Prognostic studies in patients with high-risk primary breast cancer (HRPBC) receiving high-dose chemotherapy (HDC)

Excerpt

After standard-dose chemotherapy (SDC), more than 50% of patients with HRPBC (defined as extensive axillary node involvement or inflammatory disease) experience relapse. Controversy has surrounded the use of HDC for HRPBC for over a decade. Current results from at least 15 randomized trials comparing diverse forms of HDC and SDC for HRPBC appear contradictory at this point [1]. In addition, some studies suggest that younger women might benefit selectively from HDC. An NCI-sponsored meta-analysis is in progress. Regardless of this unsettled issue, it is clear that a substantial percentage of HRPBC patients still relapse after HDC. Extensive prognostic studies are required to improve their outcome. Such investigations may allow us to identify adequate patient subsets and new therapeutic targets for trials of developmental therapeutics. Combinations of HDC, capable of ample cytoreduction, with novel agents that target specific tumor features responsible for post-transplant relapse may hold promise. …