RATIONALE: Biological therapies use different ways to stimulate the immune system and stop
cancer cells from growing. Combining different types of biological therapies may kill more
PURPOSE: Phase I/II trial to study the effectiveness of T cells and interleukin-2 combined
with peripheral stem cell transplantation or bone marrow transplantation in treating women
who have stage IIIB or metastatic breast cancer.
OBJECTIVES: I. Evaluate the toxicities of the combination of low dose interleukin-2 (IL-2)
sargramostim (GM-CSF), and multiple doses of activated T cells (ATC) following peripheral
blood stem cell transplantation in women with stage IIIB or metastatic adenocarcinoma of the
breast. II. Evaluate the efficacy of this regimen in these patients.
OUTLINE: Patients receive filgrastim (G-CSF) subcutaneously daily for 5 days prior to
peripheral blood stem cell (PBSC) collection or for 2 days prior to bone marrow harvest.
Following PBSC collection or bone marrow harvest, patients receive high dose chemotherapy
consisting of cyclophosphamide IV, carboplatin IV, and thiotepa IV over days -6 through -3.
Patients undergo PBSC transplantation on day 0. Following PBSC transplantation, patients
receive multiple doses of monoclonal antibody OKT3 activated T lymphocytes IV over 1 hour
between days 1 and 65, continuous low dose interleukin-2 (IL-2) IV over days 1-65, and
sargramostim (GM-CSF) subcutaneously on days 5-21. Patients are followed at day 100, as
clinically indicated, and then annually.
PROJECTED ACCRUAL: Approximately 40-60 patients will be accrued for this study within 1-2
DISEASE CHARACTERISTICS: Histologically documented metastatic adenocarcinoma of the breast
Concurrent intraductal or lobular carcinoma in situ allowed Bilateral disease allowed
Measurable or evaluable recurrent metastatic disease (Stage IIIB or IV) documented by
radiograph, CT scan, nuclear medicine scan, or physical exam Tumor must be clinically
chemosensitive as documented by a reduction in tumor burden No clinical evidence of brain
PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 70-100% Life
expectancy: Not specified Hematopoietic: Granulocyte count at least 1,500/mm3 Platelet
count at least 50,000/mm3 Hemoglobin at least 8 g/dL Hepatic: Bilirubin less than 1.5
times normal Hepatitis B surface antigen negative Renal: Creatinine less than 1.8 mg/dL
Creatinine clearance normal Blood urea nitrogen (BUN) less than 1.5 times normal
Cardiovascular: Ejection fraction at least 45% by MUGA No uncontrolled or significant
cardiovascular disease including myocardial infarction (less than 1 year) or congestive
heart failure Pulmonary: PFT-FEV1 at least 60% of predicted DLCO and FVC at least 60% of
predicted Other: Not pregnant Negative pregnancy test HIV negative No serious medical or
psychiatric illness No prior or concurrent malignancy, other than curatively treated
carcinoma in situ of the cervix or basal cell skin cancer
PRIOR CONCURRENT THERAPY: See Disease Characteristics No concurrent hormonal therapy for