Breast Cancer Clinical Trial
Official title:
A Phase III Randomized Comparison of High Dose Chemotherapy G-CSF To G-CSF For Mobilization of Peripheral Blood Stem Cells For Autologous Transplantation For Patients With Responsive Metastatic Breast Cancer Or High Risk Stage II-III Patients
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
they stop growing or die. Colony-stimulating factors such as filgrastim may increase the
number of immune cells found in bone marrow or peripheral blood and may help a person's
immune system recover from the side effects of chemotherapy. Peripheral stem cell
transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more
tumor cells. It is not yet known which treatment regimen is more effective for breast cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of chemotherapy plus
filgrastim with filgrastim alone in treating women undergoing peripheral stem cell
transplantation for stage II, stage III, or metastatic breast cancer.
OBJECTIVES:
I. Determine whether high dose chemotherapy in addition to growth factors increases the yield
of filgrastim mobilized progenitor cells.
II. Determine the kinetics of hematopoietic reconstitution following myeloablative therapy
and mobilized blood stem cell transplantation.
III. Determine whether the use of high dose chemotherapy in addition to growth factors for
mobilization of stem cells reduces risk of relapse as measured by time to progression in
responsive relapsed breast cancer patients receiving autologous peripheral blood stem cell or
bone marrow transplants.
IV. Determine the morbidity and cost differences of the use of high dose chemotherapy plus
growth factors compared to growth factors alone for mobilization of peripheral blood
progenitors and treatment of breast cancer with high dose chemotherapy.
OUTLINE: Patients will be randomized into 2 groups. Group 1 patients undergo CVP chemotherapy
treatment by vein (IV) on days 1-3, with cyclophosphamide (CTX), etoposide, and cisplatin.
Filgrastim SC (subcutaneously) is given on day 4 every 12 hours until completion of
apheresis. Group 2 patients only receive filgrastim SC given on day 1 every 12 hours until
completion of apheresis. Stem cells are removed beginning on day 4 for a maximum of 6 days.
Upon recovery of hematopoiesis patients then receive high IV doses of CBT chemotherapy with
CTX, carmustine, and thiotepa for 3 days, followed 4 days later by autologous stem cell
reinfusion. Beginning on day of reinfusion, filgrastim is given bid until WBC reaches a safe
level. Patients are followed for 90 days posttransplant, and then followed indefinitely for
antitumor response and time to progression.
PROJECTED ACCRUAL: This study will include about 218 patients.
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