In the 1990s, a number of trials found that treatment with high-dose chemotherapy after conventional chemotherapy did not improve overall survival for women with breast cancer at high-risk of spreading. However, in the latest trial, involving 403 patients with advanced breast cancer, Ulrike Nitz (University of Dusseldorf, Germany) and colleagues found that a rapidly cycled tandem high-dose chemotherapy regimen improved both event-free and overall survival when compared with conventional dose-dense chemotherapy. After 4 years event-free survival was 60% in the high-dose chemotherapy group and 44% in the conventional chemotherapy group. The corresponding overall survival was 75% and 70%, respectively.
Professor Nitz states: "Our finding of significant improvements in both event-free and overall survival for high-dose chemotherapy compared with a dose-dense conventional regimen contrasts with the results of other studies...The heterogeneous [different] designs of the trials that have been conducted to date have not allowed identification of a single promising strategy. Nevertheless, the superiority of high-dose chemotherapy in our trial suggests that this strategy remains valid for further investigation."
Professor Ulrike Nitz
University of Dusseldorf, Moorenstr
5, D 40225 Dusseldorf, Germany.