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  • Meeting abstract
  • Open Access

High-dose chemotherapy in breast cancer: Dutch randomized studies

  • 1,
  • 1 and
  • 2
Breast Cancer Research20013 (Suppl 1) :A54

https://doi.org/10.1186/bcr382

  • Received: 10 May 2001
  • Published:

Keywords

  • Breast Cancer
  • Carboplatin
  • Thiotepa
  • Dutch Study
  • Activation Route

The role of high-dose chemotherapy in the adjuvant treatment of breast cancer will eventually be defined by a range of randomized trials that still require years for maturation. Two underpowered single-institution studies (from the MD Anderson Cancer Center and from the Netherlands Cancer Institute) failed to show an advantage for high-dose therapy. A randomized Scandinavian study compared prolonged and intensive chemotherapy without stem-cell support with brief chemotherapy followed by the STAMP-V regimen. The intensive conventional treatment arm was shown to be superior in terms of relapse-free survival. Two large studies comparing conventional dose adjuvant chemotherapy with high-dose chemotherapy have been reported in abstract form: the American Intergroup study (ASCO 1999) and the Dutch National Study (ASCO 2000). The American study shows fewer relapses in the high-dose arm. The Dutch study suggests a modest disease-free survival advantage for the high-dose arm, but further follow up is required to ascertain statistical significance (P = 0.057, two-sided, at the early analysis). In 2002, a 24% reduction in hazard rate will be detectable with 80% power. Both the efficacy and toxicity of high-dose therapy may depend on the drugs, dosage and schedules selected. In the Dutch study, a regimen was employed that is similar to the frequently used CTCb (STAMP-V) regimen. The carboplatin dose is, however, twice as high, and the agents are administered as short-term infusions rather than as continuous 96-h infusions. This may have an impact on the activation of the prodrug cyclophosphamide; the activation route is strongly inhibited by the presence of even low concentrations of thiotepa.

Authors’ Affiliations

(1)
The Netherlands Cancer Institute, Amsterdam, The Netherlands
(2)
Groningen University Hospital, Groningen, The Netherlands

Copyright

© BioMed Central Ltd 2001

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