The current look at high-dose chemotherapy in breast cancer - Minireview

High-dose chemotherapy (HDC) in high-risk breast cancer is one of the possi ble approaches how to improve therapeutic results, eventually, to overcome the incurability of the disease. In recent randomized studies superiority o f HDC to conventional therapy has not been unambiguously established. Never theless, many oncologists, as well as, patients are so convinced of HDC ben efits, that they are not willing to take part in randomized studies. At an ASCO Annual Meeting (American Society of Clinical Oncology) in May 19 99 in Atlanta - preliminary results of five large randomized studies phase III were presented (2 studies on metastatic breast cancer and 3 studies on high-risk breast cancer with more than 10 positive lymph nodes). The ASCO w as informed of an investigation into serious scientific misconduct in a cli nical trial that was presented in a plenary session of its Annual Meeting. The results of Dr. Bezwoda's research were presented at ASCO's Meeting as o ne of four plenary papers on the investigational therapy and was the only o ne to clearly indicate a survival benefit in the high-dose regimen. Preliminary results presented there, however, did not confirm the original hypothesis of the high efficacy of HDC. It is necessary to wait for definit e results (within two or three years, because enrollment of patients either has been finished or is being finished just now) and several parameters ma y change. In view of hitherto results, some investigators think that there is no need to continue in similar intensive studies. Still some believe tha t different modifications of therapeutic regimens or new, less toxic drugs should be tested which may lead to more effective and safer HDC.