Weekly paclitaxel and paraplatin as first line chemotherapy in patients with advanced NSCLC

Optimal platinum based combination regimen for advanced NSCLC remains to be defined. Weekly Taxol and paraplatin is an effective and generally well tolerated regimen for first line treatment for stage III and IV NSCLC and affords potential for lower toxicity and increases exposure to drugs with alternative cytotoxic/cytostatic mechanisms. Thirty patients with histologically or cytologically proven NSCLC stages IIIb and IV were included during the period between March 2001-March 2003 with the following criteria, median age was 55 years, measurable or evaluable disease, PS

Biweekly administration of irinotecan [CPT11] and 5-fluorouracil/folinic acid [5FU/FA] "De Gramont" as first line treatment in advanced or metastatic colorectal cancer [CRC]

The combination of CPT11, 5 fluorouracil and folinic acid "De Gramont" is now thought to be the 1st line chemotherapy for advanced or metastatic colorectal cancer. The aim of this study was to evaluate the efficacy and safety profile of the biweekly administration of CPT11 and 5FU/FA as 1[st] line treatment in patients with advanced or metastatic colorectal cancer. Patients with histologically confirmed advanced CRC, >1 measurable metastatic lesion. ECOG PS 0-1 and adequate bone marrow, renal and hepatic function were included. CPT11 [180mg/m[2] was administered on day 1 as 90 minutes infusion] and FA [200mg/m[2]] as 2 hour infusion followed by 5FU [400mg/m[2] bolus and 600mg/m[2] as 22 hours infusion] on days 1 and 2. This schedule was repeated every 2 weeks and each cycle consisted of 6 weeks for 6-9 cycles. Between October 2000 and December 2002, thirty patients were enrolled, M/F [20/10] with a median age of 48 years [40-60] and ECOG PS of 0-1. Primary tumor sites were colon [10 patients], rectum [15 patients], and colorectal [5 patients]. Tumor histology was adenocarcinoma, median number of involved sites was 2 [60% with 2 sites or more], liver [80%], lung [10%], lymph nodes [20%] and local recurrence [50%]. Previous treatment included palliative or radical surgery in 100% of cases, adjuvant chemotherapy in 12 patients [40%] and pelvic radiotherapy in 9 patients [30%]. A total of 235 cycles has been delivered with a median of 8 cycles/patient [6-9 cycles]. All patients were evaluable for toxicity, grade III toxicity was; neutropenia in 2 patients [6.6%], febrile neutropenia in one patient [3.3%] and diarrhea in one patient [3.3%]. Of the thirty patients evaluable, 3 patients [10%] achieved CR, 14 PR [46.6%] 7 SD [23.3%] and 6 patients progressed [20%] resulting in an overall response rate [ORR] of 56.6%. Median time to progression and survival was 12.5 and 21 months respectively. Median duration of response was 14.5 months. Biweekly administration of CPT11 and 5 FU/FA is an active and well tolerated regimen as first line treatment in patients with advanced or metastatic CRC with an ORR of 56.6%

Prognostic value of HER-2/NEU expression in breast carcinoma

Although axillary lymph node status is still the most powerful prognostic indicator, 15 to 45% of patients whose lymph nodes do not contain metastases still experience a recurrence and die. Conversely, up to 15% of patients with >10 positive lymph nodes treated only with surgery and radiotherapy survive without recurrence or metastases. Because of this, other prognostic markers have been developed to improve prognostic accuracy, particularly in the group of patients with node-negative tumors. To study the expression and prognostic value of HER-2/neu in breast cancer patients, to determine its role in defining high risk patients in cases with a relatively good prognosis [e.g. node negative cases and progesterone receptor [PR] positive cases]. This study included 90 patients with invasive breast cancer [44 patients node positive and 46 patients node negative]. Study for histopathologic prognostic factors was done and immunohistochemical study for HER-2/neu, oestrogen receptors [ER] and pogestrone receptors. HER-2/neu was positive in 26.1% of lymph node negative cases, positive in 31.8% of lymph node positive cases and positive in 28.9% of all patients.HER-2/neu overexpression, by itself, possessed a highly significant prognostic value for shorter overall survival [O.S] and disease free survival [D.F.S] for the whole patients group and for progesterone receptor positive cases. However, in the lymph node negative group it has significant prognostic value for shorter overall survival, by itself, but it lost its effect on steroid receptors. HER-2/neu overexpression seemed to identify patients with poor outcome from those subgroups known to have good prognosis e.g. progesterone receptor positive cases [regarding both disease free survival and overall survival] and node-negative patients [regarding overall survival]