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Breast Cancer pp 313-324 | Cite as

High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Breast Cancer

  • Edward A. Stadtmauer
Chapter
Part of the Current Clinical Oncology book series (CCO)

Abstract

The combination of surgery, radiation therapy, chemotherapy, and hormonal therapy has led to the cure of over 50% of patients with low stage breast cancer (1). Despite this success, however, most patients with locally advanced and metastatic disease will ultimately progress and succumb despite conventional dose therapy. By the mid-1980s, a strong relationship of dose to response, particularly for alkylating agents in breast cancer, had been demonstrated. The major dose-limiting toxicity was myelosuppression, and techniques of bone marrow and blood-derived stem cell harvesting, storage, and infusion allowed for the ready utilization of hematopoietic stem cells as support and rescue after high-dose therapy. The use of myeloid hematopoietic growth factors enhanced the collection of stem cells and marrow recovery after stem cell transplantation and allowed for rapid and reliable trilineage engraftment after high-dose chemotherapy.

Keywords

Breast Cancer Stem Cell Transplantation Metastatic Breast Cancer Induction Chemotherapy Autologous Bone Marrow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Henderson IC (1990) Basic principles in the use of adjuvant therapy. Semin. Oncol 17, 40–44.PubMedGoogle Scholar
  2. 2.
    )ABMTR Newslett 5 5.Google Scholar
  3. 3.
    Peters WP, Shpall EJ, Jones RB, et al. (1988) High-dose combination alkylating agents with bone marrow support as initial treatment for metastatic breast cancer. J. Clin. Oncol 6, 1368–1376.PubMedGoogle Scholar
  4. 4.
    Williams, SF, Mick R, Desser R, et al. (1989) High dose consolidation therapy with autologous stem cell rescue in stage IV breast cancer. J. Clin. Oncol 7, 1824–1830.Google Scholar
  5. 5.
    Antman K, Ayash L, Elias A, et al. (1992) 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. J. Clin. Oncol 10, 102–110.Google Scholar
  6. 6.
    Williams SF, Gilewski T, Mick R, et al. (1992) High-dose consolidation therapy with autologous stem cell rescue in stage IV breast cancer: follow-up report. J. Clin. Oncol 10, 1743–1747.PubMedGoogle Scholar
  7. 7.
    Moonneier JA, Williams SF, Kamminer LS, et al. (1990) High dose trialkylator chemotherapy with autologous stem cell rescue in patients with refractory malignancies. J. Natl. Cancer. Inst 82, 29–34.CrossRefGoogle Scholar
  8. 8.
    Kennedy MJ, Beveridge RA, Rowley SD, et al. (1991) High-dose chemotherapy with reinfusion of purged autologous bone marrow following dose intense induction as initial therapy for metastatic breast cancer. J. Natl. Cancer. Inst 83, 920–926.PubMedCrossRefGoogle Scholar
  9. 9.
    Eddy DM (1992) Review article. High-dose chemotherapy with autologous bone marrow transplantation for the treatment of metastatic breast cancer. J. Clin. Oncol 10, 657–670.PubMedGoogle Scholar
  10. 10.
    Klumpp TR, Mangan KF, Glenn LD (1993) Phase II pilot study of high-dose busulfan and CY followed by autologous BM or peripheral blood stem cell transplantation in patients with advanced chemosensitive breast cancer. Bone Marrow Transplant. 11, 337–339.PubMedGoogle Scholar
  11. 11.
    Lazarus HM, Gray R, Ciobanu N, et al. (1994) A phase I trial of high-dose melphalan, high-dose etoposide, and autologous bone marrow reinfusion in solid tumors: an Eastern Cooperative Oncology Group (ECOG) study. Bone Marrow Transplant. 14, 443–448.PubMedGoogle Scholar
  12. 12.
    Weaver CH, Bensinger WI, Appelbaum FR, et al. (1994) Phase I study of high-dose busulfan, melphalan, and thiotepa with autologous stem cell support in patients with refractory malignancies. Bone Marrow Transplant. 14, 813–819.PubMedGoogle Scholar
  13. 13.
    Vaughan WP, Reed EC, Edwards B, et al. (1994) High-dose cyclophosphamide, thiotepa and hydroxyurea with autologous hematopoietic stem cell rescue: an effective consolidation chemotherapy regimen for early metastatic breast cancer. Bone Marrow Transplant. 13, 619–624.PubMedGoogle Scholar
  14. 14.
    Fields KK, Elfenbein GJ, Lazarus HM, et al. (1995) Maximum tolerated doses of ifosfamide, carboplatin, and etoposide given over six days followed by autologous stem cell rescue: toxicity profile. J. Clin. Oncol 13, 323–332.PubMedGoogle Scholar
  15. 15.
    Spitzer TR, Cirenza E, McAfee S, et al. (1995) Phase I-II trial of high-dose cyclophosphamide, carboplatin and autologous bone marrow or peripheral blood stem cell rescue. Bone Marrow Transplant. 15, 537–542.PubMedGoogle Scholar
  16. 16.
    Gisselbrecht C, Extra JM, Lotz JP, et al. (1996) Cyclophosphamide/mitoxantrone/melphalan (CMA) regimen prior to autologous bone marrow transplantation (ABMT) in metastatic breast cancer. Bone Marrow Transplant. 18, 857–863.PubMedGoogle Scholar
  17. 17.
    Stemmer SM, Cagnoni PJ, Shpall EJ, et al. (1996) High-dose paclitaxel, cyclophosphamide, and cisplatin with autologous hematopoietic progenitor-cell support: a phase I trial. J. Clin. Oncol 14, 1463–1472.PubMedGoogle Scholar
  18. 18.
    Stadtmauer EA, O’Neill A, Goldstein LJ, et al. (2000) Conventional-dose chemotherapy compared with high-dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer. Philadelphia Bone Marrow Transplant Group. N. Engl. J. Med 342, 1069–1076.PubMedCrossRefGoogle Scholar
  19. 19.
    Lotz JP, Cure H, Janvier M, et al. (1999) High-dose chemotherapy with hematopoietic stem cells transplantation for metastatic breast cancer: results of the French protocol Pegase 04. Proc. Am. Soc. Clin. Oncol 18, 43A.Google Scholar
  20. 20.
    Berry DA, Broadwater G, Perry MC, et al. (2002) High-dose vs standard chemotherapy in metastatic breast cancer: comparison of Cancer and Leukemia Group B trials with data from the Autologous Blood and Marrow Transplant Registry. J. Clin. Oncol 20, 743–750.PubMedCrossRefGoogle Scholar
  21. 21.
    Peters W, Jones R, Vredenburgh J, et al. (1996) A large prospective randomized trial of high-dose combination alkylating agents (CPB) with autologous cellular support as consolidation for patients with metastatic breast cancer achieving complete remission after intensive doxorubicin-based induction therapy (AFM). Proc. Am. Soc. Clin. Oncol 15, 121.Google Scholar
  22. 22.
    Rowlings PA, Williams SF, Antman KH, et al. (1999) Factors correlated with progression-free survival after high-dose chemotherapy and hematopoietic stem cell transplantation for metastatic breast cancer. DAMA 282, 1335–1343.Google Scholar
  23. 23.
    Ayash LJ, Elias A, Schwartz G, et al. (1996) Double dose-intensive chemotherapy with autologous stem-cell support for metastatic breast cancer: no improvement in progression-free survival by the sequence of high-dose melphalan followed by cyclophosphamide, thiotepa and carboplatin. J. Clin. Oncol 14, 2984–2992.PubMedGoogle Scholar
  24. 24.
    Bezwoda W, Seymour L, Dansey R (1995) High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial. J. Clin. Oncol 13, 2483–2489.PubMedGoogle Scholar
  25. 25.
    Elias AD, Richardson P, Avigan D, et al. (1999) Phase I development of double cycle stem cell supported high dose chemotherapy (HDC) for metastatic breast cancer (BC): the DFCIJBIDMC experience. Proc. ASCO 18, 123a.Google Scholar
  26. 26.
    Pecora AL, Lazarus HM, Stadtmauer EA, et al. (2001) Effect of induction chemotherapy and tandem cycles of high-dose chemotherapy on outcomes in autologous stem cell transplant for metastatic breast cancer. Bone Marrow Transplant 27, 1245–1253.PubMedCrossRefGoogle Scholar
  27. 26a.
    a.Crump M (2001) A randomized trial of high-dose chemotherapy with autologous peripheral blood stem cell support compared to standard therapy in women with metastatic breast cancer. Proc. Am. Soc. Clin. Oncol. 20, Abstr. 82.Google Scholar
  28. 27.
    Peters WP, Ross M, Vredenburgh JJ, et al. (1993) High-dose chemotherapy and autologous bone marrow transplant support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer. J. Clin. Oncol 11, 1132–1143.PubMedGoogle Scholar
  29. 28.
    Peters WP, Rosner G, Vredenburgh J, et al. (1999) A prospective, randomized comparison of two doses of combination alkylating agents as consolidation after CAF in high-risk primary breast cancer involving ten or more axillary lymph nodes. Proc. Am. Soc. Clin. Oncol. 18, IA.Google Scholar
  30. 29.
    Bezwoda WR (1998) Primary high-dose chemotherapy for metastatic breast cancer: update and analysis of prognostic factors. Proc. Am. Soc. Clin. Oncol 17, 115A.Google Scholar
  31. 30.
    Rodenhuis S, Richel KJ, Wall E, et al. (1998) Randomized trial of high-dose chemotherapy and hematopoietic progenitor cell support in operable breast cancer with extensive axillary lymph node involvement. Lancet 352, 515–521.PubMedCrossRefGoogle Scholar
  32. 31.
    Ayash LJ, Elias A, Ibrahim J, et al. (1998) High-dose multimodality therapy with autologous stem-cell support for Stage IIIB breast carcinoma. J. Clin. Oncol 16, 1000–1007.PubMedGoogle Scholar
  33. 31a.
    a.Rodenhuis S (2001) Randomized phase III study of high-dose chemotherapy in operable breast cancer with 4 or more axillary lymph nodes. Proc. Am. Soc. Clin. Oncol. 19, Abstr. 286.Google Scholar
  34. 32.
    Hortobagyi GN, Buzdar AU, Theriault RL, et al. (2000) Randomized trial of hig-dose chemotherapy and blood cell autografts for high-risk primary breast carcinoma. J. Natl. Cancer. Inst 92, 225–233.PubMedCrossRefGoogle Scholar
  35. 33.
    Bergh J, Wiklund T. Erikstein B, et al. (2000) Tailored fluorouracil, epirubicin, and cyclophosphamide compared with marrow-supported high-dose chemotherapy as adjuvant treatment for high-risk breast cancer: a randomised trial. Scandinavian Breast Group 9401 study. Lancet 356, 1384–1391.Google Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Edward A. Stadtmauer

There are no affiliations available

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