Stage III and oestrogen receptor negativity are associated with poor prognosis after adjuvant high-dose therapy in high-risk breast cancer
We report on the efficacy and toxicity of a sequential high-dose therapy with peripheral blood stem cell (PBSC) support in 85 patients with high-risk stage II/III breast cancer. There were 71 patients with more than nine tumour-positive axillary lymph nodes. An induction therapy of two cycles of ifo...
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| Hauptverfasser: | , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
26 February 1999
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| In: |
British journal of cancer
Year: 1999, Jahrgang: 79, Heft: 9, Pages: 1500-1507 |
| ISSN: | 1532-1827 |
| DOI: | 10.1038/sj.bjc.6690239 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/sj.bjc.6690239 Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/6690239 
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| Verfasserangaben: | S. Hohaus, L. Funk, S. Martin, R. F. Schlenk, A. Abdallah, U. Hahn, G. Egerer, H. Goldschmidt, A. Schneeweiß, N. Fersis, S. Kaul, D. Wallwiener, G. Bastert, R. Haas |
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| 245 | 1 | 0 | |a Stage III and oestrogen receptor negativity are associated with poor prognosis after adjuvant high-dose therapy in high-risk breast cancer |c S. Hohaus, L. Funk, S. Martin, R. F. Schlenk, A. Abdallah, U. Hahn, G. Egerer, H. Goldschmidt, A. Schneeweiß, N. Fersis, S. Kaul, D. Wallwiener, G. Bastert, R. Haas |
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| 520 | |a We report on the efficacy and toxicity of a sequential high-dose therapy with peripheral blood stem cell (PBSC) support in 85 patients with high-risk stage II/III breast cancer. There were 71 patients with more than nine tumour-positive axillary lymph nodes. An induction therapy of two cycles of ifosfamide (total dose, 7.5 g m-2) and epirubicin (120 mg m-2) was given, and PBSC were harvested during G-CSF-supported leucocyte recovery following the second cycle. The PBSC-supported high-dose chemotherapy consisted of two cycles of ifosfamide (total dose, 12 000 mg m-2), carboplatin (900 mg m-2) and epirubicin (180 mg m-2). Patients were autografted with a median number of 3.7 × 106 CD34+ cells kg-1 (range, 1.9-26.5 × 106) resulting in haematological reconstitution within approximately 2 weeks following high-dose therapy. The toxicity was moderate in general, and there was no treatment-related toxic death. Twenty-one patients relapsed between 3 and 30 months following the last cycle of high-dose therapy (median, 11 months). The probability of disease-free and overall survival at 4 years were 60% and 83%, respectively. According to a multivariate analysis, patients with stage II disease had a significantly better probability of disease-free survival (74%) in comparison to patients with stage III disease (36%). The probability of disease-free survival was also significantly better for patients with oestrogen receptor-positive tumours (70%) compared to patients with receptor-negative ones (40%). Bone marrow samples collected from 52 patients after high-dose therapy were examined to evaluate the prognostic relevance of isolated tumour cells. The proportion of patients presenting with tumour cell-positive samples did not change in comparison to that observed before high-dose therapy (65% vs 71%), but a decrease in the incidence and concentration of tumour cells was observed over time after high-dose therapy. This finding was true for patients with relapse and for those in remission, which argues against a prognostic significance of isolated tumour cells in bone marrow. In conclusion, sequential high-dose chemotherapy with PBSC support can be safely administered to patients with high-risk stage II/III breast cancer. Further intensification of the therapy, including the addition of non-cross resistant drugs or immunological approaches such as the use of antibodies against HER-2/NEU, may be envisaged for patients with stage III disease and hormone receptor-negative tumours. | ||
| 650 | 4 | |a Biomedicine | |
| 650 | 4 | |a Cancer Research | |
| 650 | 4 | |a Drug Resistance | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a general | |
| 650 | 4 | |a Molecular Medicine | |
| 650 | 4 | |a Oncology | |
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