title: Critical issues on high-dose chemotherapy with autologous hematopoietic progenitor cell transplantation in breast cancer patients.
abstract: BACKGROUND
  High-dose chemotherapy (HDC) with autologous hematopoietic progenitor cell transplantation (AHPCT) for high-risk (HR) or metastatic breast cancer (MBC) is no longer an option.
  
  
  METHODS
  An expert panel including medical oncologists and hematologists produce an opinion paper on the use of HDC and AHPCT in BC patients and they explain why they believe that; despite inconclusive results thus far, this treatment should have an ongoing role in breast cancer management under clinical trials.
  
  
  CONCLUSIONS
  HDC with AHPCT has become a safe treatment modality and an advantage in disease-free survival has been observed in most of the studies with HDC, with the caveat that today, even a limited relapse-free survival and progression-free survival benefit is sufficient for the approval of new antineoplastic agents. Moreover, in HRBC, an overall survival benefit by HDC could be achieved in the HER2-ve and triple-negative populations and, in this setting, HDC with AHPCT represents a therapeutic option that can be proposed to well-informed patients. In MBC, the HDC approach should be investigated further in selected patients with HER2-ve, chemosensitive disease. This paper is not intended to give any conclusion, but rather to open a debate on the value of HDC in HR and MBC.
authors.affiliation: Ematologia con Trapianto di Midollo Osseo e Terapia Intensiva, Dipartimento di Oncologia, Azienda Ospedaliera Bianchi-Melacrino-Morelli, 89100Reggio Calabria, Italy. maxmartino65@alice.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Martino
authors.forename: Alberto
authors.initials: A
authors.lastname: Bottini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosti
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.forename: Simona
authors.initials: S
authors.lastname: Secondino
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.forename: Roberto
authors.initials: R
authors.lastname: Maisano
authors.forename: Francesco
authors.initials: F
authors.lastname: Lanza
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.forename: Paolo
authors.initials: P
authors.lastname: Pedrazzoli
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D014182:Transplantation, Autologous / Q000379:methods / Q000401:mortality
chemical_list: D000970:Antineoplastic Agents