TMJ: A well-tolerated high-dose regimen for the adjuvant chemotherapy of high risk breast cancer

Following local treatment and doxorubicin-containing standard chemotherapy, 42 patients with surgical Stage II or IIIA breast cancer containing ten or more involved axillary nodes and 13 patients with Stage IIIB disease were treated with high-dose chemotherapy (TMJ) consisting of thiotepa (750 mg/m²), mitoxantrone (40 mg/m²), and carboplatin (1000 mg/m²), with autologous bone marrow (ABM) and peripheral stem cell (PSC) transplant, followed by irradiation and/or hormone therapy. Sargramostim (GM- CSF) support was given to most patients. The median time to transfusion independence was two weeks. Severe nonhematologic toxicity was uncommon, with no intensive care admission or treatment-related death. At a median follow- up of 17 months, eight patients have relapsed and five have died of tumor progression. No statement can yet be made regarding adjuvant efficacy, but this high-dose regimen is very well tolerated.