A Multi-Center Study of Paclitaxel/Cyclophosphamide and High Dose Melphalan/Etoposide With Autologous Progenitor Cell Transplantation for the Treatment of Inflammatory Breast Cancer

Study start date: July 12, 1996

ELIGIBILITY CRITERIA: INCLUSION CRITERIA: Age greater or equal to 18 years. All patients must have a histologically confirmed diagnosis of Inflammatory Breast Carcinoma stage III B. Patients with no clinical inflammatory signs but with tumor invasion of dermal lymphatic on histology are eligible. Patients with metastatic disease and Inflammatory Breast Carcinoma are not eligible. All pathologic material must be reviewed and confirmed by the Department of Pathology of the treating institution prior to treatment (there will be no central pathology review). Patients may be untreated or may have received prior induction chemotherapy outside the NCI. If patients received prior induction chemotherapy, they may not have been unresponsive to it. They may have received chemotherapy either before (neo-adjuvant setting) or after local surgery (adjuvant setting). Karnofsky performance status of greater than 70% (ECOG 0 or 1). Ejection fraction by MUGA or 2-D echocardiogram within institution normal limits. Creatinine clearance of greater than 60 cc/mm. AST and ALT less than 3 times the upper limit of normal. Bilirubin less than 1.5 (except in cases of Gilbert's disease). ANC greater than l000/mm(3). Platelet count greater than 90,000/mm(3). DLCO greater than 50%. No history of medical or psychiatric disease which would preclude safe treatment in the view of the principal investigator. No history of abnormal bleeding tendency or predisposition to repeated infections. Patients must be able to give informed consent. EXCLUSION CRITERIA: Patients with Inflammatory Breast Cancer but with metastatic disease. Any patient may be excluded from this study at the discretion of the principal investigator if it is deemed that allowing participation would represent an unacceptable medical or psychiatric risk. Any patient with a need for chronic steroids or anticoagulation will be ineligible. Any patient testing positive for HIV (AIDS) or hepatitis B or C will be ineligible. Any female patient known or found to be pregnant will be considered ineligible. Patients of childbearing potential unwilling to practice contraception will be ineligible. Any patient with an active second malignancy (excluding treated skin cancers or carcinoma in situ) will be ineligible.