Autologous Bone Marrow Transplantation - Blog Science Connections

Strategies in the Treatment of Breast Cancer With
Intensive Chemotherapy and Autologous
Bone Marrow Support
William P. Peters, Roy B. Jones, Elizabeth J. Shpall, Jon Gockerman,
Joanne Kurtzberg, Joseph Moore, Robert C. Bast, Colleen Gilbert,
Barbara Blackburn, David Coniglio, Lynn Brophy, and
Sharon Edwards for the Bone Marrow Transplant Program,
Duke University Medical Center
The treatment of metastatic breast cancer is currently disappointing. Despite
the availability of more than 15 active chemotherapeutic agents and
numerous combinations, no curative regimen has been developed. Further,
notwithstanding considerable effort and many clinical trials, the improvement
in survival over the past 20 years has been at best limited. However, several
leads have appeared over the past decade. First, convincing evidence for a
dose-response relationship has been demonstrated in the treatment of breast
cancer, both in the adjuvant and advanced disease situations. This
relationship appears to hold also when doses are escalated beyond the
conventional range and the patient is supported with autologous bone
marrow (1). Second, regimens that cannot cure or even produce a high
complete response rate (e.g., the cyclophosphamide, methotrexate, and
5-fluorouracil regimen [CMF]) in metastatic disease, have been shown to
improve survival when used as adjuvant treatment (2).
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