Breast cancer cell transplantation

Toremifene (Fareston , chlorotamoxifen Figure 5.15) has been thoroughly investigated in the laboratory [269-272] and has antitumor activity in carcinogen-induced rat mammary cancer, but is less potent than tamoxifen [272-274]. Toremifene has been tested extensively in phase I—III clinical trials [275-278] and has been approved for use in postmenopausal women with metastatic breast cancer [279]. As predicted from the reduced potency in animal studies, the dose required for activity is 60 mg of toremifene daily (tamoxifen is used at 20 mg daily). The side-effects are similar to those of tamoxifen and, as with tamoxifen, the responses are observed in ER-positive tumors. However, because adjuvant therapy with tamoxifen is standard throughout the world, issues of cross-resistance of tamoxifen and toremifene are important considerations for the use of toremifene in recurrent breast cancer. Laboratory studies by Osborne et al. [280] have demonstrated that toremifene-stimulated tumors can develop from MCF-7 breast cancer cells transplanted into athymic mice. Toremifene is cross-resistant with tamoxifen in tamoxifen-stimulated breast cancer in the laboratory [281]. Similarly, cross-over clinical trials demonstrate that there is little possibility of a second response to toremifene after tamoxifen failure [282, 283]. 

Viens P, Penault-Llorca F, Jacquemier J, et al. High-dose chemotherapy and haematopoietic stem cell transplantation for inflammatory breast cancer pathologic response and outcome. Bone Marrow Transplant 1998 21 249-254. 

Cyclophosphamide is a component of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) and other drug combinations used in the treatment of breast cancer. Cyclophosphamide in combination may produce complete remissions in some patients with ovarian cancer and oat cell (small cell) lung cancer. Other tumors in which benehcial results have been reported include non-oat cell lung cancers, various sarcomas, neuroblastoma, and carcinomas of the testes, cervix, and bladder. Cyclophosphamide also can be employed as an alternative to azathioprine in suppressing immunological rejection of transplant organs. 

Sawada M, Tsurumi H, Kara T, Goto H, Yamada T, Oyama M, Moriwaki H. Graft failure of autologous peripheral blood stem cell transplantation due to acute metabohc acidosis associated with total parenteral nutrition in a patient with relapsed breast cancer. Acta Haematol 2000 102(3) 157-9. 

Kroger N. Frick M. Glisz O. et al. Randomized trial of single compared with tandem high-dose chemotherapy followed by autologous stem-cell transplantation in patients with chemotherapy-sensitive metastatic breast cancer. J Clin Oncol 1WS6.24, 3919-3926. 

Nieto Y. Shpall E. J. McNiece I. K. et al. Prognostic analysis of early lymphocyte recovery in patients with advanced breast cancer receiving high-dose chemotherapy with an autologous hematopoietic progenitor cell transplant. Clinic Cancer Res 2004,10, 5076-86. 

Avigan D. Wu J. Joyce R. et al. Immune reconstitution following high-dose chemotherapy with stem cell rescue in patients with advanced breast cancer. Bone Marrow Transplant 2000, 26, 169-176. 

ThioTEPA) Breast cancer bladder cancer (instillation) BMT preparation crosses blood-brain barrier doses for BMT preparation mucositis pruritus and dermatitis stem cell transplants... 

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