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Annals of Oncology Advance Access originally published online on June 9, 2005
Annals of Oncology 2005 16(9):1463-1468; doi:10.1093/annonc/mdi268
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© 2005 European Society for Medical Oncology

High-dose mitoxantrone–vinblastine–cyclophosphamide and autologous stem cell transplantation for stage III breast cancer: final results of a prospective multicentre study

D. A. Stewart1,*, A. H. G. Paterson1, J. D. Ruether1, J. Russell1, P. Craighead2, M. Smylie3 and J. Mackey3

1 Department of Medical Oncology and 2 Department of Radiation Oncology, University of Calgary, and Tom Baker Cancer Centre, Calgary; 3 Department of Medical Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada

* Correspondence to: Dr D. Stewart, 1331–29th Street NW, Calgary, AB, Canada T2N 4N2. Tel: +1-403-944-8569; Fax: +1-403-283-1651; Email: douglast{at}cancerboard.ab.ca

Background: Stage III breast cancer patients continue to suffer high relapse and death rates despite standard chemotherapy regimens. High-dose alkylator chemotherapy does not further improve outcome. This phase II study evaluated a novel high-dose chemotherapy regimen which combined active breast cancer agents with differing mechanisms of action.

Patients and methods: Eligibility included at least seven involved axillary nodes (AxLNs) for tumours <5 cm, at least four AxLNs for tumours >5 cm or locally advanced breast cancer (LABC). Patients received four cycles of fluorouracil–adriamycin–cyclophosphamide (FAC) followed by one cycle of mitoxantrone 63 mg/m2–vinblastine 12.5 mg/m2–cyclophosphamide 6 g/m2 (MVC) with autologous blood stem cell transplantation (ASCT).

Results: Between April 1995 and December 1998, 92 patients aged 21–65 years (median 45 years) were enrolled, of whom 25 were treated preoperatively for LABC and 67 were treated postoperatively. Although there was no early treatment-related mortality, one late death occurred from secondary acute myeloid leukaemia. The 7-year event-free and overall survival rates were 53% (95% confidence interval 42–64%) and 62% (95% CI 52–73%), respectively, with no significant difference between pre- and postoperative groups.

Conclusion: FAC followed by MVC–ASCT is feasible and reasonably well tolerated, but does not result in improved survival rates compared with other conventional or high-dose regimens for stage III breast cancer.

Key words: adjuvant, autologous, breast, hematopoietic, neo-adjuvant, transplantation


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