Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer

D. Adkins, R. Brown, K. Trinkaus, Richard Maziarz, S. Luedke, C. Freytes, B. Needles, D. Wienski, P. Fracasso, T. Pluard, W. Moriconi, T. Ryan, K. Hoelzer, S. Safdar, T. Rearden, G. Rodriguez, H. Khoury, R. Vij, J. DiPersio

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Abstract

Purpose: To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. Patients and Methods: Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)positive cancer. Results: The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7% and 59.1%, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3% and 51.7%, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P = .04) and receipt of tamoxifen (P = .06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow- up, 28 patients (59.6%) were alive and disease-free. Seventeen patients (36.2%) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2%) from treatment-related mortality due to HDCT. Conclusion: In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow- up and controlled studies.

Original languageEnglish (US)
Pages (from-to)2006-2014
Number of pages9
JournalJournal of Clinical Oncology
Volume17
Issue number7
StatePublished - Jul 1999
Externally publishedYes

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Inflammatory Breast Neoplasms
Stem Cell Transplantation
Drug Therapy
Combined Modality Therapy
Tamoxifen
Disease-Free Survival
Survival
Kaplan-Meier Estimate
Estrogen Receptors
Breast Neoplasms
Mortality
Adjuvant Chemotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Adkins, D., Brown, R., Trinkaus, K., Maziarz, R., Luedke, S., Freytes, C., ... DiPersio, J. (1999). Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer. Journal of Clinical Oncology, 17(7), 2006-2014.

Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer. / Adkins, D.; Brown, R.; Trinkaus, K.; Maziarz, Richard; Luedke, S.; Freytes, C.; Needles, B.; Wienski, D.; Fracasso, P.; Pluard, T.; Moriconi, W.; Ryan, T.; Hoelzer, K.; Safdar, S.; Rearden, T.; Rodriguez, G.; Khoury, H.; Vij, R.; DiPersio, J.

In: Journal of Clinical Oncology, Vol. 17, No. 7, 07.1999, p. 2006-2014.

Research output: Contribution to journalArticle

Adkins, D, Brown, R, Trinkaus, K, Maziarz, R, Luedke, S, Freytes, C, Needles, B, Wienski, D, Fracasso, P, Pluard, T, Moriconi, W, Ryan, T, Hoelzer, K, Safdar, S, Rearden, T, Rodriguez, G, Khoury, H, Vij, R & DiPersio, J 1999, 'Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer', Journal of Clinical Oncology, vol. 17, no. 7, pp. 2006-2014.
Adkins, D. ; Brown, R. ; Trinkaus, K. ; Maziarz, Richard ; Luedke, S. ; Freytes, C. ; Needles, B. ; Wienski, D. ; Fracasso, P. ; Pluard, T. ; Moriconi, W. ; Ryan, T. ; Hoelzer, K. ; Safdar, S. ; Rearden, T. ; Rodriguez, G. ; Khoury, H. ; Vij, R. ; DiPersio, J. / Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 7. pp. 2006-2014.
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abstract = "Purpose: To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. Patients and Methods: Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)positive cancer. Results: The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7{\%} and 59.1{\%}, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3{\%} and 51.7{\%}, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P = .04) and receipt of tamoxifen (P = .06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow- up, 28 patients (59.6{\%}) were alive and disease-free. Seventeen patients (36.2{\%}) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2{\%}) from treatment-related mortality due to HDCT. Conclusion: In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow- up and controlled studies.",
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T1 - Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer

AU - Adkins, D.

AU - Brown, R.

AU - Trinkaus, K.

AU - Maziarz, Richard

AU - Luedke, S.

AU - Freytes, C.

AU - Needles, B.

AU - Wienski, D.

AU - Fracasso, P.

AU - Pluard, T.

AU - Moriconi, W.

AU - Ryan, T.

AU - Hoelzer, K.

AU - Safdar, S.

AU - Rearden, T.

AU - Rodriguez, G.

AU - Khoury, H.

AU - Vij, R.

AU - DiPersio, J.

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N2 - Purpose: To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. Patients and Methods: Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)positive cancer. Results: The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7% and 59.1%, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3% and 51.7%, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P = .04) and receipt of tamoxifen (P = .06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow- up, 28 patients (59.6%) were alive and disease-free. Seventeen patients (36.2%) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2%) from treatment-related mortality due to HDCT. Conclusion: In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow- up and controlled studies.

AB - Purpose: To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. Patients and Methods: Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)positive cancer. Results: The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7% and 59.1%, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3% and 51.7%, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P = .04) and receipt of tamoxifen (P = .06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow- up, 28 patients (59.6%) were alive and disease-free. Seventeen patients (36.2%) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2%) from treatment-related mortality due to HDCT. Conclusion: In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow- up and controlled studies.

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