Complete Response after High-Dose Chemotherapy and Autologous Hemopoietic Stem Cell Transplatation in Metastatic Breast Cancer Results in Survival Benefit

: Metastatic breast cancer is an incurable disease even with high‐dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (ASCT). Even though phase III studies have not shown a survival advantage for this group as a whole, it is possible that a small subset of patients may benefit from HDC/ASCT with careful patient selection. A total of 198 patients from three different institutions were treated with HDC/ASCT. After complete staging, patients with central nervous system or bone marrow involvement were excluded. The HDC regimen consisted of: Carboplatin 600 mg/m2 IV infusion over 48 hours, Thiotepa 300 mg/m2 IV infusion over 2 hours, and Cytoxan 60 mg/kg IV infusion given over 2 hours ×3 days. The median age at the time of transplant was 46 (24–62) years and median follow‐up was 20 months. Hormone receptor status was known in 148 patients, of whom 84 had estrogen receptor (ER) and/or progestrone receptor (PgR)‐positive tumors. Eighty patients had no evidence of disease at the time of HDC/ASCT (CR1). At the completion of HDC and ASCT, complete responses (CR) were seen in an additional 57 patients (CR2). Using Kaplan–Meier analysis, the median relapse‐free survival (RFS) for the entire group was 15 months and overall survival (OS) was 27 months. The patients in CR1 had a median RFS and OS of 20.7 and 50.6 months, respectively. This was very similar to the RFS and OS in patients achieving CR2 after HDC/ASCT (p