High-dose chemotherapy with peripheral blood progenitor cell support for patients with non-small cell lung cancer: the experience of the European Group for Bone Marrow Transplantation (EBMT) Solid Tumours Working Party

Abstract

We report the experience of the EBMT Solid Tumours Working Party (STWP) using high-dose chemotherapy (HDCT) with PBPC support in patients with non-small cell lung cancer (NSCLC). Between 1989 and 2004, 36 NSCLC patients (27 men and 9 women), median age 53.5 years (range: 24-62) were treated with 63 HDCT courses. A high-dose carboplatin-based regimen was used in 53% of the cases. Thirty-two patients had relapsed/metastatic disease, while four classified as stage IIIB received HDCT followed by radiotherapy. No treatment-related death occurred. Of 25 patients who were planned to receive multi-cycle HDCT, 4 cases (16%) interrupted the treatment early due to prolonged severe toxicities and 4 (16%) due to progressive disease. Of 36 evaluable patients, 3 (8%) achieved a complete remission and 13 (36%) had a partial remission at an overall response rate of 44%. Of these, one patient with stage IIIB and one with stage IV are alive disease free at 71 þ and 149 þ months, respectively. After a median follow-up of 48 months (range: 6-149), median survival was 7 months (range: 1-149). Despite one anecdotal case, HDCT did not show significant activity, but induced relevant morbidity in NSCLC patients.

O transplante de células-tronco hematopoéticas como opção no tratamento de doenças não hematológicas

“…Em outros tumores sólidos, o TCTH tem sido utilizado e a literatura sempre demonstra casuística pequena e preferência para a modalidade alogênica com a finalidade de erradicação da moléstia, induzir a DECH para se obter um efeito antitumoral. [50][51][52][53][54] Os resultados atuais são tímidos, com alta toxicidade seguida de morbidade e mortalidade, abrindo perspectivas para novas estratégias baseadas na terapia imune e celular, que podem ser apropriadas ao tratamento de tumores sólidos e a cânceres refratários. 55…”