| Abstract | Patients with metastatic breast cancer in complete remission are the ones most likely to have an improved outcome with subsequent high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDC-PBSCT). Peripheral blood stem cells are usually procured following mobilization with single agent chemotherapy and colony-stimulating factor support. We utilized a dose-intense regimen of paclitaxel 200 mg/m2 i.v., etoposide 60 mg/kg i.v., and cyclophosphamide 3 g/m2 i.v. (TEC) followed by daily administration of granulocyte colony-stimulating factor. The aim was not only to mobilize stem cells but also to achieve optimal tumor cytoreduction prior to HDC/PBSCT. One hundred consecutive patients with metastatic breast cancer received 257 cycles of TEC between March 1994 and June 1997, with the aim of collecting 5 x 106 CD34-positive cells/kg usually following the second cycle of chemotherapy. Patient characteristics included a median age of 45 years, a median of two organ systems involved by disease, a median of two prior chemotherapy regimens and eight prior chemotherapy cycles, and a median interval of 8 months from diagnosis of metastases to first cycle of TEC. There were 61 febrile episodes during neutropenia and 13 of these were associated with bacteremia or fungemia. Mortality rate was 1%. An adequate number of stem cells was collected in 90% of patients. The overall response rate of the tumor was 58.8% with 23.7% complete responders among 97 evaluable patients. Multivariate analysis demonstrated chemosensitivity to the most recent standard chemotherapy regimen administered for metastatic disease, an ECOG performance score of 0 as opposed to 1, 2 or 3, and involvement by disease of only one organ system as significant variables for achieving a complete remission with TEC. This novel dose-intense regimen was safe and well tolerated, highly active against metastatic breast cancer, and capable of excellent stem cell mobilization. Bone Marrow Transplantation (2000) 25, 123-130. |
| Authors | S Bilgrami, J M Feingold, R D Bona, R L Edwards, A M Khan, F Rodriguez-Pinero, I A Khan, D Kazierad, J Clive, P J Tutschka
(Affiliation: Bone Marrow Transplant Program, University of Connecticut Health Center, Farmington, CT 06030, USA.)
|
| Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 25
Issue 2
Pg. 123-30
(Jan 2000)
ISSN: 0268-3369 ENGLAND |
| PMID | 10673668
(Publication Type: Clinical Trial, Journal Article)
|
| Chemical References |
- Antineoplastic Agents, Hormonal
- TEC protocol
- Taxoids
- Granulocyte Colony-Stimulating Factor
- Paclitaxel
- Etoposide
- Cyclophosphamide
|
| Topics |
- Antineoplastic Agents, Hormonal
(therapeutic use)
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects, therapeutic use)
- Breast Neoplasms
(blood, drug therapy, pathology, therapy)
- Combined Modality Therapy
(adverse effects)
- Cyclophosphamide
(administration & dosage, adverse effects, therapeutic use)
- Etoposide
(administration & dosage, adverse effects, therapeutic use)
- Female
- Granulocyte Colony-Stimulating Factor
(administration & dosage, pharmacology, therapeutic use)
- Hematopoietic Stem Cell Mobilization
- Hematopoietic Stem Cell Transplantation
- Humans
- Middle Aged
- Multivariate Analysis
- Neoplasm Metastasis
(drug therapy, pathology, radiotherapy)
- Paclitaxel
(administration & dosage, adverse effects, therapeutic use)
- Remission Induction
- Taxoids
- Treatment Outcome
|
