High-dose versus standard chemotherapy in metastatic breast cancer

Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry

Donald A. Berry, Gloria Broadwater, John P. Klein, Karen Antman, Joseph Aisner, Jacob Bitran, Mary Costanza, Cesar O. Freytes, Edward Stadtmauer, Robert Peter Gale, I. Craig Henderson, Hillard M. Lazarus, Philip L. McCarthy, Larry Norton, Howard Parnes, Andrew Pecora, Michael C. Perry, Philip Rowlings, Gary Spitzer, Mary M. Horowitz

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess survival of patients with metastatic breast cancer treated with high-dose chemotherapy (HDC) versus standard-dose chemotherapy (SDC). Patients and Methods: SDC in four Cancer and Leukemia Group B (CALGB) trials was compared with hematopoietic stem-cell support in patients from the Autologous Blood and Marrow Transplant Registry. Cox proportional hazard regression incorporated potentially confounding effects. A total of 1,509 women were enrolled onto CALGB trials, and 1,188 women received HDC. No significant survival differences existed by CALGB trial or HDC regimen. Consideration was restricted to candidates for both SDC and HDC. The resulting sample included 635 SDC and 441 HDC patients. The outcome of interest was overall survival. Results: The HDC group displayed better performance status. The SDC group had slightly better survival in first year after treatment. The HDC group had lower hazard of death from years 1 to 4 and had somewhat higher probability of 5-year survival (adjusted probabilities [95% confidence intervals], 23% [17% to 29%] v 15% [11 to 19%], P = .03). Conclusion: After controlling for known prognostic factors in this nonrandomized analysis of two large independent data sets, women receiving HDC versus SDC for metastatic breast cancer have a similar shortterm probability of survival, and might have a modestly higher long-term probability of survival.

Original languageEnglish (US)
Pages (from-to)743-750
Number of pages8
JournalJournal of Clinical Oncology
Volume20
Issue number3
DOIs
StatePublished - Feb 1 2002
Externally publishedYes

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Registries
Leukemia
Bone Marrow
Breast Neoplasms
Transplants
Drug Therapy
Neoplasms
Survival
Hematopoietic Stem Cells
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Berry, Donald A. ; Broadwater, Gloria ; Klein, John P. ; Antman, Karen ; Aisner, Joseph ; Bitran, Jacob ; Costanza, Mary ; Freytes, Cesar O. ; Stadtmauer, Edward ; Gale, Robert Peter ; Henderson, I. Craig ; Lazarus, Hillard M. ; McCarthy, Philip L. ; Norton, Larry ; Parnes, Howard ; Pecora, Andrew ; Perry, Michael C. ; Rowlings, Philip ; Spitzer, Gary ; Horowitz, Mary M. / High-dose versus standard chemotherapy in metastatic breast cancer : Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry. In: Journal of Clinical Oncology. 2002 ; Vol. 20, No. 3. pp. 743-750.
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title = "High-dose versus standard chemotherapy in metastatic breast cancer: Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry",
abstract = "Purpose: To assess survival of patients with metastatic breast cancer treated with high-dose chemotherapy (HDC) versus standard-dose chemotherapy (SDC). Patients and Methods: SDC in four Cancer and Leukemia Group B (CALGB) trials was compared with hematopoietic stem-cell support in patients from the Autologous Blood and Marrow Transplant Registry. Cox proportional hazard regression incorporated potentially confounding effects. A total of 1,509 women were enrolled onto CALGB trials, and 1,188 women received HDC. No significant survival differences existed by CALGB trial or HDC regimen. Consideration was restricted to candidates for both SDC and HDC. The resulting sample included 635 SDC and 441 HDC patients. The outcome of interest was overall survival. Results: The HDC group displayed better performance status. The SDC group had slightly better survival in first year after treatment. The HDC group had lower hazard of death from years 1 to 4 and had somewhat higher probability of 5-year survival (adjusted probabilities [95{\%} confidence intervals], 23{\%} [17{\%} to 29{\%}] v 15{\%} [11 to 19{\%}], P = .03). Conclusion: After controlling for known prognostic factors in this nonrandomized analysis of two large independent data sets, women receiving HDC versus SDC for metastatic breast cancer have a similar shortterm probability of survival, and might have a modestly higher long-term probability of survival.",
author = "Berry, {Donald A.} and Gloria Broadwater and Klein, {John P.} and Karen Antman and Joseph Aisner and Jacob Bitran and Mary Costanza and Freytes, {Cesar O.} and Edward Stadtmauer and Gale, {Robert Peter} and Henderson, {I. Craig} and Lazarus, {Hillard M.} and McCarthy, {Philip L.} and Larry Norton and Howard Parnes and Andrew Pecora and Perry, {Michael C.} and Philip Rowlings and Gary Spitzer and Horowitz, {Mary M.}",
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Berry, DA, Broadwater, G, Klein, JP, Antman, K, Aisner, J, Bitran, J, Costanza, M, Freytes, CO, Stadtmauer, E, Gale, RP, Henderson, IC, Lazarus, HM, McCarthy, PL, Norton, L, Parnes, H, Pecora, A, Perry, MC, Rowlings, P, Spitzer, G & Horowitz, MM 2002, 'High-dose versus standard chemotherapy in metastatic breast cancer: Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry', Journal of Clinical Oncology, vol. 20, no. 3, pp. 743-750. https://doi.org/10.1200/JCO.20.3.743

High-dose versus standard chemotherapy in metastatic breast cancer : Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry. / Berry, Donald A.; Broadwater, Gloria; Klein, John P.; Antman, Karen; Aisner, Joseph; Bitran, Jacob; Costanza, Mary; Freytes, Cesar O.; Stadtmauer, Edward; Gale, Robert Peter; Henderson, I. Craig; Lazarus, Hillard M.; McCarthy, Philip L.; Norton, Larry; Parnes, Howard; Pecora, Andrew; Perry, Michael C.; Rowlings, Philip; Spitzer, Gary; Horowitz, Mary M.

In: Journal of Clinical Oncology, Vol. 20, No. 3, 01.02.2002, p. 743-750.

Research output: Contribution to journalArticle

TY - JOUR

T1 - High-dose versus standard chemotherapy in metastatic breast cancer

T2 - Comparison of cancer and leukemia group B trials with data from the autologous blood and marrow transplant registry

AU - Berry, Donald A.

AU - Broadwater, Gloria

AU - Klein, John P.

AU - Antman, Karen

AU - Aisner, Joseph

AU - Bitran, Jacob

AU - Costanza, Mary

AU - Freytes, Cesar O.

AU - Stadtmauer, Edward

AU - Gale, Robert Peter

AU - Henderson, I. Craig

AU - Lazarus, Hillard M.

AU - McCarthy, Philip L.

AU - Norton, Larry

AU - Parnes, Howard

AU - Pecora, Andrew

AU - Perry, Michael C.

AU - Rowlings, Philip

AU - Spitzer, Gary

AU - Horowitz, Mary M.

PY - 2002/2/1

Y1 - 2002/2/1

N2 - Purpose: To assess survival of patients with metastatic breast cancer treated with high-dose chemotherapy (HDC) versus standard-dose chemotherapy (SDC). Patients and Methods: SDC in four Cancer and Leukemia Group B (CALGB) trials was compared with hematopoietic stem-cell support in patients from the Autologous Blood and Marrow Transplant Registry. Cox proportional hazard regression incorporated potentially confounding effects. A total of 1,509 women were enrolled onto CALGB trials, and 1,188 women received HDC. No significant survival differences existed by CALGB trial or HDC regimen. Consideration was restricted to candidates for both SDC and HDC. The resulting sample included 635 SDC and 441 HDC patients. The outcome of interest was overall survival. Results: The HDC group displayed better performance status. The SDC group had slightly better survival in first year after treatment. The HDC group had lower hazard of death from years 1 to 4 and had somewhat higher probability of 5-year survival (adjusted probabilities [95% confidence intervals], 23% [17% to 29%] v 15% [11 to 19%], P = .03). Conclusion: After controlling for known prognostic factors in this nonrandomized analysis of two large independent data sets, women receiving HDC versus SDC for metastatic breast cancer have a similar shortterm probability of survival, and might have a modestly higher long-term probability of survival.

AB - Purpose: To assess survival of patients with metastatic breast cancer treated with high-dose chemotherapy (HDC) versus standard-dose chemotherapy (SDC). Patients and Methods: SDC in four Cancer and Leukemia Group B (CALGB) trials was compared with hematopoietic stem-cell support in patients from the Autologous Blood and Marrow Transplant Registry. Cox proportional hazard regression incorporated potentially confounding effects. A total of 1,509 women were enrolled onto CALGB trials, and 1,188 women received HDC. No significant survival differences existed by CALGB trial or HDC regimen. Consideration was restricted to candidates for both SDC and HDC. The resulting sample included 635 SDC and 441 HDC patients. The outcome of interest was overall survival. Results: The HDC group displayed better performance status. The SDC group had slightly better survival in first year after treatment. The HDC group had lower hazard of death from years 1 to 4 and had somewhat higher probability of 5-year survival (adjusted probabilities [95% confidence intervals], 23% [17% to 29%] v 15% [11 to 19%], P = .03). Conclusion: After controlling for known prognostic factors in this nonrandomized analysis of two large independent data sets, women receiving HDC versus SDC for metastatic breast cancer have a similar shortterm probability of survival, and might have a modestly higher long-term probability of survival.

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