Treatment of Breast Cancer with Autologous Transplantation of Stem Cell
Breast cancer is the most common type of cancer in women. The treatment varies from patient to patient depending on the size and spread of the tumor, and metastases or secondary tumors in other parts of the body. In most cases the tumor is surgically removed but it often also requires treatment with hormonal therapy, radiotherapy or chemotherapy.
Patients with metastasized breast cancer are commonly initially treated with high-dose chemotherapy to reduce the chances of the remaining cancer cells to become resistant to chemotherapy treatments. However, in addition to cancer cells, high-dose chemotherapy often damages the haematopoietic stem cells. The Institute for Quality and Efficiency in Health Care (IQWiG) conducted a search for the studies of autologous transplantation of stem cell (removal of haematopoietic stem cells before treatment with chemotherapy and their re-implantation after the treatment) and compared the results with chemotherapy without transplantation of stem cells. Based on results of the conducted clinical trials in breast cancer patients both with and without metastases, the IQWiG came to the conclusion that autologous transplantation of stem cells has several advantages in compare to treatment with chemotherapy without transplantation of stem cells and that it can extend the survival after the treatment before the cancer progression or return.
In addition to potential benefits of autologous transplantation of stem cells, the IQWiG also discovered the potential harms of the treatment. The clinical trials have shown that autologous transplantation of stem cells might cause severe complications affecting nearly all organ systems, especially the haematopoietic system and gastrointestinal tract. In addition, the IQWiG also expressed concern over the fact that some of the trials are relatively old.
The final report of the IQWiG that was published on December 16 in 2009 did not give a conclusive answer to the question whether the benefits of autologous transplantation of stem cells overweight the health risks and applied to further research in order to better assess the advantages and disadvantages of the treatment.
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