High dose chemotherapy and autologous stem cell transplantation as adjuvant therapy for primary breast cancer patients with four or more lymph nodes involved: long-term results of an international randomised trial.

2.50
Hdl Handle:
http://hdl.handle.net/10541/72893
Title:
High dose chemotherapy and autologous stem cell transplantation as adjuvant therapy for primary breast cancer patients with four or more lymph nodes involved: long-term results of an international randomised trial.
Authors:
Coombes, R C; Howell, Anthony ( 0000-0002-3879-5991 ) ; Emson, M; Peckitt, Clare; Gallagher, C; Bengala, C; Tres, A; Welch, Richard; Lawton, P; Rubens, R; Woods, E; Haviland, Joanne; Vigushin, D; Kanfer, E; Bliss, Judith M
Abstract:
BACKGROUND: The purpose of this study was to assess whether a short course of anthracycline containing chemotherapy followed by high dose therapy with autologous stem-cell support improves disease-free and overall survival as compared with conventional, anthracycline containing chemotherapy, in patients with primary breast cancer and four or more histologically involved lymph nodes. PATIENTS AND METHODS: Two hundred and eighty one patients entered into a randomised clinical trial were allocated to receive standard, conventional treatment (5-fluorouracil, epirubicin and cyclophosphamide-FEC for six cycles) or FEC for three cycles followed by high dose therapy consisting of cyclophosphamide, thiotepa and carboplatin and stem cell rescue (HDT). To be eligible, patients had to be free of overt metastatic disease and be < or =60 years of age. Analyses were according to intention to treat. RESULTS: At a median follow up of 68 months, 118 patients have experienced a relapse or death from breast cancer (62 in the FEC followed by HDT arm and 56 in the conventional FEC arm) and a total of 100 patients have died (54 in the FEC followed by HDT arm and 46 in the conventional FEC arm). No significant difference was observed in relapse-free survival [hazard ratio 1.06, 95% CI 0.74-1.52, p = 0.76] or overall survival [hazard ratio 1.18, 95% CI 0.80-1.75, p = 0.40]. Five patients died from treatment related causes, three as a consequence of HDT and two in the conventional FEC arm. CONCLUSIONS: At the present time, no benefit has been observed from replacing three cycles of conventional chemotherapy with the HDT regimen described here. Patients should continue to receive conventional chemotherapy as adjuvant therapy for breast cancer.
Affiliation:
Cancer Research UK Department of Cancer Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London. c.coombes@imperial.ac.uk
Citation:
High dose chemotherapy and autologous stem cell transplantation as adjuvant therapy for primary breast cancer patients with four or more lymph nodes involved: long-term results of an international randomised trial. 2005, 16 (5):726-34 Ann. Oncol.
Journal:
Annals of Oncology
Issue Date:
May-2005
URI:
http://hdl.handle.net/10541/72893
DOI:
10.1093/annonc/mdi166
PubMed ID:
15817602
Type:
Article
Language:
en
ISSN:
0923-7534
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorCoombes, R C-
dc.contributor.authorHowell, Anthony-
dc.contributor.authorEmson, M-
dc.contributor.authorPeckitt, Clare-
dc.contributor.authorGallagher, C-
dc.contributor.authorBengala, C-
dc.contributor.authorTres, A-
dc.contributor.authorWelch, Richard-
dc.contributor.authorLawton, P-
dc.contributor.authorRubens, R-
dc.contributor.authorWoods, E-
dc.contributor.authorHaviland, Joanne-
dc.contributor.authorVigushin, D-
dc.contributor.authorKanfer, E-
dc.contributor.authorBliss, Judith M-
dc.date.accessioned2009-07-07T16:48:23Z-
dc.date.available2009-07-07T16:48:23Z-
dc.date.issued2005-05-
dc.identifier.citationHigh dose chemotherapy and autologous stem cell transplantation as adjuvant therapy for primary breast cancer patients with four or more lymph nodes involved: long-term results of an international randomised trial. 2005, 16 (5):726-34 Ann. Oncol.en
dc.identifier.issn0923-7534-
dc.identifier.pmid15817602-
dc.identifier.doi10.1093/annonc/mdi166-
dc.identifier.urihttp://hdl.handle.net/10541/72893-
dc.description.abstractBACKGROUND: The purpose of this study was to assess whether a short course of anthracycline containing chemotherapy followed by high dose therapy with autologous stem-cell support improves disease-free and overall survival as compared with conventional, anthracycline containing chemotherapy, in patients with primary breast cancer and four or more histologically involved lymph nodes. PATIENTS AND METHODS: Two hundred and eighty one patients entered into a randomised clinical trial were allocated to receive standard, conventional treatment (5-fluorouracil, epirubicin and cyclophosphamide-FEC for six cycles) or FEC for three cycles followed by high dose therapy consisting of cyclophosphamide, thiotepa and carboplatin and stem cell rescue (HDT). To be eligible, patients had to be free of overt metastatic disease and be < or =60 years of age. Analyses were according to intention to treat. RESULTS: At a median follow up of 68 months, 118 patients have experienced a relapse or death from breast cancer (62 in the FEC followed by HDT arm and 56 in the conventional FEC arm) and a total of 100 patients have died (54 in the FEC followed by HDT arm and 46 in the conventional FEC arm). No significant difference was observed in relapse-free survival [hazard ratio 1.06, 95% CI 0.74-1.52, p = 0.76] or overall survival [hazard ratio 1.18, 95% CI 0.80-1.75, p = 0.40]. Five patients died from treatment related causes, three as a consequence of HDT and two in the conventional FEC arm. CONCLUSIONS: At the present time, no benefit has been observed from replacing three cycles of conventional chemotherapy with the HDT regimen described here. Patients should continue to receive conventional chemotherapy as adjuvant therapy for breast cancer.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Stagingen
dc.subjectCancer Recurrenceen
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBreast Neoplasms-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshConfidence Intervals-
dc.subject.meshDisease-Free Survival-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshDrug Administration Schedule-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInternational Cooperation-
dc.subject.meshLymph Nodes-
dc.subject.meshMastectomy, Segmental-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshNeoplasm Staging-
dc.subject.meshPatient Selection-
dc.subject.meshProbability-
dc.subject.meshPrognosis-
dc.subject.meshProportional Hazards Models-
dc.subject.meshReference Values-
dc.subject.meshRisk Assessment-
dc.subject.meshStem Cell Transplantation-
dc.subject.meshSurvival Rate-
dc.subject.meshTransplantation, Autologous-
dc.subject.meshTreatment Outcome-
dc.titleHigh dose chemotherapy and autologous stem cell transplantation as adjuvant therapy for primary breast cancer patients with four or more lymph nodes involved: long-term results of an international randomised trial.en
dc.typeArticleen
dc.contributor.departmentCancer Research UK Department of Cancer Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London. c.coombes@imperial.ac.uken
dc.identifier.journalAnnals of Oncologyen

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