Paclitaxel-containing high-dose chemotherapy in high-risk breast cancer patients

Despite standard-dose adjuvant chemotherapy, the prognosis for patients wit h breast cancer and extensive axillary lymph node involvement at diagnosis is poor. The efficacy of a paclitaxel-containing, high-dose chemotherapy pr otocol in 21 high-risk breast cancer patients is assessed. After standard-d ose chemotherapy followed by peripheral blood stem cell (PBSC) mobilization , high-dose therapy with paclitaxel, carboplatin, and cyclophosphamide and CD34-selected PBSC rescue was given. Hematologic reconstitution after high- dose therapy was rapid. Main toxicity included diarrhea grade I or II in ab out half of the patients and infections were observed in 19%. Five-year pro babilities for relapse and failure-free survival were 32% and 62%. respecti vely. High-dose consolidation with paclitaxel, carboplatin, and cyclophosph amide achieves a high failure-free survival in patients with high-risk brea st cancer with acceptable toxicities and stable, long-term hematopoietic re constitution. Evaluation of the benefit of high-dose therapy in these patie nts in larger prospective, randomized trials is warranted and currently und er way.