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High-dose chemotherapy and autologous peripheral blood stem cell transplantation for primary breast cancer refractory to neoadjuvant chemotherapy.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2006 May; Vol. 37 (10), pp. 929-35. - Publication Year :
- 2006
-
Abstract
- The role of high-dose chemotherapy (HDCT) in patients with refractory breast cancer is not well established. Forty-two female patients (median age of 46 years) with breast cancer refractory to neoadjuvant chemotherapy received HDCT (cyclophosphamide, carmustine and thiotepa) supported by an autologous peripheral blood stem cells transplant. Their disease had been refractory (defined as less than partial response) to one (18 patients) or two (24 patients) regimens of neoadjuvant chemotherapy. Twenty-nine patients had surgery before HDCT. The best response after surgery, HDCT, and radiation therapy was assessed 60 days after transplantation. Thirty patients had complete remission, eight had a PR, one had a minor response, and three had progressive disease. In seven of 13 patients whose disease was inoperable before HDCT, it became operable. After a median follow-up of 42 months, 21 patients were alive, and 15 remained disease free. Five-year overall survival (OS) was 57% (CI, 50-64%), and the estimated 5-year progression-free survival was 40% (CI, 32-48%). Both OS and PFS were better in patients whose disease became operable after chemotherapy than in those whose disease remained inoperable. A randomized study is warranted in this patient population.
- Subjects :
- Adult
Antineoplastic Agents pharmacology
Blood Component Removal
Breast Neoplasms drug therapy
Carmustine administration & dosage
Cyclophosphamide administration & dosage
Disease-Free Survival
Female
Humans
Middle Aged
Neoadjuvant Therapy
Thiotepa administration & dosage
Time Factors
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms therapy
Chemotherapy, Adjuvant methods
Peripheral Blood Stem Cell Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 0268-3369
- Volume :
- 37
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 16565737
- Full Text :
- https://doi.org/10.1038/sj.bmt.1705355