A comparative study of high-dose chemotherapy with autologous hematopoietic progenitor cell transplantation versus conventional chemotherapy as treatment for metastatic breast cancer.

Abstract

Objectives. Data from one small randomized trial has suggested a benefit for high-dose chemotherapy/autologous hematopoietic progenitor cell transplantation (HDCT/AHPCT) as compared with conventional chemotherapy (CCT) in patients with metastatic breast cancer. However, the study was considered to have had some limitations based on methodology, analysis, and sample size. The present study sought to compare differences in outcome in patients with metastatic breast cancer undergoing HDCT/AHPCT as compared with historical controls undergoing CCT. The principal endpoints analyzed were overall survival and time to first failure after beginning chemotherapy. Secondary outcomes included an analysis of predictors of time to first recurrence of breast cancer, analyses of prognostic factors for overall survival at recurrence, of time to first failure from the time of beginning chemotherapy, and for survival after HDCT/AHPCT. Conclusions. The use of HDCT/AHPCT in metastatic breast cancer may confer advantages with respect to overall survival and time to first failure after beginning chemotherapy. These advantages appear to be independent of the effects of selection bias and variously cited prognostic factors. This benefit if confirmed in ongoing randomized trials will have to be considered in light of differences in cost and quality of life between the two therapeutic modalities. (Abstract shortened by UMI.)