HIGH-DOSE CHEMOTHERAPY AND HEMATOPOIETIC STEM-CELL TRANSPLANTATION FOR INFLAMMATORY BREAST-CANCER - PATHOLOGICAL RESPONSE AND OUTCOME

Inflammatory breast cancer still has a poor prognosis despite improvem ents related to the introduction of neoadjuvant chemotherapy. The purp ose of this study was to evaluate pathologic response rate and outcome of patients receiving high-dose chemotherapy with haematopoietic stem cell support for IBC, Seventeen consecutive patients with IBC receive d an association of mitoxantrone (36 mg/m(2)), cyclophosphamide (120 m g/kg), melphalan (140 mg/m(2)), with stem cell transplantation (SCT) f ollowing four to five cycles of cyclophosphamide (1000 mg/m(2)), doxor ubicin (75 mg/m(2)) and 5FU (500 mg/m(2)), Mastectomy was performed a median of 2 months (range 1.5-45) after high-dose chemotherapy and was followed by radiotherapy, Macroscopic and microscopic pathologic comp lete response rates were respectively 56 and 39%, With a median follow -up of 36 months (range 17-52) 10 patients remain alive free of diseas e and seven patients have relapsed, Two relapses occurred in the group of patients with pathologic CR and five in the group with residual tu mour, These results show that high-dose chemotherapy (HDC) with alkyla ting agents followed by SCT allows a very high tumour eradication in i nflammatory breast cancer, suggesting a possible global benefit in pro gression-free survival and survival which remains to be demonstrated p rospectively.