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.
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M3 - Article
C2 - 8501500
AN - SCOPUS:0027191820
SN - 0732-183X
VL - 11
SP - 1132
EP - 1143
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 6
ER -