[High-dose chemotherapy with stem cell support for solid tumors in adults]

Area of Science:

• Oncology
• Hematology

Context:

• High-dose chemotherapy (HDC) has evolved significantly due to advances in supportive care and stem cell transplantation.
• Peripheral blood stem cell transplantation has largely replaced autologous bone marrow transplantation, reducing treatment-related risks.

Purpose:

• To review the current role and future potential of high-dose chemotherapy in treating advanced solid malignancies.
• To identify solid tumors where HDC is a standard or potentially beneficial treatment modality.

Summary:

• HDC is the standard for specific rare cancers like germ cell tumors and pediatric sarcomas in adults.
• Evidence suggests HDC may benefit selected patients with high-risk or disseminated breast cancer, pending randomized trial confirmation.
• Ongoing studies are investigating HDC for small cell lung cancer and ovarian cancer.
• While HDC achieves significant tumor reduction, it rarely results in a cure, highlighting the need for novel approaches against residual disease.

Impact:

• Improved survival outcomes for patients with certain advanced solid tumors.
• Reduced therapy-related mortality and morbidity associated with HDC.
• Identifies the need for novel therapeutic strategies to achieve complete eradication of microscopic disease in solid tumors.