Paclitaxel-containing high-dose chemotherapy in high-risk breast cancer patients.
Despite standard-dose adjuvant chemotherapy, the prognosis for patients with breast cancer and extensive axillary lymph node involvement at diagnosis is poor. The efficacy of a paclitaxel-containing, high-dose chemotherapy protocol in 21 high-risk breast cancer patients is assessed. After standard-dose chemotherapy followed by peripheral blood stem cell (PBSC) mobilization, high-dose therapy with paclitaxel, carboplatin, and cyclophosphamide and CD34-selected PBSC rescue was given. Hematologic reconstitution after high-dose therapy was rapid. Main toxicity included diarrhea grade I or II in about half of the patients and infections were observed in 19%. Five-year probabilities for relapse and failure-free survival were 32% and 62%, respectively. High-dose consolidation with paclitaxel, carboplatin, and cyclophosphamide achieves a high failure-free survival in patients with high-risk breast cancer with acceptable toxicities and stable, long-term hematopoietic reconstitution. Evaluation of the benefit of high-dose therapy in these patients in larger prospective, randomized trials is warranted and currently under way.
Greinix
H T
HT
Department of Medicine I, University of Vienna, Austria. Hildegard.Greinix@akh-wien.ac.at
Linkesch
W
W
Seifert
M
M
Kubista
E
E
Czerwenka
K
K
Elahi
F
F
Zielinski
C
C
Hoecker
P
P
Steger
G
G
Schulenburg
A
A
Neumeister
G
G
Rabitsch
W
W
Jakesz
R
R
Kalhs
P
P
D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel