PMID- 19532017
OWN - NLM
STAT- MEDLINE
DCOM- 20091002
LR  - 20221108
IS  - 1531-703X (Electronic)
IS  - 1040-8746 (Linking)
VI  - 21
IP  - 2
DP  - 2009 Mar
TI  - High-dose chemotherapy for high-risk primary and metastatic breast cancer: is 
      another look warranted?
PG  - 150-7
LID - 10.1097/CCO.0b013e328324f48b [doi]
AB  - PURPOSE OF REVIEW: The controversy surrounding high-dose chemotherapy (HDC) for 
      breast cancer seems to have given place to skepticism about its efficacy, 
      regardless of regimen or schedule, for any subset of patients with high-risk 
      primary breast cancer (HRPBC) or metastatic disease. We review here the main 
      publications in this field since 2006, focusing on updates of randomized trials 
      comparing HDC with standard-dose chemotherapy. RECENT FINDINGS: A meta-analysis 
      of all 15 randomized HRPBC trials (n = 6102) has detected an absolute 13% 
      event-free survival benefit in favor of HDC (P = 0.0001) at a median 6-year 
      follow-up. The absolute differences in breast cancer-specific (7%) and overall 
      survival (5%) did not reach statistical significance. Several retrospective 
      subset analyses suggest that HDC may be particularly effective among patients 
      with HER2-negative tumors, particularly if also hormone receptor negative (triple 
      negative). SUMMARY: A global event-free survival advantage favoring HDC has been 
      shown in HRPBC trials, which seems to affect particularly patients with triple 
      negative tumors. Event-free survival is a clinically relevant endpoint in the 
      adjuvant setting, in which the goal of any treatment should be cure. Therefore, 
      it seems that the current broad skepticism about HDC is unduly dismissive of this 
      benefit. HDC remains a valid research strategy in appropriate subpopulations such 
      as triple-negative HRPBC or oligometastatic disease.
FAU - Nieto, Yago
AU  - Nieto Y
AD  - Department of Stem Cell Transplantation and Cellular Therapy, The University of 
      Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 423, Houston, TX 77030, 
      USA. ynieto@mdanderson.org
FAU - Shpall, Elizabeth J
AU  - Shpall EJ
LA  - eng
GR  - P30 CA016672/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Oncol
JT  - Current opinion in oncology
JID - 9007265
RN  - 0 (Antineoplastic Agents)
RN  - EC 2.7.10.1 (ERBB2 protein, human)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Antineoplastic Agents/*administration & dosage
MH  - Breast Neoplasms/*drug therapy/genetics/mortality/*secondary
MH  - Disease-Free Survival
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Meta-Analysis as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Receptor, ErbB-2/genetics
RF  - 55
EDAT- 2009/06/18 09:00
MHDA- 2009/10/03 06:00
CRDT- 2009/06/18 09:00
PHST- 2009/06/18 09:00 [entrez]
PHST- 2009/06/18 09:00 [pubmed]
PHST- 2009/10/03 06:00 [medline]
AID - 00001622-200903000-00011 [pii]
AID - 10.1097/CCO.0b013e328324f48b [doi]
PST - ppublish
SO  - Curr Opin Oncol. 2009 Mar;21(2):150-7. doi: 10.1097/CCO.0b013e328324f48b.