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Breast Cancer

A short course of induction chemotherapy followed by two cycles of high-dose chemotherapy with stem cell rescue for chemotherapy naive metastatic breast cancer: sequential phase I/II studies

Bone Marrow Transplantation volume 28, pages 447–454 (2001)Cite this article

Abstract

Two cycles of high-dose chemotherapy with stem cell support (HDC) may increase the total dose delivered and dose intensity. A brief induction phase and different non-cross-resistant agents for each HDC cycle were used to avoid drug resistance. Twenty-six women with metastatic BC had induction and stem cell mobilization with two cycles of doxorubicin/G-CSF given every 14 days. Patients with stable disease or better after induction received HD CTCb followed by HD melphalan and dose-escalated paclitaxel. At 475 mg/m2 of paclitaxel by 24-h infusion, dose-limiting transient peripheral sensory neuropathy was encountered. No toxic deaths occurred. Complete and near complete response after completion of therapy was achieved in 22 (85%) of 26 patients. The median EFS was 38 months. The median OS has not yet been reached. At a median follow-up of 33 (25–43) months, actuarial EFS and OS were 54% (95% confidence interval (CI), 39–69%) and 69% (95% CI, 56–79%), respectively. This double transplant approach lasts only 14 weeks and is feasible, safe, and tolerable. Whilst selection biases may in part contribute to favorable EFS and OS, a randomized comparison of standard therapy vs double transplant in both metastatic and locally advanced breast cancer is warranted. Bone Marrow Transplantation (2001) 28, 447–454.

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Acknowledgements

This work was supported in part by a grant from the Public Health Service Grant CA13849 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services.

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Author notes

  1. C Wheeler

    Present address: Astrazeneca, 200 West St, Waltham, MA 02451, USA

Authors and Affiliations

  1. Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    AD Elias, P Richardson, J Ibrahim, D Warren, M McCauley & E Frei III

  2. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    D Avigan, R Joyce, D McDermott, J Levine & C Wheeler

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  1. AD Elias
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Elias, A., Richardson, P., Avigan, D. et al. A short course of induction chemotherapy followed by two cycles of high-dose chemotherapy with stem cell rescue for chemotherapy naive metastatic breast cancer: sequential phase I/II studies. Bone Marrow Transplant 28, 447–454 (2001). https://doi.org/10.1038/sj.bmt.1703148

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