CAF
Meaning of CAF: Three older drugs given together on a fixed schedule, a breast cancer regimen now largely displaced by newer combinations.
Definition of CAF
CAF is an abbreviation for a chemotherapy combination of cyclophosphamide, doxorubicin and fluorouracil, given in repeated cycles for breast cancer. The letter A stands for Adriamycin, an older trade name for doxorubicin. Each of the three damages dividing cells by a different route, and giving them together was intended to attack the tumor from several directions at once.
What does each letter stand for?
| Letter | Drug | How it acts |
|---|---|---|
| C | Cyclophosphamide | Attaches chemical groups to DNA and links the strands |
| A | Doxorubicin, once sold as Adriamycin | Slots between DNA strands and jams the untangling enzyme |
| F | Fluorouracil | Blocks the supply of a building block DNA needs |
Why combine drugs at all?
A tumor is not made of identical cells. Some already carry a change that lets them survive one particular drug, and giving that drug alone simply clears the field for them. Combining agents that work by different mechanisms means a cell must be resistant to all three at once, which is far less likely. Drugs are also chosen so their worst effects fall on different tissues, which allows each to be given at a useful strength. This is the reasoning behind almost every chemotherapy regimen written as a string of letters.
What effects follow from those mechanisms?
All three hit fast-renewing normal tissue as well as tumor. Low blood counts, mouth soreness, nausea and hair loss follow from that. Doxorubicin adds two of its own: it is an irritant that damages skin if it leaks from a vein, and it can weaken heart muscle in a way related to the total amount given across a lifetime, which is why that running total is tracked. Cyclophosphamide can irritate the bladder lining, and both it and doxorubicin carry a small long-term risk of a second blood cancer.
Where does the regimen stand now?
CAF and the closely related FAC were mainstays of breast cancer treatment for many years. Schedules built around taxanes, and treatment matched to hormone receptor and HER2 status, have since taken over most of that ground. The abbreviation still appears in older records, in long-term follow-up studies and in trial reports used as historical comparisons.
Also known as
Used in a sentence
The earlier records documented six cycles of CAF completed without dose reduction.
Good to know
The A in CAF stands for Adriamycin, a former trade name for doxorubicin, which is why the letter does not match the generic name of the drug.