Prolonged Disease Control after Myeloablative Chemotherapy, Autologous Transplantation and Immunotherapy in High-risk Early Breast Cancer

• Published in: Anticancer research Vol. 30; no. 1; pp. 209 - 216
• Main Authors: RECCHIA, Francesco, CANDELORO, Giampiero, NECOZIONE, Stefano, ACCORSI, Patrizia, RECCHIA, Cornelia Ortensia Carla, TOMBOLINI, Vincenzo, REA, Silvio
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-01-2010
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Breast Neoplasms - immunology; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Carcinoma, Ductal, Breast - immunology; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - therapy; CD4-CD8 Ratio; Combined Modality Therapy; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Epirubicin - administration & dosage; Epirubicin - adverse effects; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Gynecology. Andrology. Obstetrics; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Interleukin-2 - adverse effects; Interleukin-2 - therapeutic use; Killer Cells, Natural - immunology; Mammary gland diseases; Medical sciences; Methotrexate - administration & dosage; Middle Aged; Neoplasm Staging; Prospective Studies; Treatment Outcome; Tretinoin - therapeutic use; Tumors; Antineoplastic agent; High risk; Breast disease; Stem cell; Hematopoietic cell; Autograft; Cancerology; Immunotherapy; Myelosuppression; Epirubicin; Methotrexate; Fluorouracil; high-dose chemotherapy; NK cells; VEGF; Etoposide; Breast cancer; IL-2; Malignant tumor; 5-fluorouracil; Mammary gland diseases; Chemotherapy; Cyclophosphamide; retinoic acid; Treatment; Antimetabolic; Carboplatin; radiotherapy; Cancer
• ISSN: 0250-7005; 1791-7530

Background: Failure to eradicate all cancer stem cells, lymphocytopenia, and high levels of vascular endothelial growth factor
(VEGF) may explain the limited efficacy of high dose-chemotherapy (HDCT) with peripheral progenitor cell transplantation (PBPCT)
in high-risk early breast cancer with more than 10 axillary nodes (HRBC). Patients and Methods: With the aim of increasing
patient's lymphocyte count and reducing VEGF, wich could translate into an improved immune function and a better clinical
outcome, patients with HRBC, received HDCT, PBPCT and immunotherapy with interleukin-2 (IL-2) and 13-cis retinoic acid (RA).
Results: A total of 30 HRBC patients were entered into the study. Grade 4 hematological toxicity was universal, while major
adverse effects of IL-2 were fever, rash and autoimmune reactions. After a median follow-up of 61 months, immune function
improved with a statistically significant increase of lymphocyte count and a decrease in VEGF levels. This translated into
an unexpected 5-year relapse-free and overall survival rates of 76% and 85%, respectively. Conclusion: These data show that
IL-2 and RA administration after HDCT and PBPCT is feasible and, as well as giving a statistically significant improvement
in lymphocyte count and a decrease of VEGF, also seems to improve the expected clinical outcome.