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Annals of Oncology Advance Access published online on June 9, 2005
Annals of Oncology, doi:10.1093/annonc/mdi268
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© 2005 European Society for Medical Oncology
Received December 19, 2004
Revised April 13, 2005
Accepted April 18, 2005

Original article

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

D. A. Stewart 1*, A. H. G. Paterson 1, J. D. Ruether 1, J. Russell 1, P. Craighead 2, M. Smylie 3, and J. Mackey 3

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

* To whom correspondence should be addressed.
D. A. Stewart, E-mail: douglast{at}cancerboard.ab.ca


  Abstract

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.

Keywords: adjuvant; autologous; breast; hematopoietic; neo-adjuvant; transplantation.
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