[High-dose chemotherapy and peripheral hemtopoietic cells (PBPC) in solid tumors]

Area of Science:

• Oncology
• Hematology
• Cancer Therapeutics

Context:

• High-dose chemotherapy is increasingly utilized for solid tumors in Europe and North America.
• Autologous bone marrow transplantation (ABMT) and peripheral blood progenitor cell transplantation (PBPCT) are common procedures, particularly for breast carcinoma.
• Ongoing trials are evaluating the efficacy of high-dose chemotherapy in the adjuvant setting for high-risk breast cancer.

Purpose:

• To review the current status of high-dose chemotherapy for solid tumors.
• To discuss new technologies and their applications in high-dose chemotherapy.
• To highlight the benefits and challenges associated with ABMT and PBPCT.

Summary:

• Phase II trials indicate high-dose chemotherapy yields superior disease-free survival rates in high-risk breast cancer patients compared to standard doses.
• A trial in advanced disease favored high-dose cyclophosphamide, mitoxantrone, and etoposide over standard regimens, improving overall survival and time to relapse.
• The adoption of PBPCT over ABMT has improved tolerability and reduced costs, with a significant decrease in toxic death rates for breast cancer patients.

Impact:

• High-dose chemotherapy demonstrates significant potential in improving outcomes for patients with various solid tumors, including breast cancer and germ cell tumors.
• Reduced toxicity and cost-effectiveness associated with PBPCT enhance patient management.
• Further research is needed to address the debate surrounding PBPC contamination by tumor cells.