Breast Cancer Clinical Trial
Official title:
Peripheral Stem Cell Transplantation Protocol for Patients With Previously Treated Advanced Breast Cancer - A Phase II Pilot Study
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. Combining chemotherapy with
autologous peripheral stem cell transplantation may allow the doctor to give higher doses of
chemotherapy drugs and kill more tumor cells. Radiation therapy uses high-energy x-rays to
damage tumor cells.
PURPOSE: Phase II trial to compare the effectiveness of two regimens of chemotherapy and
filgrastim plus stem cell transplantation in treating patients who have previously untreated
stage III or stage IV breast cancer.
OBJECTIVES: I. Assess the antitumor response, survival, and disease free survival following
high dose carboplatin, ifosfamide, and thiotepa with autologous peripheral blood stem cell
(PBSC) support and consolidation radiotherapy to sites of pretreatment bulk disease in
patients with previously treated advanced breast cancer. II. Assess the toxicity of high
dose chemotherapy in these patients. III. Compare the effectiveness of PBSC mobilization
with high dose cyclophosphamide and filgrastim (G-CSF) vs G-CSF alone in this patient
population.
OUTLINE: Patients are assigned to 1 of 2 peripheral blood stem cell (PBSC) mobilization
groups at the discretion of the attending physician: Group 1: Patients receive high dose
cyclophosphamide IV over 6 hours and filgrastim (G-CSF) subcutaneously (SQ) daily beginning
24 hours after completion of cyclophosphamide and continuing until 3 days after blood counts
have recovered and until PBSC are harvested. Group 2: Patients receive G-CSF SQ daily alone
until PBSC are harvested. Both groups: PBSC are harvested on days 15-19 after
cyclophosphamide infusion or when blood counts recover. Patients receive high dose
carboplatin IV continuously, ifosfamide IV over 4 hours, and thiotepa IV over 1 hour on days
-5 to -3. PBSC are reinfused beginning 48 hours after completion of combination
chemotherapy. Patients receive G-CSF SQ beginning on day 0 and continuing until 3 days after
blood counts have recovered. Sites of pretransplantation metastases greater than 3 cm are
irradiated beginning after transplantation and after blood counts recover. Patients are
followed every month for 1 year.
PROJECTED ACCRUAL: A total of 12-24 patients will be accrued for this study.
;
Primary Purpose: Treatment
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