High-dose chemotherapy with peripheral blood progenitor cell transplantation in the adjuvant treatment of breast cancer

High-dose chemotherapy as adjuvant treatment for high-risk breast cancer ha s been and is being investigated in a series of randomized trials. The prel iminary information from 5 studies is difficult to interpret. The data are consistent with a modest benefit of high-dose therapy, but strong evidence for this is lacking. Additional follow-up and the results of several large trials outside the United States are awaited. Hitherto unrecognized pharmac ologic interactions between high-dose agents and long-term to toxicities su b as cognitive function impairment complicate the issue considerably.