Abstract：
:In recent years, the most frequent indication for high-dose autologous stem-cell-supported chemotherapy in the United States has been breast cancer. This approach is applied in "high-risk," early-stage disease as adjuvant treatment, and with either curative or palliative intent in metastatic disease. Among both lay persons and medical professionals, high-dose therapy is broadly viewed as standard and appropriate, even though the results of the largest prospective randomized studies are not yet available. This view is based on extrapolation from preclinical data, a fundamental belief that "more is better," a faith in high technology, and the results of numerous pilot and phase I and II trials. Because high-dose therapy is promising, but also more difficult to administer than standard therapy, controversy rages in all circles concerning its use. Unless and until we have the results of properly randomized, prospective studies, this controversy will likely continue. Against this background, we will review the theoretical basis for high-dose treatment in breast cancer, the translation of this laboratory science into the clinic, usual treatment approaches, the available data, ongoing clinical trials, and future research directions.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Hudis CA,Münster PNsubject
Has Abstractpub_date
1999-02-01 00:00:00pages
35-47issue
1eissn
0093-7754issn
1532-8708journal_volume
26pub_type
杂志文章,评审abstract：:ZD1839 (Iressa; AstraZeneca Pharmaceuticals LP, Wilmington, DE) is an orally active, selective inhibitor of epidermal growth factor receptor-tyrosine kinase (EGFR-TK) that blocks signaling pathways responsible for driving proliferation, invasion, and survival of cancer cells. In preclinical studies of cell lines and h...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2003.50028
更新日期：2003-02-01 00:00:00
abstract：:Richter syndrome (RS) is the development of an aggressive lymphoma in patients with a previous or concomitant diagnosis of chronic lymphocytic leukemia (CLL). The incidence rate RS is ~0.5% per year of observation. Two biomarkers (NOTCH1 mutations and subset 8 configuration of the B-cell receptor) may help identifying...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2016.02.012
更新日期：2016-04-01 00:00:00
abstract：:Letrozole has proven efficacious in a variety of therapeutic scenarios, including that of extended adjuvant therapy following 5 years of tamoxifen treatment in postmenopausal women with estrogen-receptor-positive early breast cancer. The Breast International Group 1-98 trial (BIG 1-98) is the first to study the effica...
journal_title：Seminars in oncology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1053/j.seminoncol.2006.03.026
更新日期：2006-04-01 00:00:00
abstract：:Treatment of hormone-refractory prostate cancer (HRPC) historically has shown limited efficacy. However, taxane-based chemotherapy regimens recently have demonstrated more promising results. Several groups have reported significant efficacy and minimal toxicity in patients with hormone-refractory disease receiving est...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1999-10-01 00:00:00
abstract：:The liver is the most common site of metastatic colorectal cancer (CRC) and the status of this organ is an important determinant of overall survival in patients with advanced disease. Complete resection of hepatic CRC metastases can provide a long-term cure for some patients, but the majority of liver metastases are n...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2004.09.025
更新日期：2005-02-01 00:00:00
abstract：:In studies conducted by the Eastern Cooperative Oncology Group, treatment with either paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) or carboplatin was associated with an improvement in 1-year survival in patients with stage IV non-small cell lung cancer (NSCLC). Based on these findings, a phase II tr...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：
更新日期：1996-12-01 00:00:00
abstract：:There are several treatment options for patients with metastatic colorectal cancer (mCRC), including those with disease that has progressed after treatment with chemotherapy. Bevacizumab-containing regimens show good efficacy in patients with previously treated disease. Compared with infused 5-fluorouracil, leucovorin...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2006.08.003
更新日期：2006-10-01 00:00:00
abstract：:The goal of this National Cancer Institute-sponsored phase I trial is to determine the feasibility, toxicity, and pharmacokinetics of continuous-infusion (24 hr/d, 7 d/wk, 7 weeks total) intravenous paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) when combined with standard, curative-intent radiation t...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：:A large meta-analysis showed that chemotherapy results in significant prolongation of survival for patients with non-small cell lung cancer (NSCLC). Pemetrexed is a new multitargeted antifolate chemotherapeutic agent that has shown activity in NSCLC and appears to be similar to the third-generation antitumor agents cu...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2002.37470
更新日期：2002-12-01 00:00:00
abstract：:Pathologic complete response after neoadjuvant chemoradiation therapy is associated with increased survival in esophageal cancer. Early detection of response or nonresponse to neoadjuvant chemoradiation might allow individualization of treatment strategies and avoidance of unnecessary treatment. Positron emission tomo...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2006.10.011
更新日期：2006-12-01 00:00:00
abstract：:The Wayne State University Waldenstrom's Macroglobulinemia xenograft model in mice with severe combined immune deficiency (WSU-WM-SCID) is the only preclinical animal model available for this disease. It is based on a permanent, EBV- IgMlambda cell line (WSU-WM) established from a patient with a 10-year history of Wal...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/sonc.2003.50043
更新日期：2003-04-01 00:00:00
abstract：:Experimental and clinical observations of the proliferation of cancer cells and their responses to cytotoxic drugs already have had an impact on the design of anticancer therapies and it is possible that further understanding of the natural history of tumors will enable better treatments to be developed. This review a...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1997-08-01 00:00:00
abstract：:Data from various phase I/II studies of carboplatin in combination with paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) have suggested that the degree of thrombocytopenia seen is less than that expected when carboplatin is given alone. However, some studies also have suggested that the area under the p...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-10-01 00:00:00
abstract：:Non-small cell lung cancer (NSCLC) represents almost three quarters of all cases of lung cancer. Most NSCLC patients present with either locally advanced inoperable disease, stage IV metastatic disease, or comorbid medical conditions that make them unsuitable for curative resection. Among NSCLC patients in the United ...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
abstract：:Cardiovascular toxicity is one of the most feared complications of cancer treatment. Recent advances in oncologic therapies have resulted in improved cancer outcomes but also a new set of cardiovascular adverse effects. Common toxicities include left ventricular dysfunction/heart failure, hypertension, and myocardial ...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2013.01.003
更新日期：2013-04-01 00:00:00
abstract：:Predicting which patients with primary melanoma are at risk of developing metastastic disease is important for making rational therapeutic decisions. Tumor thickness alone is the most commonly used predictor of survival, but other clinical and pathologic variables also play an important role. We have developed two mul...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1997-02-01 00:00:00
abstract：:A major consequence of administering increasingly aggressive therapies (chemotherapy with or without radiation therapy) in the treatment of non-small cell lung cancer is the adverse effects on the bone marrow that may lead to neutropenia, thrombocytopenia, and/or anemia. Myelosuppression or bone marrow toxicity may al...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2005.03.014
更新日期：2005-04-01 00:00:00
abstract：:Lung cancer is the leading cause of cancer death in the United States. Lung cancer is frequently encountered by the radiologist, whether the lung cancer is detected on a chest radiograph obtained in a symptomatic patient, or is an incidental finding. The radiologic workup of pulmonary lesions suspected of being lung c...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1997-08-01 00:00:00
abstract：:Preclinical models in vitro and in vivo have shown that tumor hypoxia alters the malignant cell phenotype, selecting for p53 mutations, stimulating angiogenesis and metastasis, and markedly reducing the efficacy of both radiotherapy and chemotherapy. Similarly, clinical studies measuring pretreatment tumor oxygen stat...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2002.31531
更新日期：2002-02-01 00:00:00
abstract：:We resected 158 cases of hepatocellular carcinoma (HCC), including 20 (12.6%) cases of large HCC. These 20 cases were divided into group 1 (curative resection, n = 9) and group 2 (noncurative resection, n = 11). The clinicopathologic features and long-term survival of the cases were evaluated. In groups 1 and 2, porta...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1997-04-01 00:00:00
abstract：:This article summarizes the likely attenuation properties of RRx-001 in COVID-19 based on its mechanism of action and the putative pathogenesis of the disease, which appears to activate inflammatory, oxidative, and immune cascades with the potential to culminate in acute respiratory distress syndrome, cytokine storm a...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2020.07.002
更新日期：2020-10-01 00:00:00
abstract：:Fludara I.V. (fludarabine phosphate) (9-beta-D-arabinosyl-2-fluoroadenine, F-ara-A) is an adenine nucleoside analogue resistant to adenosine deaminase that shows promising therapeutic activity in the clinical treatment of lymphocytic hematologic malignancies. F-ara-A is transported into cells, where it is converted to...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1990-10-01 00:00:00
abstract：:Chemotherapy for prostate cancer currently has an established role in the treatment of hormone-refractory prostate cancer. There is strong evidence that combined modality treatment with androgen ablation in addition to radiotherapy provides a benefit above and beyond radiotherapy alone in patients with a poor prognosi...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1016/s0093-7754(03)00274-4
更新日期：2003-08-01 00:00:00
abstract：:Although the benefit of adjuvant therapy for pancreas cancer is clear, the most effective therapy remains elusive. In the United States, combination therapy with chemotherapy and radiation remains the standard of care, while in other parts of the world the contribution of radiation is questioned. Clinical trials are r...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2007.05.006
更新日期：2007-08-01 00:00:00
abstract：:The effectiveness of current chemotherapeutic approaches for the treatment of solid tumors has reached a near plateau, suggesting we are nearing the limit of cytoreduction. It is hypothesized that this may be due to "subset effect," and that drugs administered according to responses predicted for particular subgroups ...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1016/s0093-7754(01)90123-x
更新日期：2001-06-01 00:00:00
abstract：:Among new patients with small cell lung cancer (SCLC), 20% to 25% are over 70 years of age and account for 8,000 cases annually in the United States. For such patients, intensive, aggressive, cytotoxic, combination chemotherapy is not often used because of its association with unacceptable morbidity and mortality rate...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1990-02-01 00:00:00
abstract：:The control of nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy has remained difficult, even with the use of combination antiemetic regimens containing metoclopramide. Although these patients receive a lower daily dose of cisplatin, the emetogenic potential remains high. In addition, many ...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 00:00:00
abstract：:Because studies of breast cancer patients and their relatives provide statistical evidence for involvement of autosomal dominant genes, the identification of specific genetic effects has long been the focus of efforts to identify women at exceedingly high risk. BRCA1, a gene that confers greatly increased susceptibili...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1996-02-01 00:00:00
abstract：:A dose-response relationship has long been suspected for progestin compounds in the treatment of breast cancer, but only recently have trials been implemented to investigate this issue. In 1985, we began a phase I-II study of high-dose megestrol acetate in dosages of 480 mg/d to 1,600 mg/d in heavily pretreated postme...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:The combination of gemcitabine and docetaxel exhibits good activity in the treatment of advanced breast cancer. Phase II trial response rates using 21- or 28-day schedules have ranged from 36% to 79% in patient populations with varying degrees of pretreatment. In studies of extensively pretreated anthracycline-resista...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2003.37270
更新日期：2003-04-01 00:00:00
