High-Dose Chemotherapy with Hematopoietic Stem Cell Transplant in Patients with High-Risk Breast Cancer and 4 or More Involved Axillary Lymph Nodes

Secondary analysis of RCT (n=885) found high-dose chemotherapy provided no long-term survival benefit in unselected patients with stage III breast cancer but did improve overall survival in very high-risk patients (≥10 involved axillary lymph nodes).

SPS commentary:

In the study, participants were randomized 1:1 to receive 5 cycles of chemotherapy consisting of fluorouracil, epirubicin and cyclophosphamide; or high dose chemotherapy in which the first 4 cycles were identical to control, but the fifth cycle was replaced by cyclophosphamide, thiotepa and carboplatin followed by hematopoietic stem cell transplant.

Results of the analysis also showed high-dose chemotherapy did not affect long-term risk of a second malignant neoplasm or major cardiovascular events.


JAMA Oncology