Yazarlar : Somlo G, Vanderwalde A, Ye W, Frankel P, Asuncion D, Leong L, Luu T, Morgan R, Twardowski P, Koczywas M, Pezner R, Paz IB, Margolin K, Wong J, Doroshow J, Forman S, Shibata S.

Yayın : Biol Blood Marrow Transplant.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22306735

Konu : Tıbbi Onkoloji

Literatür İçeriği :  

Abstract

Patients with high-risk locally-advanced/inflammatory and oligometastatic (≤3 sites) breast cancer frequently relapse or experience early progression. High-dose chemotherapy combined with peripheral stem cell rescue may prolong progression/relapse-free (PFS/RFS) and overall survival (OS). For this study, patients initiated high-dose chemotherapy with STAMP-V (carboplatin, thiotepa, and cyclophosphamide), ACT (doxorubicin, paclitaxel, and cyclophosphamide), or tandem melphalan and STAMP-V. Eighty-six patients were diagnosed with locally-advanced/inflammatory (17 inflammatory), and 12 with oligometastatic breast cancer. Median follow-up was 84 months (range 6-136) for locally-advanced patients; 40 months (range 24-62) for metastatic patients. Five-year RFS and OS for locally-advanced patients were 53% (95% CI 41%-63%) and 71% (95% CI 60%-80%). Hormone receptors were positive in 74% of locally-advanced patients; HER2 was overexpressed in 23%. In multivariate analysis hormone receptor-positive disease and lower stage were associated with better five-year RFS (60% for ER/PR+ vs. 30% for ER/PR-, p<0.01) and OS (83% for ER/PR+ vs. 38% for ER/PR-, p<0.001). Three-year PFS and OS were 49% (95% CI 19%-73%) and 73% (95% CI 38%-91%), respectively, for metastatic patients. Favorable long term RFS/PFS and OS for high-dose chemotherapy with peripheral stem cell rescue in this selected patient population reflect the relative safety of the procedure and warrant validation in defined subgroups through prospective, randomized, multi-institutional trials

Literatür Arşivi