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High-dose chemo and stem cell transplant shows little or no survival benefit for breast cancer
Date:12/13/2007

study would show a statistical significance in overall survival.

"At a minimum, I thought we would have a chance to identify subsets of patients that would benefit and, with 6,200 patients randomized in the 15 trials, that we would be able to confirm our findings. The fact that we did not identify such subsets in no way lessens the value of our study. It is the definitive study for high-dose breast cancer in the adjuvant setting," Berry says.

To appreciate the importance of the study itself and its findings one must understand the nature of the therapy and its conflicting history.

High-dose chemotherapy can be arduous for the patient: it includes administering very high doses of chemotherapy followed by bone marrow or stem cell transplantation of the patient's own blood stem cells that are collected prior to receiving chemotherapy. The autologous transplant rebuilds the bone marrow, which was effected by the intense chemotherapy, explains Naoto Ueno, M.D., Ph.D., associate professor in M. D. Anderson's Departments of Stem Cell Transplantation and Cellular Therapy and Breast Medical Oncology. While it has become far more tolerable, in the past, the therapy was often debilitating and was associated with a number of serious side effects, including infection, nausea, vomiting, and extreme weakness - sometimes resulting in death from the treatment alone.

"The 1980s and early 1990s represented a period in breast cancer history where more was better in terms of treatment," says Ueno, an author on the study.

Despite its side effects, a few small studies emerged in the early 1990s suggesting that the treatment was beneficial for women with high-risk breast cancer, those with at least ten positive axillary lymph nodes. Yet, these studies were not randomized, the gold standard for testing a therapy, explains Berry. Rather they compared one database to another.

Regardless, breast cancer patients and advocates began demandi
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Contact: Laura Sussman
lsussman@mdanderson.org
832-264-8893
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

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