Strategies to Improve Long-Term Outcome in Stage IIIB Inflammatory Breast Cancer: Multimodality Treatment Including Dose-Intensive Induction and High-Dose Chemotherapy

Claude Sportes, Seth M. Steinberg, David J. Liewehr, Juan Gea-Banacloche, David N. Danforth, Daniele N. Avila, Kelly E. Bryant, Michael C. Krumlauf, Daniel H. Fowler, Steven Pavletic, Nancy M. Hardy, Michael R. Bishop, Ronald E. Gress

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Inflammatory breast cancer (IBC) is a rare clinicopathologic entity with a poor prognosis, lagging far behind any other form of nonmetastatic breast cancer. Since the advent of systemic chemotherapy over 35 years ago, only minimal progress has been made in long-term outcome. Although multiple randomized trials of high-dose chemotherapy and autologous progenitor cell transplantation (ASCT) for the treatment of breast cancer have yielded disappointing results, these data are not necessarily relevant to IBC, a distinct clinical and pathologic entity. Therefore, the optimal multimodality therapy for IBC is not well established, and remains unsatisfactory. We treated 21 women with nonmetastatic IBC with a multimodality strategy including high-dose melphalan (Mel)/etoposide and ASCT. The treatment was overall tolerated with acceptable morbidity, and no post-ASCT 100-day mortality. With a median potential follow-up of approximately 8 years, the estimated progression-free survival (PFS), event-free survival (EFS), and overall survival (OS) at 6 years from on-study date are: 67%, 55%, and 69%, respectively. These results from a small phase II study are among the most promising of mature outcome data for IBC. They strongly suggest, along with results of several already published phase II trials, that ASCT could play a significant role in the first line treatment of IBC.

Original languageEnglish (US)
Pages (from-to)963-970
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Inflammatory Breast Neoplasms
Cell Transplantation
Drug Therapy
Stem Cells
Disease-Free Survival
Therapeutics
Breast Neoplasms
Melphalan
Etoposide
Morbidity
Survival
Mortality

Keywords

  • Autologous transplantation
  • High-dose chemotherapy
  • Inflammatory breast cancer
  • Multimodality therapy

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Strategies to Improve Long-Term Outcome in Stage IIIB Inflammatory Breast Cancer : Multimodality Treatment Including Dose-Intensive Induction and High-Dose Chemotherapy. / Sportes, Claude; Steinberg, Seth M.; Liewehr, David J.; Gea-Banacloche, Juan; Danforth, David N.; Avila, Daniele N.; Bryant, Kelly E.; Krumlauf, Michael C.; Fowler, Daniel H.; Pavletic, Steven; Hardy, Nancy M.; Bishop, Michael R.; Gress, Ronald E.

In: Biology of Blood and Marrow Transplantation, Vol. 15, No. 8, 01.08.2009, p. 963-970.

Research output: Contribution to journalArticle

Sportes, C, Steinberg, SM, Liewehr, DJ, Gea-Banacloche, J, Danforth, DN, Avila, DN, Bryant, KE, Krumlauf, MC, Fowler, DH, Pavletic, S, Hardy, NM, Bishop, MR & Gress, RE 2009, 'Strategies to Improve Long-Term Outcome in Stage IIIB Inflammatory Breast Cancer: Multimodality Treatment Including Dose-Intensive Induction and High-Dose Chemotherapy', Biology of Blood and Marrow Transplantation, vol. 15, no. 8, pp. 963-970. https://doi.org/10.1016/j.bbmt.2009.04.018
Sportes, Claude ; Steinberg, Seth M. ; Liewehr, David J. ; Gea-Banacloche, Juan ; Danforth, David N. ; Avila, Daniele N. ; Bryant, Kelly E. ; Krumlauf, Michael C. ; Fowler, Daniel H. ; Pavletic, Steven ; Hardy, Nancy M. ; Bishop, Michael R. ; Gress, Ronald E. / Strategies to Improve Long-Term Outcome in Stage IIIB Inflammatory Breast Cancer : Multimodality Treatment Including Dose-Intensive Induction and High-Dose Chemotherapy. In: Biology of Blood and Marrow Transplantation. 2009 ; Vol. 15, No. 8. pp. 963-970.
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abstract = "Inflammatory breast cancer (IBC) is a rare clinicopathologic entity with a poor prognosis, lagging far behind any other form of nonmetastatic breast cancer. Since the advent of systemic chemotherapy over 35 years ago, only minimal progress has been made in long-term outcome. Although multiple randomized trials of high-dose chemotherapy and autologous progenitor cell transplantation (ASCT) for the treatment of breast cancer have yielded disappointing results, these data are not necessarily relevant to IBC, a distinct clinical and pathologic entity. Therefore, the optimal multimodality therapy for IBC is not well established, and remains unsatisfactory. We treated 21 women with nonmetastatic IBC with a multimodality strategy including high-dose melphalan (Mel)/etoposide and ASCT. The treatment was overall tolerated with acceptable morbidity, and no post-ASCT 100-day mortality. With a median potential follow-up of approximately 8 years, the estimated progression-free survival (PFS), event-free survival (EFS), and overall survival (OS) at 6 years from on-study date are: 67{\%}, 55{\%}, and 69{\%}, respectively. These results from a small phase II study are among the most promising of mature outcome data for IBC. They strongly suggest, along with results of several already published phase II trials, that ASCT could play a significant role in the first line treatment of IBC.",
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