IS METASTATIC BREAST-CANCER REFRACTORY TO USUAL THERAPY CURABLE

Breast cancer with metastatic disease is presently incurable. Signific antly shorter survival rates are seen in premenopausal women despite u sual therapies when compared to survival rates in older women. Median survival rates of 24-30 months are documented in large-scale prospecti ve clinical trials of previously untreated women with metastatic breas t cancer regardless of the protocol employed (chemotherapy, hormone th erapy). High dose chemotherapy followed by autologous stem cell rescue (bone marrow or peripheral brood) is associated with significant resp onse and possibly improved survival in chemosensitive patients with me tastatic disease without visceral metastases though with significant t oxicities and cost (median survival rate of 20 months). Patients with refractory disease have dismal results regardless of therapy (median s urvival rates of 8-9 months in a number of prospective trials with or without stem cell rescue). The use of alpha-interferon in such patient s has not improved response. Whole body hyperthermia is of benefit in the presence of liver metastases although median survival rate is in t he range of 12 months. New treatment approaches with curative intent a re clearly required. We report fifty-nine patients with metastatic bre ast cancer refractory to common therapies who were treated with whole body hyperthermia (40 degrees C) with low dose chemotherapy and immuno modulation: live presented with brain metastases; 13 with multiple bon e metastases; 8 with liver metastases; 10 with lung metastases; and 23 with multiple soft tissue metastases. Fifteen were premenopausal; 44 postmenopausal. Twenty-three achieved complete remission. Fourteen hav e been sustained with patients remaining alive from 17-80 months (medi an, 40 months). Nine failed after 20-40 months of being disease-free ( mean, 32 months). Outcomes did not differ significantly by age or meta static site. Myelotoxicity, stomatitis, and alopecia were not seen. Re lief of bone pain was striking.