The use of high-dose chemotherapy (HDC) in the range requiring autologous haematopoietic stem cell support can produce very high rates of response in patients with a variety of solid tumours but it remains controversial. The solid tumour in which HDC has been most extensively studied is breast cancer, and this disease is used as a model for the current discussion. Comparisons are made with ovarian, testicular and small-cell lung cancers and random assignment trials are suggested to demonstrate and to quantitate any survival advantages associated with therapy. Further development work is indicated.