[MOL] High Dos chemotherapy for high=risk b.c...... [00982] Medicine On Line

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[MOL] High Dos chemotherapy for high=risk b.c......

Lancet 2000; 355: 903 - 910 Download PDF (103 Kb)
>Just a month after doubt was thrown onto the results of a trial of high-dose chemotherapy for high-risk breast cancer (see Lancet
>2000; 355: 553), the results of a trial in which high-dose chemotherapy was used in metastatic breast cancer have been published. In
>an early release on the New England Journal of Medicine website (www.nejm.org ), Edward Stadtmauer (University of Pennsylvania
>Cancer Center, Philadelphia, PA, USA) and co-workers report that "high-dose chemotherapy plus autologous stem-cell transplantation
>soon after the induction of a complete or partial remission with conventional-dose chemotherapy does not improve survival in women
>with metastatic breast cancer" when compared with standard maintenance chemotherapy.
>553 women, aged 18-60 years, with untreated metastatic breast cancer were enrolled in the trial. 58 women had a complete response to
>standard induction chemotherapy; 252 had a partial response. Of these responders, 110 received high-dose chemotherapy with stem-cell
>rescue and 89 received conventional chemotherapy. There was no significant difference between treatment groups in 3-year survival or
>median time to progression. However, there was a higher rate of moderate and severe, but non-fatal, side-effects in the high-dose
>group compared with the standard-dose group. Full quality-of-life data will be presented later this year, says Stadtmauer.
>Gabriel Hortobagyi (University of Texas M D Anderson Cancer Center, Houston, TX, USA) describes the study as "the best and largest
>randomised trial so far of high-dose chemotherapy in metastatic breast cancer". But, he adds, it was underpowered to detect "modest
>differences in relapse-free and overall survival, especially for patients who received high-dose therapy after achieving a complete
>remission with induction chemotherapy; there may still be an advantage, but it will be relatively modest". Nevertheless, say both
>Hortobagyi and Stadtmauer, "if that advantage can be achieved with minimal mortality and morbidity, high-dose therapy might still be
>an important addition to our treatment strategies".
>Jane Bradbury
>The Association of Cancer Online Resources, a non-profit 501 (c)-3 organization.   ACOR, 173 Duane Street, Third Floor, NY, NY 10013
Warmly, lillian
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