Is there a role for dose-intensive chemotherapy with stem cell rescue in breast cancer?

Over the past decade, high-dose chemotherapy with autologous bone marrow and/or peripheral blood rescue has been increasingly used to treat women with breast cancer. Laboratory and clinical studies have shown that dose intensity may be important in treating selected patients with breast cancer. Initial phase I studies showed good response rates of short durations. Further trials in metastatic disease with high-dose chemotherapy and stem cell rescue earlier in the treatment course had been encouraging. However, the optimal timing of high-dose chemotherapy remains a question. In addition, randomized trials in high-risk early-stage breast cancer have completed accrual. Technologic improvements in stem cell procurement and hematopoietic growth factors have contributed to decreased morbidity and mortality. This review will discuss the role of such therapy in the treatment of women with breast cancer.