Tandem autotransplantation for the treatment of metastatic breast cancer
| Autor: | George W. Sledge, Lawrence H. Einhorn, D Loesch, R Sridhara, Robert Hromas, E R Broun, P H Kneebone, Mark Hanna, K Cornetta |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Diarrhea Oncology Cancer Research medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Breast Neoplasms Transplantation Autologous Disease-Free Survival Carboplatin Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Doxorubicin Neoplasm Metastasis Bone Marrow Transplantation Etoposide Stomatitis Chemotherapy Mitoxantrone business.industry Remission Induction Mouth Mucosa Middle Aged medicine.disease Combined Modality Therapy Metastatic breast cancer Surgery Transplantation Tolerability Fluorouracil Feasibility Studies Female business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 13:2050-2055 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | PURPOSE To investigate the tolerability and impact on progression-free and overall survival of two consecutive cycles of high-dose chemotherapy (HDC) with autologous bone marrow transplantation (ABMT) in patients with previously untreated metastatic breast cancer. PATIENTS AND METHODS Twenty-eight patients received conventional-dose induction therapy (ITx) followed by a planned two cycles of HDC with ABMT. Median age was 45 years (range, 34 to 60 years). Sites of disease were bone (seven patients), visceral (three), soft tissue (11), multiple (six), and CNS (one). The ITx regimens of cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), methotrexate, fluorouracil, prednisone, and tamoxifen (CAMFTP) (three patients); fluorouracil, doxorubicin, and cyclophosphamide (FAC; 11 patients); cyclophosphamide, methotrexate, and fluorouracil (CMF; four patients); or doxorubicin or mitoxantrone/cyclophosphamide (10 patients) were given to maximum response (three to five cycles). HDC was cyclophosphamide 6 g/m2, carboplatin 2 g/m2, and etoposide 625 mg/m2 with ABMT. RESULTS Of 28 patients, 24 received two (86%) cycles of HDC. Four received only one cycle due to persistent toxicity from course 1 (one patient), no response to course 1 (two), and death on course 1 (one). Grade 3 to 4 nonhematologic toxicities included mucositis (in one or both cycles in 21 of 28 patients; 75%), diarrhea, nausea, and vomiting. Reversible peripheral neuropathy was seen in 15 of 28 patients and was severe in one. Documented infections were seen in 19 of 52 cycles. There was one transplant-related death. Six patients were converted from partial remission (PR) to complete remission (CR) with HDC; two of 24 patients (8%) were converted from PR to CR with the second cycle of HDC. Progression-free survival rate is nine of 28 patients (32%) with median follow-up of 23 months (range, 13 to 36+ months). Eighteen of 28 patients (64%) have progressed at 1 to 17 months from ABMT. CONCLUSION Two cycles of HDC with ABMT was well tolerated with a high response rate in patients with metastatic breast cancer. The importance of the second cycle of HDC in this population is unclear. |
| Databáze: | OpenAIRE |
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