HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM-CELL SUPPORT FOR THE TREATMENT OF METASTATIC BREAST-CANCER

被引:14
作者
AYASH, LJ
机构
[1] Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
关键词
BREAST CANCER; BONE MARROW TRANSPLANTATION; HIGH DOSE CHEMOTHERAPY;
D O I
10.1002/cncr.2820741343
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The overall median survival of women with advanced or high risk primary disease has not changed with conventional chemotherapy. Regimens employing high dose chemotherapy with autologous stem cell support (ABMT) have been developed with the hope of optimizing tumor response and increasing survival. Early Phase I studies of patients with advanced refractory disease demonstrated the feasibility of administering agents in doses 5-30 times higher than those conventionally used. These studies achieved high response rates of short duration. Second generation studies combined an induction phase followed by one high dose intensification at the time of maximum tumor response. To date, between 15 and 30% of women with metastatic disease remain progression free after being treated with this approach, with median lengths of follow-up approaching 36 months in the larger series. With the advent of hematologic support, such as blood stem cells and colony stimulating factors, the morbidity, mortality, and costs associated with this treatment have been reduced substantially. These supports now allow for two or more cycles of high dose intensification to be employed, to exploit the potential of dose intensity to optimize response. Recent single-institution studies using ABMT for high risk Stages II and III breast cancer have reported preliminary findings suggesting a prolonged disease free survival. The cooperative groups now have begun prospective randomized studies in high risk women with Stages II and III disease with 10 or more positive axillary lymph nodes, and soon will study the efficacy of ABMT in women with inflammatory or locally unresectable breast cancer (Stage IIIB).
引用
收藏
页码:532 / 535
页数:4
相关论文
共 21 条
  • [1] A PHASE-II STUDY OF HIGH-DOSE CYCLOPHOSPHAMIDE, THIOTEPA, AND CARBOPLATIN WITH AUTOLOGOUS MARROW SUPPORT IN WOMEN WITH MEASURABLE ADVANCED BREAST-CANCER RESPONDING TO STANDARD-DOSE THERAPY
    ANTMAN, K
    AYASH, L
    ELIAS, A
    WHEELER, C
    HUNT, M
    EDER, JP
    TEICHER, BA
    CRITCHLOW, J
    BIBBO, J
    SCHNIPPER, LE
    FREI, E
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1992, 10 (01) : 102 - 110
  • [2] DUNPHY F, 1989, P AN M AM SOC CLIN, V8, P25
  • [3] DUNPHY FR, 1980, J CLIN ONCOL, V8, P1207
  • [4] HIGH-DOSE COMBINATION ALKYLATING AGENT CHEMOTHERAPY WITH AUTOLOGOUS BONE-MARROW SUPPORT FOR METASTATIC BREAST-CANCER
    EDER, JP
    ANTMAN, K
    PETERS, W
    HENNER, WD
    ELIAS, A
    SHEA, T
    SCHRYBER, S
    ANDERSEN, J
    COME, S
    SCHNIPPER, L
    FREI, E
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1986, 4 (11) : 1592 - 1597
  • [5] A PHASE-I-II STUDY OF CYCLOPHOSPHAMIDE, THIOTEPA, AND CARBOPLATIN WITH AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN SOLID TUMOR PATIENTS
    EDER, JP
    ELIAS, A
    SHEA, TC
    SCHRYBER, SM
    TEICHER, BA
    HUNT, M
    BURKE, J
    SIEGEL, R
    SCHNIPPER, LE
    FREI, E
    ANTMAN, K
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1990, 8 (07) : 1239 - 1245
  • [6] CYCLOPHOSPHAMIDE AND THIOTEPA WITH AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN PATIENTS WITH SOLID TUMORS
    EDER, JP
    ANTMAN, K
    ELIAS, A
    SHEA, TC
    TEICHER, B
    HENNER, WD
    SCHRYBER, SM
    HOLDEN, S
    FINBERG, R
    CHRITCHLOW, J
    FLAHERTY, M
    MICK, R
    SCHNIPPER, LE
    FREI, E
    [J]. JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1988, 80 (15): : 1221 - 1226
  • [7] ELIAS AD, 1992, BLOOD, V79, P3036
  • [8] FISHER ER, 1984, CANCER-AM CANCER SOC, V53, P712
  • [9] ALKYLATING AGENT RESISTANCE - INVITRO STUDIES WITH HUMAN CELL-LINES
    FREI, E
    CUCCHI, CA
    ROSOWSKY, A
    TANTRAVAHI, R
    BERNAL, S
    ERVIN, TJ
    RUPRECHT, RM
    HASELTINE, WA
    [J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1985, 82 (07) : 2158 - 2162
  • [10] HENDERSON IC, 1987, BREAST DISEASES, P428