High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer

William P. Peters, Maureen Ross, James J. Vredenburgh, Barry Meisenberg, Lawrence B. Marks, Eric Winer, Joanne Kurtzberg, Robert C. Bast, Roy Jones, Elizabeth Shpall, Katherine Wu, Gary Rosner, Colleen Gilbert, Barbara Mathias, David Coniglio, William Petros, I. Craig Henderson, Larry Norton, Raymond B. Weiss, Daniel Budman & 1 others David Hurd

Research output: Contribution to journalArticle

Abstract

Purpose: We studied high-dose cyclophosphamide, cisplatin, and carmustine (CPA/cDDP/BCNU) with autologous bone marrow support (ABMS) as consolidation after standard-dose adjuvant chemotherapy treatment of primary breast cancer involving 10 or more axillary lymph nodes. Patients and Methods: One hundred two women with stage IIA, IIB, IIIA, or IIIB breast cancer involving 10 or more lymph nodes at surgery were registered; 85 were eligible, treated, and assessable. Patients were treated with four cycles of standard-dose cyclophosphamide, doxorubicin, and fluorouracil (CAP), followed by high-dose CPA/cDDP/BCNU with ABMS. Results: Actuarial event-free survival for the study patients at a median follow-up of 2.5 years is 72% (95% confidence interval, 56% to 82%). Comparison to three historical or concurrent Cancer and Leukemia Group B (CALGB) adjuvant chemotherapy trials selected for similar patients showed event-free survival at 2.5 years to be between 38% and 52%. Therapy-related mortality was 12%; pulmonary toxicity of variable severity occurred in 31% of patients. Quality-of-life evaluations indicate that patients are functioning well without major impairments. Conclusion: High-dose consolidation with CPA/cDDP/BCNU and ABMS after standard-dose CAF results in a decreased frequency of relapse in patients with high-risk primary breast cancer compared with historical series at the median follow-up of 2.5 years. Evaluation in a prospective, randomized trial is warranted and currently underway.

Original languageEnglish (US)
Pages (from-to)1132-1143
Number of pages12
JournalJournal of Clinical Oncology
Volume11
Issue number6
StatePublished - 1993
Externally publishedYes

Fingerprint

Bone Marrow
Carmustine
Breast Neoplasms
Drug Therapy
Adjuvant Chemotherapy
Cyclophosphamide
Therapeutics
Disease-Free Survival
Lymph Nodes
Fluorouracil
Doxorubicin
Cisplatin
Leukemia
Quality of Life
Confidence Intervals
Recurrence
Lung
Mortality
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Peters, W. P., Ross, M., Vredenburgh, J. J., Meisenberg, B., Marks, L. B., Winer, E., ... Hurd, D. (1993). High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer. Journal of Clinical Oncology, 11(6), 1132-1143.

High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer. / Peters, William P.; Ross, Maureen; Vredenburgh, James J.; Meisenberg, Barry; Marks, Lawrence B.; Winer, Eric; Kurtzberg, Joanne; Bast, Robert C.; Jones, Roy; Shpall, Elizabeth; Wu, Katherine; Rosner, Gary; Gilbert, Colleen; Mathias, Barbara; Coniglio, David; Petros, William; Henderson, I. Craig; Norton, Larry; Weiss, Raymond B.; Budman, Daniel; Hurd, David.

In: Journal of Clinical Oncology, Vol. 11, No. 6, 1993, p. 1132-1143.

Research output: Contribution to journalArticle

Peters, WP, Ross, M, Vredenburgh, JJ, Meisenberg, B, Marks, LB, Winer, E, Kurtzberg, J, Bast, RC, Jones, R, Shpall, E, Wu, K, Rosner, G, Gilbert, C, Mathias, B, Coniglio, D, Petros, W, Henderson, IC, Norton, L, Weiss, RB, Budman, D & Hurd, D 1993, 'High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer', Journal of Clinical Oncology, vol. 11, no. 6, pp. 1132-1143.
Peters, William P. ; Ross, Maureen ; Vredenburgh, James J. ; Meisenberg, Barry ; Marks, Lawrence B. ; Winer, Eric ; Kurtzberg, Joanne ; Bast, Robert C. ; Jones, Roy ; Shpall, Elizabeth ; Wu, Katherine ; Rosner, Gary ; Gilbert, Colleen ; Mathias, Barbara ; Coniglio, David ; Petros, William ; Henderson, I. Craig ; Norton, Larry ; Weiss, Raymond B. ; Budman, Daniel ; Hurd, David. / High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer. In: Journal of Clinical Oncology. 1993 ; Vol. 11, No. 6. pp. 1132-1143.
@article{f6d418bd58e040278bb38519313252ee,
title = "High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer",
abstract = "Purpose: We studied high-dose cyclophosphamide, cisplatin, and carmustine (CPA/cDDP/BCNU) with autologous bone marrow support (ABMS) as consolidation after standard-dose adjuvant chemotherapy treatment of primary breast cancer involving 10 or more axillary lymph nodes. Patients and Methods: One hundred two women with stage IIA, IIB, IIIA, or IIIB breast cancer involving 10 or more lymph nodes at surgery were registered; 85 were eligible, treated, and assessable. Patients were treated with four cycles of standard-dose cyclophosphamide, doxorubicin, and fluorouracil (CAP), followed by high-dose CPA/cDDP/BCNU with ABMS. Results: Actuarial event-free survival for the study patients at a median follow-up of 2.5 years is 72{\%} (95{\%} confidence interval, 56{\%} to 82{\%}). Comparison to three historical or concurrent Cancer and Leukemia Group B (CALGB) adjuvant chemotherapy trials selected for similar patients showed event-free survival at 2.5 years to be between 38{\%} and 52{\%}. Therapy-related mortality was 12{\%}; pulmonary toxicity of variable severity occurred in 31{\%} of patients. Quality-of-life evaluations indicate that patients are functioning well without major impairments. Conclusion: High-dose consolidation with CPA/cDDP/BCNU and ABMS after standard-dose CAF results in a decreased frequency of relapse in patients with high-risk primary breast cancer compared with historical series at the median follow-up of 2.5 years. Evaluation in a prospective, randomized trial is warranted and currently underway.",
author = "Peters, {William P.} and Maureen Ross and Vredenburgh, {James J.} and Barry Meisenberg and Marks, {Lawrence B.} and Eric Winer and Joanne Kurtzberg and Bast, {Robert C.} and Roy Jones and Elizabeth Shpall and Katherine Wu and Gary Rosner and Colleen Gilbert and Barbara Mathias and David Coniglio and William Petros and Henderson, {I. Craig} and Larry Norton and Weiss, {Raymond B.} and Daniel Budman and David Hurd",
year = "1993",
language = "English (US)",
volume = "11",
pages = "1132--1143",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "6",

}

TY - JOUR

T1 - High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer

AU - Peters, William P.

AU - Ross, Maureen

AU - Vredenburgh, James J.

AU - Meisenberg, Barry

AU - Marks, Lawrence B.

AU - Winer, Eric

AU - Kurtzberg, Joanne

AU - Bast, Robert C.

AU - Jones, Roy

AU - Shpall, Elizabeth

AU - Wu, Katherine

AU - Rosner, Gary

AU - Gilbert, Colleen

AU - Mathias, Barbara

AU - Coniglio, David

AU - Petros, William

AU - Henderson, I. Craig

AU - Norton, Larry

AU - Weiss, Raymond B.

AU - Budman, Daniel

AU - Hurd, David

PY - 1993

Y1 - 1993

N2 - Purpose: We studied high-dose cyclophosphamide, cisplatin, and carmustine (CPA/cDDP/BCNU) with autologous bone marrow support (ABMS) as consolidation after standard-dose adjuvant chemotherapy treatment of primary breast cancer involving 10 or more axillary lymph nodes. Patients and Methods: One hundred two women with stage IIA, IIB, IIIA, or IIIB breast cancer involving 10 or more lymph nodes at surgery were registered; 85 were eligible, treated, and assessable. Patients were treated with four cycles of standard-dose cyclophosphamide, doxorubicin, and fluorouracil (CAP), followed by high-dose CPA/cDDP/BCNU with ABMS. Results: Actuarial event-free survival for the study patients at a median follow-up of 2.5 years is 72% (95% confidence interval, 56% to 82%). Comparison to three historical or concurrent Cancer and Leukemia Group B (CALGB) adjuvant chemotherapy trials selected for similar patients showed event-free survival at 2.5 years to be between 38% and 52%. Therapy-related mortality was 12%; pulmonary toxicity of variable severity occurred in 31% of patients. Quality-of-life evaluations indicate that patients are functioning well without major impairments. Conclusion: High-dose consolidation with CPA/cDDP/BCNU and ABMS after standard-dose CAF results in a decreased frequency of relapse in patients with high-risk primary breast cancer compared with historical series at the median follow-up of 2.5 years. Evaluation in a prospective, randomized trial is warranted and currently underway.

AB - Purpose: We studied high-dose cyclophosphamide, cisplatin, and carmustine (CPA/cDDP/BCNU) with autologous bone marrow support (ABMS) as consolidation after standard-dose adjuvant chemotherapy treatment of primary breast cancer involving 10 or more axillary lymph nodes. Patients and Methods: One hundred two women with stage IIA, IIB, IIIA, or IIIB breast cancer involving 10 or more lymph nodes at surgery were registered; 85 were eligible, treated, and assessable. Patients were treated with four cycles of standard-dose cyclophosphamide, doxorubicin, and fluorouracil (CAP), followed by high-dose CPA/cDDP/BCNU with ABMS. Results: Actuarial event-free survival for the study patients at a median follow-up of 2.5 years is 72% (95% confidence interval, 56% to 82%). Comparison to three historical or concurrent Cancer and Leukemia Group B (CALGB) adjuvant chemotherapy trials selected for similar patients showed event-free survival at 2.5 years to be between 38% and 52%. Therapy-related mortality was 12%; pulmonary toxicity of variable severity occurred in 31% of patients. Quality-of-life evaluations indicate that patients are functioning well without major impairments. Conclusion: High-dose consolidation with CPA/cDDP/BCNU and ABMS after standard-dose CAF results in a decreased frequency of relapse in patients with high-risk primary breast cancer compared with historical series at the median follow-up of 2.5 years. Evaluation in a prospective, randomized trial is warranted and currently underway.

UR - http://www.scopus.com/inward/record.url?scp=0027191820&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027191820&partnerID=8YFLogxK

M3 - Article

VL - 11

SP - 1132

EP - 1143

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 6

ER -