This trial did show that those receiving transplant died less frequently of breast cancer, although this positive effect was counterbalanced by an increase in treatment-related deaths at the time of this initial presentation. A third trial in the same population has finished accrual and results from this ECOG study should be available in 2001. In aggregate, the sum total of patients undergoing transplant in U.S. and international trials is rather unimpressive. Additional data is sorely needed. ASCO members will readily appreciate that it has taken many years and many thousands of patients to prove the effectiveness of systemic therapy in specific subsets of patients with adult solid tumors.
Emotions regarding transplant continue to run high.
The question has been hotly debated in courtrooms, in legislatures, and especially in the media. Sentiment among patients and physicians shifts rapidly as each piece of new data become available. A positive trial from South Africa was recently negated when evidence of seriously fraudulent data was detected. Some have equated appropriate condemnation of this trial by the medical community with condemnation of transplant. Yet, the rationale behind the treatment approach remains sound.