High Dose Chemotherapy with Peripheral Blood Progenitor Rescue in Metastatic Breast Cancer:-•A Feasibility Study

Abstract

Introduction: Metastatic breast cancer is an incurable disease with conventionally­ dosed chemotherapy regimens. The use of high-dose chemotherapy has been proposed based on animal data suggesting a steep dose-response relationship of tumor cell kill with increasing doses of chemotherapeutic agent. Patients &methods The current study included 19 patients with chemosensitive metastatic breast cancer. After receiving initial 3 cycles of conventional-dose chemotherapy (Anthracyclin, Taxane or Vinorelbine-based regimens), patients either continued to receive the same regimen for a total of 6-8 cycles (12 patients), or received consolidation single-cycle of high­ dose chemotherapy (7 patients).Results: Patients of the first group were followed-up for a median of 13 months. Seven cases showed disease progression after a median period of I 0 months. The actuarial 2-year overall survival for this group was 30% and the actuarial 2- year progression free survival was 20%. The HDC group patients were followed up for a median period of24.5 months. The actuarial2- year overall survival was in the HDC group was 67%, while the actuarial 2-year progression free survival was 22%. Early toxic death was encountered in one case. Conclusions: Our study could not reach any firm conclusions due to the small number of patients. Longer follow-up for the results of international randomized studies are needed to define properly the subsets of patients who might benefit from dose intensive therapy in addition to new therapeutic advances including antibodies, vaccines, biological response modifiers and new drugs.