Abstract
Four large randomized studies reported at the recent American Society for Clinical Oncology (ASCO) meeting have raised questions concerning the benefit of high-dose chemotherapy with hematopoietic progenitor cell support for the treatment of patients with high-risk primary breast cancer or metastatic disease. The preliminary nature of these findings was stressed by several investigators, who noted that long-term follow-up would be required to determine whether any survival benefit exists for patients in the highdose group. These results illustrate the need for additional well-controlled clinical trials before such strategies could become standard practice. Furthermore, it appears that even if any advantage is observed for high-dose treatment with stem cell support, this treatment is unlikely to result in a major survival benefit.