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Autografting

Long-term survival in patients with metastatic breast cancer receiving intensified chemotherapy and stem cell rescue: data from the Italian registry

Bone Marrow Transplantation volume 48, pages 414–418 (2013)Cite this article

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Abstract

The median survival of women with metastatic breast cancer (MBC) is 18–24 months, and fewer than 5% are alive and disease free at 5 years. We report toxicity and survival in a cohort of MBC patients receiving high-dose chemotherapy (HDC) with autologous hematopoietic SCT (AHSCT) in Italy between 1990 and 2005. Data set for survival analysis has been obtained for 415 patients. Clinical parameters including probability of transplant-related mortality (TRM), PFS and OS. With a median follow-up of 27 months (range 0–172), OS and PFS at 5 and 10 years in the whole population were 47/23 and 32/14%, respectively. A total 239 patients are alive with a median follow-up of 33 months (range 2–174). Survival was significantly more pronounced in patients harboring hormone receptor positive tumors (P=0.028), without visceral metastases (P=0.009) and in women with chemosensitive disease (P<0.0001). Sixty eight patients (20.4%) who received HDC in partial response, stable or progressive disease underwent conversion to CR. TRM was 2.5% overall and 1.3% since 2000. Our findings suggest that could be a role for HDC and AHSCT in delaying disease progression and possibly cure a subset of MBC patient harboring chemosensitive tumors.

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Acknowledgements

We wish to thank all Italian Centers that gathered all relevant information to locate eligible patients and performed data management: Reggio Calabria (P. Iacopino); University of Genova (R. Gonella, F. Patrone); IRCCS Salvatore Maugeri Foundation, Pavia (GA. Da Prada, A. Lanza); Niguarda Hospital, Milano (S. Siena); San Giovanni Rotondo - Foggia (E. Maiello); University of Pisa; S.Orsola Malpighi Hospital, Bologna (A. Martoni); Perugia (L. Crino’, M.A. Colozza); La Maddalena Hospital, Palermo (F. Porretto); Institute for Cancer Research and Treatment, Candiolo - Torino (A. Capaldi); Noale -Venezia (O. Vinante, M. Bari, G. Azzarello); Humanitas Cancer Center, Rozzano - Milano (A. Santoro, A. Bertuzzi); IRCCS Policlinico S. Matteo Foundation, Pavia (M. Danova); Reggio Emilia (L. Gugliotta, A. Bonini, G. Bisagni); Fatebenefratelli Hospital, Milano (G. Farina, C. Bianchi); Verona (G.L. Cetto, L. Battistelli); Firenze (A. Bosi, S. Guidi); Udine (R. Fanin, F. Patriarca).

Author contributions: Study concepts: Massimo Martino, Massimo Aglietta, Luca Castagna, Giovanni Rosti and Paolo Pedrazzoli. Study design: Massimo Martino, Massimo Aglietta, Luca Castagna, Giovanni Rosti and Paolo Pedrazzoli. Data acquisition: Massimo Martino, Alberto Ballestrero, Alberto Zambelli, Simona Secondino, Michele Aieta, Carmelo Bengala, Anna Marina Liberati, Claudio Zamagni, Maurizio Musso, Massimo Aglietta, Roberta Schiavo, Luca Castagna, Giovanni Rosti and Paolo Pedrazzoli. Quality control of data and algorithms: Massimo Martino, Barbara Bruno and Paolo Pedrazzoli. Data analysis and interpretation: Massimo Martino, Barbara Bruno and Paolo Pedrazzoli. Statistical analysis: Barbara Bruno and Paolo Pedrazzoli. Manuscript preparation: Massimo Martino and Paolo Pedrazzoli. Manuscript editing: Massimo Martino and Paolo Pedrazzoli. Manuscript review: Massimo Martino, Alberto Ballestrero, Alberto Zambelli, Simona Secondino, Michele Aieta, Carmelo Bengala, Anna Maria Liberati, Claudio Zamagni, Maurizio Musso, Massimo Aglietta, Roberta Schiavo, Luca Castana, Giovanni Rosti, Barbara Bruno and Paolo Pedrazzoli.

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Authors and Affiliations

  1. Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera BMM, Reggio Calabria, Italy

    M Martino

  2. Department of Medicine, University of Genoa, Genova, Italy

    A Ballestrero

  3. Medical Oncology Unit, IRCCS Salvatore Maugeri Foundation, Pavia, Italy

    A Zambelli

  4. Medical Oncology Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy

    S Secondino & P Pedrazzoli

  5. Medical Oncology Unit, Casa Sollievo della Sofferenza,, S. Giovanni Rotondo, FG, Italy

    M Aieta

  6. Medical Oncology Unit, University of Modena, Modena, Italy

    C Bengala

  7. Department of Oncology and Hematology, University of Perugia, Terni, Italy

    A M Liberati

  8. Medical Oncology Unit, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy

    C Zamagni

  9. Hematology and Bone Marrow Transplant Unit ‘La Maddalena’, Palermo, Italy

    M Musso

  10. Medical Oncology Unit, Institute for Cancer Research and Treatment, Candiolo, TO, Italy

    M Aglietta

  11. Medical Oncology Unit ‘Falck’, Ospedale Niguarda Ca’ Granda, Milano, Italy

    R Schiavo

  12. Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, MI, Italy

    L Castagna

  13. Medical Oncology Unit, Ospedale Ca’ Foncello, Treviso, Italy

    G Rosti

  14. National Registry GITMO & Data Managing, Ospedale San Martino, Genova, Italy

    B Bruno

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on behalf of Gruppo Italiano per il Trapianto di Midollo Osseo, Cellule staminali emopoietiche e terapia cellulare (GITMO) – Sezione Tumori Solidi

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Martino, M., Ballestrero, A., Zambelli, A. et al. Long-term survival in patients with metastatic breast cancer receiving intensified chemotherapy and stem cell rescue: data from the Italian registry. Bone Marrow Transplant 48, 414–418 (2013). https://doi.org/10.1038/bmt.2012.149

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