Autologous Bone Marrow Transplantation - Blog Science Connections

Autologous Bone Marrow Transplantation for
Metastatic Breast Carcinoma
R. Bradley Slease, Craig L. Reitz, William L. Hughes,
George B. Selby, Cynthia L. Watkins,
and Robert B. Epstein
The treatment of hormone receptor-negative metastatic breast cancer in
premenopausal women remains unsatisfactory. Although most patients
respond to aggressive combination chemotherapy, the median duration of
response is only 6-12 months, and survival after failure of "first-line"
combinations is usually short ( 1 ). Complete remissions (CRs) are infrequent,
even with the most aggressive regimens (1 ). Animal studies and preliminary
clinical trials in humans, reviewed by Frei and Canellos (2), suggest that
higher doses of cytotoxic agents may produce meaningful increases in
tumor-cell killing. Peters hypothesized that combinations of non-crossresistant
alkylators with minimal overlapping toxicities might further enhance
tumor cytoreduction (3), and a recent trial employing autologous bone
marrow support demonstrated encouraging results (4). However, the relative
contribution of individual drugs in these combinations has not been studied
in detail.
In 1983, we began a clinical trial to determine the effect of high-dose
single alkylating agents on efficacy and toxicity as they were added to a
combination regimen for patients with metastatic breast carcinoma. The
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