New concepts in the treatment of breast cancer using high-dose chemotherapy

High-dose chemotherapy is now frequently used for the treatment of primary and metastatic breast cancer. Two recent randomized trials have demonstrated that this treatment approach can result in extended disease-free and overall survival for patients with metastatic disease. However, treatment results have demonstrated that long term remissions from these treatments raise complex questions about traditional models of chemotherapy principles. A detailed analysis of the principles underlying high-dose therapy is presented in the context of principles of dose-response, the inverse rule and the total tumor cell kill hypotheses.