects of adding one or more chemotherapy drugs to an established regimen in women with metastatic breast cancer.

Search strategy: We searched the Cochrane Breast Cancer Group's Specialised Register (to August 2009) using the codes for "advanced breast cancer" and "chemotherapy". This review is an update of the original Cochrane Review (Issue 3, 2006).

Selection criteria: Randomised trials with a first line regimen of at least two chemotherapy drugs compared to the same regimen plus the addition of one or more chemotherapy drugs in women with metastatic breast cancer.

Data collection and analysis: Two authors extracted data independently from published trials. We derived hazard ratios (HR) from time-to-event outcomes where possible, and used a fixed-effect model for meta-analysis. We analysed response rates as dichotomous variables and extracted toxicity data where available.

Main results: We identified 17 trials reporting on 22 treatment comparisons (2674 patients randomised). Fifteen trials (20 treatment comparisons) reported results for tumour response and 11 trials (14 treatment comparisons) published time-to-event data for overall survival. There were 1532 deaths in 2116 women randomised to trials of the addition of a drug to the regimen and control (the regimen alone). There was no detectable difference in overall survival between these patients, with an overall HR of 0.96 (95% confidence interval (CI) 0.87 to 1.07, P = 0.47) and no significant heterogeneity. We found no difference in time to progression between these regimens, with an overall HR of 0.93 (95% CI 0.81 to 1.07, P = 0.31) and no significant heterogeneity. Addition of a drug to the regimen was favourably associated with overall tumour response rates (odds ratio 1.21, 95% CI 1.01 to 1.44, P = 0.04) although we observed significant heterogeneity for this outcome across the trials. Where measured, acute toxicities such as alopecia, nausea and vomiting and leucopenia were more common with the addition of a drug.

Authors' conclusions: The addition of one or more drugs to the regimen shows a statistically significant advantage for tumour response in women with metastatic breast cancer but the results suggest no difference in survival time or time to progression. The positive effect on tumour response was also associated with increased toxicity.

PubMed Disclaimer

Conflict of interest statement

DB wrote the review published in May 2006 while u ndertaking her Masters course at The University of Sydney. Following its publication, DB was employed by the Clin ical Research Organisation Parexel (UK) from August 2006 until October 2009 and worked on a variety of oncology studies including breast cancer. DB was not involved in updating the review during 2009 and 2010 but it should be mentioned that DB wa s s till affiliated with Parexel in 2009.

Figures

1
1
2
2
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
3
3
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
1.1
1.1. Analysis
Comparison 1: Overall survival, Outcome 1: Overall survival (all trials)
1.2
1.2. Analysis
Comparison 1: Overall survival, Outcome 2: Overall survival (sensitivity analysis)
1.3
1.3. Analysis
Comparison 1: Overall survival, Outcome 3: Overall survival (addition of 'less active' drug vs addition of 'more active' drug)
1.4
1.4. Analysis
Comparison 1: Overall survival, Outcome 4: Overall survival (adjusted dose in addition of drug arm vs no dose adjustment)
1.5
1.5. Analysis
Comparison 1: Overall survival, Outcome 5: Overall survival (addition of anthracycline vs addition of non‐anthracycline)
1.6
1.6. Analysis
Comparison 1: Overall survival, Outcome 6: Overall survival (addition of 1 agent vs addition of 2 or more agents)
2.1
2.1. Analysis
Comparison 2: Time to progression, Outcome 1: Time to progression (all trials)
2.2
2.2. Analysis
Comparison 2: Time to progression, Outcome 2: Time to progression (sensitivity analysis)
3.1
3.1. Analysis
Comparison 3: Overall response (assessable patients), Outcome 1: Overall response (all trials)
3.2
3.2. Analysis
Comparison 3: Overall response (assessable patients), Outcome 2: Overall response (sensitivity analysis)
3.3
3.3. Analysis
Comparison 3: Overall response (assessable patients), Outcome 3: Overall response (addition of 'less active' drug vs addition of 'more active' drug)
3.4
3.4. Analysis
Comparison 3: Overall response (assessable patients), Outcome 4: Overall response (adjusted dose in addition of a drug arm vs no dose adjustment)
3.5
3.5. Analysis
Comparison 3: Overall response (assessable patients), Outcome 5: Overall response (addition of anthracycline vs addition of non‐anthracycline)
3.6
3.6. Analysis
Comparison 3: Overall response (assessable patients), Outcome 6: Overall response (addition of 1 agent vs addition of 2 or more agents)
4.1
4.1. Analysis
Comparison 4: Treatment‐related deaths, Outcome 1: All trials
4.2
4.2. Analysis
Comparison 4: Treatment‐related deaths, Outcome 2: All trials (sensitivity analysis)
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Ahmann 1976a {published data only}
    1. Ahmann DL, O'Connell MJ, Bisel HF. An evaluation of Cytoxan/Adriamycin (CA) vs. Cytoxan/Adriamycin/5-Fluorouracil (CAF) vs. Cytoxan/5-Fluorouracil/Prednisone (CFP) in advanced breast cancer. In: Proceedings of the American Association for Cancer Research. Vol. 17. 1976:278.
Ahmann 1976b {published data only}
    1. Ahmann DL, O'Connell MJ, Bisel HF. An evaluation of Cytoxan/Adriamycin (CA) vs. Cytoxan/Adriamycin/5-Fluorouracil (CAF) vs. Cytoxan/5-Fluorouracil/Prednisone (CFP) in advanced breast cancer. In: Proceedings of the American Association for Cancer Research. Vol. 17. 1976:278.
Aisner 1987a {published data only}
    1. Aisner J, Weinberg V, Perloff M, Weiss R, Perry M, Korzun A, et al. Chemotherapy versus chemoimmunotherapy (CAF v CAFVP v CMF each +/- MER) for metastatic carcinoma of the breast: a CALGB study. Cancer and Leukemia Group B. Journal of Clinical Oncology 1987;5(10):1523-33. - PubMed
Aisner 1987b {published data only}
    1. Aisner J, Weinberg V, Perloff M, Weiss R, Perry M, Korzun A, et al. Chemotherapy versus chemoimmunotherapy (CAF v CAFVP v CMF each +/- MER) for metastatic carcinoma of the breast: a CALGB study. Cancer and Leukemia Group B. Journal of Clinical Oncology 1987;5(10):1523-33. - PubMed
Cavalli 1983a {published data only}
    1. Cavalli F, Pedrazzini A, Martz G, Jungi WF, Brunner KW, Goldhirsch A, et al. Randomized trial of 3 different regimens of combination chemotherapy in patients receiving simultaneously a hormonal treatment for advanced breast cancer. European Journal of Cancer and Clinical Oncology 1983;19(11):1615-24. - PubMed
Cavalli 1983b {published data only}
    1. Cavalli F, Pedrazzini A, Martz G, Jungi WF, Brunner KW, Goldhirsch A, et al. Randomized trial of 3 different regimens of combination chemotherapy in patients receiving simultaneously a hormonal treatment for advanced breast cancer. European Journal of Cancer and Clinical Oncology 1983;19(11):1615-24. - PubMed
Chlebowski 1983 {published data only}
    1. Chlebowski RT, Pugh R, Weiner JM, Block JB, Bateman JR. Doxorubicin and CCNU with or without vincristine in patients with advanced refractory breast cancer. A randomized trial. Cancer 1983;52(4):606-9. - PubMed
    1. Chlebowski RT, Pugh R, Weiner JM, Block JB, Bateman JR. Influence of vincristine on survival in advanced refractory breast cancer. Breast Cancer Research and Treatment 1981;1(1):171.
Creech 1979 {published data only}
    1. Creech R, Harris D, Grotzinger P, Engstrom P. Low dose therapy of metastatic breast cancer with CAMF vs. sequential CMF and adriamycin. Proceedings of the American Association for Cancer Research 1977;Mar 16-17:300.
    1. Creech R, Holroyde C, Catalano R, Koons L, Miller D, Engstrom P. Low dose CMF vs. CAMF treatment for metastatic breast cancer. Proceedings of the American Association for Cancer Research 1976;17:259.
    1. Creech RH, Catalano RB, Harris DT, Engstrom PF, Grotzinger PJ. Low dose chemotherapy of metastatic breast cancer with cyclophosphamide, adriamycin, methotrexate, 5-fluorouracil (CAMF) versus sequential cyclophosphamide, methotrexate, 5-fluorouracil (CMF) and adriamycin. Cancer 1979;43:51-9. - PubMed
Cummings 1981a {published data only}
    1. Cummings FJ, Gelman R, Tormey DC, DeWys W, Glick J. Adriamycin plus vincristine alone or with dibromodulcitol or ICRF-159 in metastatic breast cancer. Cancer Clinical Trials 1981;4:253-60. - PubMed
Cummings 1981b {published data only}
    1. Cummings FJ, Gelman R, Tormey DC, DeWys W, Glick J. Adriamycin plus vincristine alone or with dibromodulcitol or ICRF-159 in metastatic breast cancer. Cancer Clinical Trials 1981;4:253-60. - PubMed
Inoue 1984 {published data only}
    1. Inoue K, Ogawa M, Inagaki J, Horikoshi N, Miyamoto H, Ikeda K, et al. A randomized trial of adriamycin, cyclophosphamide, ftorafur (ACF) and adriamycin, cyclophosphamide, ftorafur, methotrexate (ACFM) in patients with advanced breast cancer. Cancer Chemotherapy and Pharmacology 1984;13:95-9. - PubMed
Kennealey 1978 {published data only}
    1. Kennealey GT, Boston B, Mitchell MS, Knobf MK, Bobrow SN, Pezzimenti JF, et al. Combination chemotherapy for advanced breast cancer: two regimens containing adriamycin. Cancer 1978;42(1):27-33. - PubMed
Lokich 1977 {published data only}
    1. Lokich JJ, Skarin AT, Mayer RJ, Henderson IC, Blum RH, Frei E. Adriamycin plus alkylating agents in the treatment of metastatic breast cancer. Cancer 1977;40(6):2801-5. - PubMed
Marschke 1989 {published data only}
    1. Marschke RF Jr, Ingle JN, Schaid DJ, Krook JE, Mailliard JA, Cullinan SA, et al. Randomized clinical trial of CFP versus CMFP in women with metastatic breast cancer. Cancer 1989;63(10):1931-7. - PubMed
Nemoto 1982a {published data only}
    1. Horton J, Dao T, Cunningham T, Nemoto T, Sponzo R, Rosner D, et al. Alternating combination therapy for metastatic breast cancer. Proceedings of the American Association for Cancer Research 1976;17:247.
    1. Nemoto T, Horton J, Simon R, Dao TL, Rosner D, Cunningham T, et al. Comparison of four-combination chemotherapy programs in metastatic breast cancer: comparison of multiple drug therapy with cytoxan, 5-FU and prednisone versus cytoxan and adriamycin, versus cytoxan, 5-FU and adriamycin, versus cytoxan, 5-FU and prednisone alternating with cytoxan and adriamycin. Cancer 1982;49(10):1988-93. - PubMed
Nemoto 1982b {published data only}
    1. Nemoto T, Horton J, Simon R, Dao TL, Rosner D, Cunningham T, et al. Comparison of four-combination chemotherapy programs in metastatic breast cancer: comparison of multiple drug therapy with cytoxan, 5-FU and prednisone versus cytoxan and adriamycin, versus cytoxan, 5-FU and adriamycin, versus cytoxan, 5-FU and prednisone alternating with cytoxan and adriamycin. Cancer 1982;49(10):1988-93. - PubMed
Pannuti 1984 {published data only}
    1. Pannuti F, Iafelice G, Martoni A, Fruet F, Angelelli B, Casadei M. A new six-drug antiblastic regimen (R 14) at low doses (micropolychemotherapy) compared to CMF in the treatment of metastatic breast cancer: phase III study. Chemioterapia 1984;3(4):216-9. - PubMed
Rosner 1989 {published data only}
    1. Rosner D, Lane WW, Nemoto T. Differential response to chemotherapy in metastatic breast cancer in relation to estrogen receptor level. Results of a prospective randomized study. Cancer 1989;64(1):6-15. - PubMed
    1. Rosner D, Nemoto T, Lane WW. A randomized study of intensive versus moderate chemotherapy programs in metastatic breast cancer. Cancer 1987;59(5):874-83. - PubMed
Segaloff 1985 {published data only}
    1. Segaloff A, Hankey BF, Carter AC, Escher GC, Ansfield FJ, Talley RW. An evaluation of the effect of vincristine added to cyclophosphamide, 5-fluorouracil, methotrexate, and prednisone in advanced breast cancer. Breast Cancer Research and Treatment 1985;5(3):311-9. - PubMed
Stein 1992 {published data only}
    1. Stein RC, Bower M, Law M, Bliss JM, Barton C, Gazet JC, et al. Mitozantrone and methotrexate chemotherapy with and without mitomycin C in the treatment of advanced breast cancer: a randomised clinical trial. European Journal of Cancer 1992;28A(12):1963-5. - PubMed
Tranum 1982 {published data only}
    1. Tranum B. Treatment of advanced breast cancer: A 3-arm prospective study. Proceedings of the American Association for Cancer Research 1977;Mar 16-17:274.
    1. Tranum BL, McDonald B, Thigpen T, Vaughn C, Wilson H, Maloney T, et al. Adriamycin combinations in advanced breast cancer. A Southwest Oncology Group Study. Cancer 1982;49(5):835-9. - PubMed
Vogel 1984 {published data only}
    1. Vogel CL, Smalley RV, Raney M, Krauss S, Carpenter J, Velez Garcia E, et al. Randomized trial of cyclophosphamide, doxorubicin, and 5- fluorouracil alone or alternating with a "cycle active" non-cross-resistant combination in women with visceral metastatic breast cancer: a Southeastern Cancer Study Group project. Journal of Clinical Oncology 1984;2:643-51. - PubMed

References to studies excluded from this review

Ahmann 1974a {published data only}
    1. Ahmann DL, Bisel HF, Hahn RG. Phase II clinical trial of isophosphamide (NSC-109724) in patients with advanced breast cancer. Cancer Chemotherapy Reports - Part 1 1974;58(6):861-5. - PubMed
Ahmann 1974b {published data only}
    1. Ahmann DL, Bisel HF, Eagan RT, Edmonson JH, Hahn RG. Controlled evaluation of adriamycin (NSC-123127) in patients with disseminated breast cancer. Cancer Chemotherapy Reports 1974;58(6):877-82. - PubMed
Ahmann 1975 {published data only}
    1. Ahmann DL, Bisel HF, Hahn RG, Eagan RT, Edmonson JH, Steinfeld JL, et al. An analysis of a multiple-drug program in the treatment of patients with advanced breast cancer utilizing 5-fluorouracil, cyclophosphamide, and prednisone with or without vincristine. Cancer 1975;36(6):1925-35. - PubMed
Aisner 1981 {published data only}
    1. Aisner J, Weinberg V, Perloff M, Weiss R, Raich P, Perry M, et al. Chemoimmunotherapy for advanced breast cancer: A randomized comparison of 6 combinations (CMF, CAF vs CAFVP) each with or without MER immunotherapy. A CALGB study. In: Proceedings of the American Association of Cancer Research. 1981:C-433.
Aisner 1995 {published data only}
    1. Aisner J, Cirricione C, Perloff M, Perry M, Budman D, Abrams J, et al. Combination chemotherapy for metastatic or recurrent carcinoma of the breast - A randomised phase III trial comparing CAF versus VATH versus VATH alternating with CMFVP: Cancer and Leukemia Group B study 8281. Journal of Clinical Oncology 1995;13(6):1443-52. - PubMed
Brown 1976 {published data only}
    1. Brown I, Ward HW. Doxorubicin in the treatment of advanced breast cancer; comparative studies of three combination chemotherapy regimes. Clinical Oncology 1976;2(2):105-11. - PubMed
Brown 1977 {published data only}
    1. Brown I, Arthur K, Banks AJ, Bond WH, Chowdhury MS, Freeman WE, et al. The polychemotherapeutic treatment of advanced breast cancer. Clinical Oncology 1977;3(2):183-9. - PubMed
Cocconi 1990 {published data only}
    1. Cocconi G, Bisagni G, Bacchi M, Buzzi F, Canaletti R, Carpi A, et al. A comparison of continuation versus late intensification followed by discontinuation of chemotherapy in advanced breast cancer. A prospective randomized trial of the Italian Oncology Group for Clinical Research (G.O.I.R.C.). Annals of Oncology 1990;1(1):36-44. - PubMed
Cocconi 1999 {published data only}
    1. Cocconi G, Bisagni G, Bella M, Acito L, Anastasi P, Carpi A, et al. Comparison of CMF (cyclophosphamide, methotrexate and 5-fluorouracil) with a rotational crossing and a sequential intensification regimen in advanced breast cancer. A prospective randomised study. American Journal of Clinical Oncology 1999;22(6):593-600. - PubMed
Costanza 1999 {published data only}
    1. Costanza ME, Korzun AH, Norton L, Rice MA, Wood WC. A fair trial for trimetrexate (TMTX) in advanced breast cancer. In: Breast cancer research and treatment. Vol. 12. 1988:125.
    1. Costanza ME, Weiss RB, Henderson C, Norton L, Berry DA, Cirricione C, et al. Safety and efficacy of using a single agent or a phase II agent before instituting standard combination chemotherapy in previously untreated metastatic breast cancer patients: report of a randomised study - Cancer and Leukemia Group B 8642. Journal of Clinical Oncology 1999;17(5):1397-1406. - PubMed
Creagan 1984 {published data only}
    1. Creagan ET, Green SJ, Ahmann DL, Ingle JN, Edmonson JH, Marschke RF. A phase III clinical trial comparing the combination cyclophosphamide, adriamycin, cisplatin with cyclophosphamide, 5-fluorouracil, prednisone in patients with advanced breast cancer. Journal of Clinical Oncology 1984;2(11):1260-5. - PubMed
Horton 1975 {published data only}
    1. Horton J, Dao T, Cunningham T, Nemoto T, Sponzo R, Rosner D. A comparison of 4 combination chemotherapies for metastatic breast cancer. Proceedings of the American Association for Cancer Research 1975;16:240.
Milano 1985 {published data only}
    1. Milano G, Thyss A, Caldani C, Renée N, Buray L, Lesbats G, et al. Treatment of human carcinoma by alpha-difluoromethylornithine: Effect on polyamine levels. Journal of Experimental and Clinical Cancer Research 1985;4:25-30.
Mukaiyama 1989 {published data only}
    1. Mukaiyama T, Ogawa M, Horikoshi N, Inoue K, Tada A, Ueno K, et al. [A randomized trial comparing ACF (adriamycin, cyclophosphamide, ftorafur) and ACF/MVMF (mitomycin C, vincristine, methotrexate, ftorafur)--a non-cross-resistant alternating chemotherapy of recurrent and advanced breast cancer]. [Japanese]. Gan to Kagaku Ryoho [Japanese Journal of Cancer & Chemotherapy] 1989;16(3 Pt 1):327-32. - PubMed
Priestman 1975 {published data only}
    1. Priestman TJ. Results of a prospective clinical trial comparing two cytotoxic regimes containing adriamycin in women with advanced breast cancer. Clinical Oncology 1975;1(3):207-11. - PubMed
Saeki 2007 {published data only}
    1. Saeki T, Nomizu T, Toi M, Ito M, Noguchi S, Kobayashi T, et al. Dofequidar fumarate (MS-209) in combination with cyclophosphamide, doxorubicin, and fluorouracil for patients with advanced recurrent breast cancer. Journal of Clinical Oncology 2007;25(4):411-7. - PubMed
Venturino 2000 {published data only}
    1. Venturino A, Comandini D, Simoni C, Merlini L, Naso C, Palumbo R, et al. Is salvage chemotherapy for metastatic breast cancer always effective and well tolerated? A phase II randomized trial of vinorelbine versus 5-fluorouracil plus leucovorin versus combination of mitoxantrone, 5-fluorouracil plus leucovorin. Breast Cancer Research and Treatment 2000;60(3):195-200. - PubMed
Von Minckwitz 2005 {published data only}
    1. Von Minckwitz G, Chernozemsky I, Sirakova L, Chilingirov P, Souchon R, Marschner N, et al. Bendamustine prolongs progression-free survival in metastatic breast cancer (MBC): a phase III prospective, randomized, multicentre trial of bendamustine hydrochloride, methotrexate and 5-fluorouracil (BMF) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) as first-line treatment of MBC. Anti-Cancer Drugs 2005;16(8):871-7. - PubMed
Zhao 1986 {published data only}
    1. Zhao TP, Ding GX, Gao HY, Shen ZZ, Li KY. A clinical trial of homoharringtonine in the treatment of advanced breast cancer. Tumori 1986;72:395-8. - PubMed

Additional references

Carrick 2005
    1. Carrick S, Parker S, Wilcken N, Ghersi D, Marzo M, Simes J. Single agent versus combination chemotherapy for metastatic breast cancer. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No: CD003372. [DOI: 10.1002/14651858.CD003372.pub2] - DOI - PubMed
Esteva 2001
    1. Esteva FJ, Valero V, Pusztai L, Boehnke-Michaud L, Buzdar AU, Hortobagyi GN. Chemotherapy of metastatic breast cancer: What to expect in 2001 and beyond. The Oncologist 2001;6(2):133-46. - PubMed
Ferlay 2004
    1. Ferlay J, Bray F, Pisani P, Parkin DM. Cancer incidence, mortality and prevalence worldwide. GLOBOCAN, version 2.0;IARC CancerBase No. 5. Lyon, IARCPress, 2004: http://www-dep.iarc.fr/globocan/globocan.html.
Fossati 1998
    1. Fossati R, Confalonierir C, Torri V, Ghislandi E, Penna A, Pistotti V, et al. Cytotoxic and hormonal treatment for metastatic breast cancer: a systematic review of published randomized trials involving 31,510 women. Journal of Clinical Oncology 1998;16(10):3439-60. - PubMed
Ghersi 2004
    1. Ghersi D, Wilcken N, Simes J, Donoghue E. Taxane containing regimens for metastatic breast cancer. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No: CD003366. [DOI: 10.1002/14651858.CD003366.pub2] - DOI - PubMed
Hamilton 2005
    1. Hamilton A, Hortobagyi G. Chemotherapy: What progress in the last 5 years? Journal of Clinical Oncology 2005;23(8):1760-75. - PubMed
Higgins 2008
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Chichester: John Wiley & Sons, 2008.
Hryniuk 1987
    1. Hryniuk WA, Figueredo A, Goodyear M. Applications of dose intensity to problems in chemotherapy of breast and colorectal cancer. Seminars in Oncology 1987;11(Suppl 4):3-11. - PubMed
Lord 2004
    1. Lord S, Ghersi D, Gattellari M, Wortley S, Wilcken N, Simes J. Antitumour antibiotic containing regimens for metastatic breast cancer. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No: CD003367. [DOI: 10.1002/14651858.CD003367.pub2] - DOI - PMC - PubMed
Parmar 1998
    1. Parmar MKB, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Statistics in Medicine 1998;17:2815-34. - PubMed
Stockler 2000
    1. Stockler M, Wilcken NRC, Ghersi D, Simes RJ. Systematic reviews of chemotherapy and endocrine therapy in metastatic breast cancer. Cancer Treatment Reviews 2000;26:151-68. - PubMed
Yusuf 1985
    1. Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. In: Progress in Cardiovascular Diseases. Vol. 27. 1985:335-71. - PubMed

MeSH terms