A comparison of multiple and single cycles of dose-intensive chemotherapy with reinfusion of docetaxel or paclitaxel mobilized peripheral blood progenitor cells in solid tumor

Abstract

834 Background: To compare the clinical outcomes of multiple and single cycle dose-intensive induction therapy with autologous stem cell rescue among 48 patients with recurrent or metastatic solid tumors. Methods: Forty-eight patients(22 male, 26 female, median age was 48, ranged from19 to 73, 20 Breast cancer,6 Ovarian cancer,8 NSCLC,9 SCLC, 4 Seminoma and 1 Synovical carcinoma) were enrolled into the research. Patients were randomized to receive mobilization chemotherapy consisting of docetaxel 110mg/m2 on d1 or paclitaxel 175mg/m2 for 24 hours by continuous infusion. Patients were premedicated with dexamethasone 8mg p.o. every 12h×3 doses starting 24h prior to chemotherapy. The chemotherapy regimen was chosen based on the tumor type regardless of HDC cycle. Twenty-seven patients received 3 cycles of dose-intensive chemotherapy while 21 patients received a single cycle. Results: A significantly higher clinical response rate(CR plus PR) was observed for patients receiving 3 cycles of dose-intensive chemotherapy compared to who received a single cycle(21/27 vs 10/21,p=0.030). The 3 cycle groups also had a significantly higher 2 year survival. At a median follow-up of 40 (36–46) months, the probabilities of survival following single and multiple cycle chemotherapy were 61.90% (95% confidence interval (CI), 38.08%–78.80%) and 81.48% (95% CI, .61.09%–91.84%), respectively. The median event free survival (EFS) and the median overall survival (OS) have not yet been reached. Conclusions: Standard dose docetaxel or paclitaxel, combined with G-CSF, is an effective and well-tolerated mobilization regimen in patients with recurrent or metastatic solid tumors. Multiple cycles high dose chemotherapy has been shown to be feasible and safe in patients with these recurrent or metastatic solid tumors. No significant financial relationships to disclose.