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Annals of Oncology Advance Access originally published online on March 17, 2006
Annals of Oncology 2006 17(10):1479-1488; doi:10.1093/annonc/mdl044
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© 2006 European Society for Medical Oncology

reviews

High dose chemotherapy with autologous hematopoietic stem cell support for solid tumors other than breast cancer in adults

P Pedrazzoli1,*, JA Ledermann2, J-P Lotz3, S Leyvraz4, M Aglietta5, G Rosti6, KM Champion7, S Secondino1, F Selle3, N Ketterer4, G Grignani5, S Siena1, T Demirer8 On behalf of the European Group for Blood and Marrow Transplantation (EBMT) Solid Tumors Working Party

1 Falck Division of Medical Oncology, Ospedale Niguarda Ca' Granda, Milano, Italy
2 Department of Oncology, UCL, London, UK
3 Hôpital Tenon, Department of Clinical Oncology, Paris France
4 Centre Pluridisciplinaire d'Oncologie, Lausanne, Switzerland
5 Division of Medical Oncology, University of Turin, IRCC Candiolo, Turin, Italy
6 Medical Oncology, Ospedale Santa Maria delle Croci, Ravenna, Italy
7 EBMT Central Office, University College London Hospitals, London, UK
8 Ankara University Medical School, Ibni Sina Hospital Dept. of Hematology, Ankara, Turkey

*Correspondence to: Dr P. Pedrazzoli, S,C. Oncologia Medica Falck, Ospedale Niguarda Ca' Granda, Milano, Italy. Tel: +39-0264442291; Fax: +39-0264442910; E-mail: paolo.pedrazzoli{at}ospedaleniguarda.it

Since the early 1980s high dose chemotherapy with autologous hematopoietic stem cell support was adopted by many oncologists as a potentially curative option for solid tumors, supported by a strong rationale from laboratory studies and apparently convincing results of early phase II studies. As a result, the number and size of randomized trials comparing this approach with conventional chemotherapy initiated (and often abandoned before completion) to prove or disprove its value was largely insufficient. In fact, with the possible exception of breast carcinoma, the benefit of a greater escalation of dose of chemotherapy with stem cell support in solid tumors is still unsettled and many oncologists believe that this approach should cease. In this article, we critically review and comment on the data from studies of high dose chemotherapy so far reported in adult patients with small cell lung cancer, ovarian cancer, germ cell tumors and sarcomas.

Key words: high dose chemotherpy, solid tumors, stem cell transplantation


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