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Comment & Response
June 4, 2020

High-Dose Chemotherapy With Hematopoietic Stem Cell Transplant in Patients With High-Risk Breast Cancer—Reply

Author Affiliations
  • 1Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
  • 2Department of Medical Oncology, University Medical Center Groningen, Groningen, the Netherlands
JAMA Oncol. Published online June 4, 2020. doi:10.1001/jamaoncol.2020.1649

In Reply We thank Ertz-Archambault and colleagues for their interest in our recent article on long-term outcomes after high-dose chemotherapy (HDCT) with hematopoietic stem cell transplant in patients with high-risk breast cancer and 4 or more involved axillary lymph nodes.1 While the overall result of the trial does not support HDCT in patients with early breast cancer, a preplanned subgroup analysis in patients with 10 or more involved axillary lymph nodes showed a 14.6% absolute difference in 20-year overall survival. We agree that this subgroup result needs validation in a prospective trial using contemporary chemotherapy regimens in the control arm. The SUBITO trial (NCT02810743) has been designed with this aim and is currently open for enrollment. Based on our improved understanding of disease biology, the SUBITO trial includes patients with stage III, ERBB2-negative breast cancer with a BRCA1-like phenotype.2

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