title: Long-term survival in patients with metastatic breast cancer receiving intensified chemotherapy and stem cell rescue: data from the Italian registry.
abstract: The median survival of women with metastatic breast cancer (MBC) is 18-24 months, and fewer than 5% are alive and disease free at 5 years. We report toxicity and survival in a cohort of MBC patients receiving high-dose chemotherapy (HDC) with autologous hematopoietic SCT (AHSCT) in Italy between 1990 and 2005. Data set for survival analysis has been obtained for 415 patients. Clinical parameters including probability of transplant-related mortality (TRM), PFS and OS. With a median follow-up of 27 months (range 0-172), OS and PFS at 5 and 10 years in the whole population were 47/23 and 32/14%, respectively. A total 239 patients are alive with a median follow-up of 33 months (range 2-174). Survival was significantly more pronounced in patients harboring hormone receptor positive tumors (P=0.028), without visceral metastases (P=0.009) and in women with chemosensitive disease (P<0.0001). Sixty eight patients (20.4%) who received HDC in partial response, stable or progressive disease underwent conversion to CR. TRM was 2.5% overall and 1.3% since 2000. Our findings suggest that could be a role for HDC and AHSCT in delaying disease progression and possibly cure a subset of MBC patient harboring chemosensitive tumors.
authors.affiliation: Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera BMM, Reggio Calabria, Italy. maxmartino65@alice.it
authors.forename: M
authors.initials: M
authors.lastname: Martino
authors.forename: A
authors.initials: A
authors.lastname: Ballestrero
authors.forename: A
authors.initials: A
authors.lastname: Zambelli
authors.forename: S
authors.initials: S
authors.lastname: Secondino
authors.forename: M
authors.initials: M
authors.lastname: Aieta
authors.forename: C
authors.initials: C
authors.lastname: Bengala
authors.forename: A M
authors.initials: AM
authors.lastname: Liberati
authors.forename: C
authors.initials: C
authors.lastname: Zamagni
authors.forename: M
authors.initials: M
authors.lastname: Musso
authors.forename: M
authors.initials: M
authors.lastname: Aglietta
authors.forename: R
authors.initials: R
authors.lastname: Schiavo
authors.forename: L
authors.initials: L
authors.lastname: Castagna
authors.forename: G
authors.initials: G
authors.lastname: Rosti
authors.forename: B
authors.initials: B
authors.lastname: Bruno
authors.forename: P
authors.initials: P
authors.lastname: Pedrazzoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult