High-dose chemotherapy with stem-cell rescue for the treatment of breast cancer

McCauley, Dayna L.

doi:10.1093/ajhp/53.5.521

Cited by 9 publications

(2 citation statements)

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“…However, high-dose therapy data with marrow support further endorse the concept of a dose-response curve, i.e. patients failing on conventional doses may experience short-lived marked objective responses when given high-dose therapy (206,207). This part of the dose-response concept will be discussed under separate headings below, accordingly the other sections will focus on doses in the 'conventional dose range'.…”

Section: Dose Intensitymentioning

confidence: 99%

“…The use of very high-doses requiring marrow stem cell and:or cytokine support has been investigated in phase II studies indicating the possibility of up to 100% increase in relapse-free survival, from 30% to 60% -70% at ve years (206,207,218). Thirteen international randomised studies are presently testing different facets of high-dose therapy including cytokine-supported therapy with or without bone marrow support (246).…”

Section: High-dose Therapy With Bone Marrow Support :Peripheral Stem mentioning

confidence: 99%

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A Systematic Overview of Chemotherapy Effects in Breast Cancer

Bergh¹,

Jönsson²,

Glimelius³

et al. 2001

Acta Oncologica

150

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A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scientific literature are described separately (Acta Oncol 2001; 40: 155-65). This synthesis of the literature on chemotherapy for breast cancer is based on 233 randomised studies, 9 meta-analysis of randomised studies, a population-based cohort study and 18 overviews/retrospective analyses including a total of 155,243 patients. The conclusions reached can be summarised into the following points: Adjuvant treatment-- There is solid scientific support from randomised studies that adjuvant polychemotherapy at 10 years will result in an absolute mortality reduction for patients younger than 50 years by 12% for node positive (34% relative mortality reduction corresponding to an estimated median survival prolongation of several years) and 6% for node negative patients. For women aged 50 to 69 years, the corresponding figures for node positive and node negative patients are 6% and 2%, respectively (approximately 11% relative mortality reduction). Anthracycline-containing combinations result in an absolute survival benefit at five years of 3%, compared with non-anthracycline based polychemotherapy. There are indications that the taxane paclitaxel may further improve the survival compared with anthracyclines. However, the limited data preclude conclusions for the routine care. The addition of tamoxifen to chemotherapy further enhances the survival benefit for receptor positive subgroups. The roles of more dose-intensive regimens, including high-dose therapy with stem cell support, are presently studied in randomised investigations. The data presented so far are conflicting but they do not in general support high-dose therapy. Quality of life, based on analyses of randomised studies, demonstrate that adjuvant polychemotherapy has an initial detrimental effect, but long-term follow-up of treated patients demonstrates no impairment of quality of life compared with untreated patients. Polychemotherapy in standard doses should be offered to premenopausal node positive patients, and the corresponding postmenopausal group with a receptor-negative breast cancer and to node negative patients with high risk factors. Polychemotherapy should be combined with tamoxifen to all patients with receptor-positive tumours. Due to a need of more knowledge in this field, patients should be included in investigational protocols. Locally advanced breast cancer-- Based on current knowledge, treatment of patients with locally advanced breast cancer should include neoadjuvant/preoperative polychemotherapy since there is evidence from controlled studies that such therapy will statistically significantly increase the number of patients who can be offered breast-conserving surgery. Indirect comparisons also demonstrate survival improvements, but the scientific support is equivocal. Metastatic breast cancer-- The median survival for patients with metastatic disea...

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Section: Dose Intensitymentioning

confidence: 99%

Section: High-dose Therapy With Bone Marrow Support :Peripheral Stem mentioning

confidence: 99%

A Systematic Overview of Chemotherapy Effects in Breast Cancer

Bergh¹,

Jönsson²,

Glimelius³

et al. 2001

Acta Oncologica

150

View full text Add to dashboard Cite

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Peripheral Blood Progenitor Cells: Enabling Outpatient Transplantation

McGuire,

Tarantolo,

Reed

1998

Pharmacotherapy

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Peripheral blood progenitor cells (PBPCs) are becoming the stem cell source of choice for rescuing patients from marrow aplasia after high‐dose chemotherapy. Their advantages over bone marrow include avoidance of general anesthesia and more rapid hematologic recovery after transplantation. More rapid engraftment can reduce the risks associated with transplantation and shorten the hospital stay or, under certain circumstances, eliminate it. The cost reductions associated with a shorter stay have made PBPC transplantation cost‐competitive with more conventional therapy. The move to outpatient transplantation requires increased patient and family involvement with posttransplantation care, as well as increased patient education and a multidisciplinary care team for the safe transition of patients between care sites. Improvements in outpatient transplantation may incorporate a cooperative care model with the intent of reducing readmission rates and extending this modality to most patients who undergo autologous transplantation.

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Anaplastic large cell lymphoma (ALCL) and breast implants: Breaking down the evidence

Shokrollahi

Rozen

et al. 2014

Mutation Research/Reviews in Mutation Research

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High-dose chemotherapy with stem-cell rescue for the treatment of breast cancer

Cited by 9 publications

References 0 publications

A Systematic Overview of Chemotherapy Effects in Breast Cancer

A Systematic Overview of Chemotherapy Effects in Breast Cancer

Peripheral Blood Progenitor Cells: Enabling Outpatient Transplantation

Anaplastic large cell lymphoma (ALCL) and breast implants: Breaking down the evidence

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