OnCo
Cancers & treatments·Regimen libraryAdjuvant

CMF

Checked 2026-09-09

Historical adjuvant chemotherapy for early breast cancer; still an option when anthracyclines and taxanes are contraindicated

One cycle

every 28 days × 6 · about 24 weeks in total
1781415212228Cyclophosphamide: 100 mg/m² once daily, OralCyclophosphamideMethotrexate: 40 mg/m², IntravenousMethotrexateFluorouracil: 600 mg/m², IntravenousFluorouracil
28-day cycle × 6 (about 24 weeks)OralIntravenous Daily oral course

Components

DrugDoseRouteDays
Cyclophosphamide
Alkylating agent (oxazaphosphorine prodrug)
100 mg/m² once dailyOralD1-14
Methotrexate
Antifolate (DHFR inhibitor)
40 mg/m²IVD1, 8
Fluorouracil
Fluoropyrimidine antimetabolite
600 mg/m²IVD1, 8
Cycles
6
28-day cycle
Emetogenicity
Moderate (30-90%)
G-CSF
Not routine

Notes

  • The first adjuvant chemotherapy shown to reduce breast cancer recurrence; anthracycline and taxane regimens later proved superior.

Used in

HR-positive / HER2-negative breast cancerHER2-positive breast cancerTriple-negative breast cancer (TNBC)
Products
CyclophosphamideMethotrexateFluorouracil (5-FU)

Source

Bonadonna, NEJM 1976: adjuvant CMF in node-positive breast cancer

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers

Everolimus
Advanced progressive NET (RADIANT-3, RADIANT-4); RCC and HR-positive breast cancer after prior therapy
every 28 days
Dose-dense AC → T
Node-positive or high-risk early breast cancer, adjuvant or neoadjuvant
every 14 days × 4
TC (docetaxel + cyclophosphamide)
Early breast cancer when an anthracycline is not wanted
every 21 days × 4
KEYNOTE-522 (pembrolizumab + chemotherapy, then adjuvant pembrolizumab)
Stage II-III triple-negative breast cancer
every 21 days × 4
TCHP
Stage II-III HER2-positive breast cancer, neoadjuvant
every 21 days × 6
APT (weekly paclitaxel + trastuzumab)
Stage I HER2-positive breast cancer, node-negative, tumour 3 cm or smaller
weekly × 12
THP (docetaxel + trastuzumab + pertuzumab)
HER2-positive metastatic breast cancer first line, then HP maintenance
every 21 days
Trastuzumab deruxtecan 5.4 mg/kg
HER2-positive metastatic breast cancer second line; HER2-low or ultralow after chemotherapy or endocrine therapy; HER2-mutant NSCLC
every 21 days
All regimensTAC →