Efficacy and survival outcomes of dose-dense carboplatin plus paclitaxel as neoadjuvant chemotherapy for triple-negative breast cancer / 中华肿瘤杂志

Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P=0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P=0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance (P=0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant (P=0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.

Clinical efficacy of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer / 北京大学学报(医学版)

OBJECTIVE@#To observe the early efficacy and toxicity of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer (mCRPC).@*METHODS@#From May 2017 to July 2019, fifteen patients with mCRPC treated in Peking University First Hospital were collected. The median age was 70 years (43-77 years), and the pathological types were all adenocarcinoma, which was confirmed as distant metastasis by imaging examination. They were given the chemotherapy of docetaxel combined with carboplatin. The specific method was as follows: each cycle was 28 days. Androgen deprivation therapy was administered routinely throughout the treatment period. Blood routine, liver and kidney function, blood clotting function and prostate-specific antigen (PSA) tests were performed before each cycle. Docetaxel was administered intravenously on the first day of each cycle at a dose of 75 mg/m2, and carboplatin was administered intravenously on the second day at the dose calculated by Calvert formula. The main outcome measures including PSA decline range, pain remission rate and occurrence of adverse reactions were observed and analyzed.@*RESULTS@#Among the 15 patients, 12 had completed at least 4 cycles of chemotherapy and had short-term efficacy evaluation. PSA decline range > 50% was observed in 8 patients (66.7%). Among the 9 patients with bone pain, remarkable pain relief was observed in 4 patients (44.4%). Among the 4 patients with measurable metastatic lesions, 2 achieved partial response, 1 was evaluated as stable disease, and 1 was evaluated as progressive disease. The main adverse reactions of chemotherapy included bone marrow suppression, gastrointestinal reactions, fatigue and neurological disorders, and most of them were within the tolerable range.@*CONCLUSION@#This report is a case series study of docetaxel combined with carboplatin in the treatment of mCRPC reported in China and the conclusions are representative. The chemotherapy of docetaxel combined with carboplatin has positive short-term efficacy and high safety in patients with mCRPC, which is worthy of further promotion and exploration in clinical practice.

Unknown primary large-cell neuroendocrine tumor

Large-cell neuroendocrine tumors (NETs) are poorly differentiated malignancies of rare incidence and aggressive nature. NETs mostly arise in the lung followed by the gastrointestinal tract, although they are potentially ubiquitous throughout the body. Primary unknown NET has a worse prognosis and shorter survival comparing with other NETs, with limited available data in the literature concerning this subgroup. The authors report the case of large-cell NET with supraclavicular lymph node presentation. Total excisional biopsy revealed an enlarged adenopathy 18 × 15 × 10 mm, which was extensively infiltrated by a solid malignant neoplasm composed of large cells with granular chromatin, nuclear pseudo-inclusions, high mitotic index, and focal necrosis, with a Ki 67 index 25-30% and positive immunohistochemical study for the expression of cytokeratin 8/18, chromogranin, synaptophysin, and thyroid transcriptional factor-1 (TTF-1). There was no evidence of primary location apart from two infracentimetric lung lesions that could not be accessed for biopsy and were negative at both somatostatin receptor scintigraphy and positron emission tomography. The NET relapsed with three mediastinal masses, so the patient was started on chemotherapy with carboplatin and etoposide with initial total response. Early progression showed no response to further chemotherapy regimens (temozolomide, oral etoposide); therefore, the patient was treated with local radiotherapy. This patient has an atypical long survival (54 months) compared to the literature data. In fact, there are few long-term survivors of large-cell NET and they are all related to complete surgical resection.

Evaluation of adjuvant chemotherapy in feline injection site-associated sarcoma / Avaliação da quimioterapia no tratamento do sarcoma de aplicação felino

Feline Injection Site-Associated Sarcoma (FISS) is a neoplasm that implies in reduction of quality of life and overall survival in feline patients. A retrospective study of 13 cases of FISS was conducted to evaluate the efficacy of surgical treatment associated to chemotherapy with doxorubicin or carboplatin. Local recurrence occurred in all patients. Patients treated with surgery and chemotherapy presented a longer overall survival and disease-free interval when compared to those that solely received surgical treatment, although no statistical significance was observed (p= 0.3360 and 0.7506, respectively). Surgery remains as the main option for FISS treatment. Further prospective studies with larger samples are warranted to investigate the benefit of chemotherapy for this neoplasm.(AU)

O Sarcoma de Aplicação Felino (SAF) é uma neoplasia associada a redução na qualidade de vida e sobrevida global. O objetivo deste estudo foi avaliar a eficácia da quimioterapia associada à cirurgia no manejo do SAF. Estudo retrospectivo de 13 pacientes com SAF submetidos à cirurgia isolada ou associada a quimioterapia com carboplatina ou doxorrubicina. Recorrência local ocorreu em todos os pacientes. Pacientes tratados com cirurgia e quimioterapia apresentaram maior sobrevida global e intervalo livre de doença quando comparados àqueles que receberam apenas tratamento cirúrgico, mas não foi observada diferença estatística (p=0,3360 e 0,7506, respectivamente). A cirurgia continua sendo a principal opção para o tratamento do SAF. Estudos prospectivos são necessários para investigação do real benefício da quimioterapia para esta neoplasia.(AU)

Neutropenia febril postquimioterapia, Instituto de Oncología y Radiobiología / Febrile neutropenia after cytostatic therapy observed in the Institute of Oncology and Radiobiology

Objetivo: caracterizar a los pacientes oncológicos que presenten episodios de neutropenia febril postquimioterapia ingresados en el Instituto de Oncología y Radiobiología en el periodo de enero a mayo del 2015. Métodos: se realizó un estudio descriptivo de corte transversal a una muestra de 36 pacientes. Se revisaron las historias clínicas donde se tomaron las variables analizadas. Resultados: predominaron los pacientes del sexo femenino (61,1 por ciento). Dentro de las enfermedades oncológicas predominaron los pacientes con Linfomas no Hodgkin (25,0 por ciento) y los medicamentos citostáticos vinculados a la neutropenia fueron el carboplatino, paclitaxel, ifosfamida y etopósido. La recuperación hematológica se logró en la mayoría de los casos antes de las 72 horas y el mayor número de pacientes (72,2 por ciento) fueron clasificados como una neutropenia de bajo riesgo, según los criterios de la Multinational Association for Supportive Care. Conclusiones: en la muestra estudiada la neutropenia febril presenta un incremento proporcional con la edad y las enfermedades de origen hematopoyéticos, cuyos esquemas quimioterápicos consisten en altas dosis de agentes citostáticos(AU)

Objective: to characterize the oncological patients who present with post chemotherapy febrile neutropenia and were admitted to the Institute of Oncology and Radiobiology in the period of January to May, 2015. Methods: a descriptive cross-sectional study of a sample of 36 patients. Their medical histories were checked from which the analyzed variables were taken. Results: females predominated in the study (61,1 percent). Among the oncological diseases, non-Hodgkin lymphomas (25,0 percent) prevailed whereas the cytostatic drugs found related to neutropenia were carboplatin, paclitaxel, ifosfamide and etoposide. The hematological recovery was reached in most cases before 72 hours and a lot of patients (72, 2 percent) were classified as low risk neutropenia according to the Multinational Association for Supportive Care criteria. Conclusions: in the study sample, the febrile neutropenia increases with the age and with hematopoietic diseases whereas chemotherapy schemes are based on high dose cytostatic agents(AU)

A Rare Case of Intra-Endometrial Leiomyoma of Uterus Simulating Degenerated Submucosal Leiomyoma Accompanied by a Large Sertoli-Leydig Cell Tumor

A 50-year-old peri-menopausal woman presented with hard palpable mass on her lower abdomen and anemia from heavy menstrual bleeding. Ultrasonography showed a 13x12 cm sized hypoechoic solid mass in pelvis and a 2.5x2 cm hypoechoic cystic mass in uterine endometrium. Abdomino-pelvic computed tomography revealed a hypodense pelvic mass without enhancement, suggesting a leiomyoma of intraligamentary type or sex cord tumor of right ovary with submucosal myoma of uterus. Laparoscopy revealed a large Sertoli-Leydig cell tumor of right ovary with a very rare entity of intra-endometrial uterine leiomyoma accompanied by adenomyosis. The final diagnosis of ovarian sex-cord tumor (Sertoli-Leydig cell), stage Ia with intra-endometrial leiomyoma with adenomyosis, was made. Considering the large size of the tumor and poorly differentiated nature, 6 cycles of chemotherapy with Taxol and Carboplatin regimen were administered. There is neither evidence of major complications nor recurrence during 20 months' follow-up.

Quimioterapia de salvataje con carboplatino y doxorrubicina liposomal pegilada en una paciente con cáncer de ovario pretratado / Salvage chemotherapy with carboplatin and pegylated liposomal doxorubicin in a pretreated patient with ovarian cancer

Se presenta a una mujer peruana de 56 años con cáncer de ovario, estadio IIIC, tipo seroso, de alto grado, con citorredución primaria óptima, que recibió en primera línea carboplatino/paclitaxel por seis ciclos. Al quinto mes desarrolló recurrencia retroperitoneal, por lo que recibió doxorrubicina liposomal pegilada por tres ciclos, con progresión de enfermedad. Luego de progresar a cuatro líneas adicionales de tratamiento, en séptima línea tuvo respuesta completa con carboplatino/doxorrubicina liposomal pegilada...

In the present article described a Peruvian patient of 56 years old with Ovarian carcinoma stage IIIC type high serous with optimal primary cytoreduction. In first line, she received carboplatin/paclitaxel each 3 weeks for 6 cycles. Five months from last cycle of chemotherapy, she developed a retroperitoneal recurrence. As second line, patient received pegylated liposomal doxorubicin for 3 cycles with progression disease. Then she received four additional lines of treatment without response. In seven line a combination of carboplatin/pegylated liposomal doxorubicin had a complete response...

Compostos coordenados híbridos de platina no tratamento do câncer / Platinum hybrid coordinated compounds in cancertreatment

O câncer, ou neoplasia, é uma doença caracterizada pela propagação descontrolada de formas anormais das próprias células corporais e corresponde à segunda doença que mais causa mortes no mundo. A história da platina no tratamento do câncer teve início com a descoberta da sua atividade, em 1965, com a aprovação para uso clínico acontecendo apenas após 10 anos. Atualmente, os fármacos com platina estão entre os mais bem sucedidos agentes anticancerígenos, onde se destacam cisplatina (1), carboplatina (2) e oxaliplatina (3). Seus mecanismos de ação são similares: estes fármacos formam adutos com o DNA, impedindo a sua síntese e reparo, levando à morte celular. Contudo, os efeitos adversos desencadeados pelo tratamento e o desenvolvimento de resistência ao medicamento têm limitado suas aplicações. Uma das principais estratégias para a diminuição de tais efeitos consiste em alterar a estrutura destas moléculas, levando à formação de compostos híbridos, que se caracterizam pela presença de pelo menos dois fragmentos funcionais distintos em uma mesma molécula e podem apresentar maior espectro de atividade antitumoral. Dentre as alterações mais comuns encontram-se a modificação da solubilidade, através da inserção de grupos abandonadores mais ou menos hidrofóbicos e a introdução de ligantes com atividade biológica própria. Dessa forma, esta revisão visa verificar os avanços mais recentes na síntese de compostos híbridos de platina, bem como as melhorias na atividade anticâncer dos novos compostos platinados...

Cancer, or neoplasm, is a disease characterized by the uncontrolled propagation of abnormal cells of the body and is the second leading death-causing disease. The history of platinum in cancer treatment goes back to the discovery of its activity in 1965 and its approval for clinical use just 10 years later. Some of the most successful anticancer agents are Pt-based chemotherapeutics, among which cisplatin (1), carboplatin (2), and oxaliplatin (3) stand out. They have similar mechanisms of action: they form adducts with DNA, preventing its synthesis and repair and leading to cell death. However, adverse effects triggered by treatment and the development of resistance to these drugs have limited their application. One of the most important strategies to reduce such effects is to carry out structural modifications of these molecules, leading to hybrid compounds that are characterized by the presence of at least two distinct functional fragments on the same molecule and can exhibit a broader antitumor activity spectrum. Among the most typical modifications are changes to the solubility pattern, created by the insertion of leaving groups with high or low hydrophobicity, and the introduction of biologically active ligands as non-leaving groups. The purpose of these strategies is to obtain compounds capable of reducing systemic toxicity and/or overcoming acquired resistance factors to cisplatin. Therefore, the aim of this review is to discuss the most recent advances in the synthesis of hybrid platinum compounds, as well as improvements in the anticancer activity of Pt-compounds...

ATP-Based Chemotherapy Response Assay in Primary or Recurrent Ovarian and Peritoneal Cancer

PURPOSE: To investigate chemosensitivity with an adenosine triphosphate-based chemotherapy response assay in patients with epithelial ovarian or peritoneal cancer according to tumor histology, grade, and disease status. MATERIALS AND METHODS: One hundred specimens were collected during primary or secondary debulking from 67 patients with primary ovarian cancer, 24 patients with recurrent ovarian cancer, 5 patients with primary peritoneal cancer, and 4 patients with recurrent peritoneal cancer; samples were collected between August 2006 and June 2009. Tumor cells were isolated and cultured for 48 hours in media containing chemotherapy. The chemosensitivity index (CI) was calculated as 300 minus the sum of the cell death rate at 0.2x, 1x, and 5x drug concentrations, and the CI values were compared. RESULTS: CI values were obtained from 93 of 100 patients. The most active agents against primary disease were ifosfamide and paclitaxel. For primary serous adenocarcinoma, paclitaxel and irinotecan were the most active, followed by ifosfamide. For clear cell carcinoma, ifosfamide was the most active, followed by paclitaxel and irinotecan. Although not statistically significant, the CIs of cisplatin, carboplatin, paclitaxel, and docetaxel decreased as tumor grade increased. In 14 cases of recurrent disease, paclitaxel was the most active, followed by ifosfamide and cisplatin. CONCLUSION: Ifosfamide and paclitaxel were the most active drugs for primary and recurrent disease. Therefore, we recommend further clinical studies to confirm the efficacy of paclitaxel, ifosfamide, and cisplatin combination chemotherapy for recurrent and primary ovarian cancer.

Overexpression of the epithelial cell adhesion molecule is associated with a more favorable prognosis and response to platinum-based chemotherapy in ovarian cancer / 부인종양

OBJECTIVE: Epithelial cell adhesion molecule (EpCAM) has experienced a renaissance lately as a binding site for targeted therapy as well as a prognostic marker in epithelial malignancies. Aim of this study was to study EpCAM as a potential prognostic marker in epithelial ovarian cancer (EOC). METHODS: EpCAM expression was assessed by immunohistochemistry on paraffin-embedded primary EOC-tissue samples. EpCAM overexpression was defined as an expression of EpCAM of 76% to 100%. Tissue samples and clinical data were systematically collected within the international and multicenter "Tumorbank Ovarian Cancer" network. RESULTS: Seventy-four patients, diagnosed with EOC between 1994 and 2009, were included in the study (median age, 56 years; range, 31 to 86 years). The majority of the patients (81.1%) presented with an advanced stage International Federation of Gynecology and Obstetrics (FIGO) III/IV disease. Histology was of the serous type in 41 patients (55.4%), endometrioid in 19 (25.6%), and mucinous in 14 (19%). EpCAM was overexpressed in 87.7%. Serous tumors overexpressed EpCAM significantly more often than mucinous tumors (87.8% vs. 78.6%, p=0.045); while no significant difference was noted between the other histological subgroups. EpCAM overexpression was significantly associated with a better progression free survival and higher response rates to platinum based chemotherapy (p=0.040 and p=0.048, respectively). EpCAM was identified as an independent prognostic marker for overall survival (p=0.022). CONCLUSION: Our data indicate a significant association of EpCAM overexpression with a more favorable survival in EOC-patients. Serous cancers showed a significant EpCAM overexpression compared to mucinous types. Larger multicenter analyses are warranted to confirm these findings.

Concurrent Low Dose Carboplatin with Radiotherapy Versus Radiotherapy alone in Management of Locally Advanced Head and Neck Cancer Patients.

A prospective study was performed to evaluate the efficacy and safety of concurrent chemotherapy with single agent low dose Carboplatin and radiotherapy on survival, functional and quality of life outcomes in locally advanced head and neck cancer patients. Material and Methods : Sixty inoperable, previously untreated locally advanced head and neck cancer patients were planned to be treated with radical radiotherapy 66 Gy with concurrent single agent chemotherapy with low dose Carboplatin 150 mg IV weekly up to 6.3 weeks (Group A) and conventional radical radiotherapy alone (Group B). Results : After completion of therapy in Group A complete response was observed in 19/30 (63%) patient and in control group B in 10/30 (33%).Grade II mucosal toxicities were observed in 40% of cases and 33 % of cases in study and control group respectively. Conclusion : Concomitant single agent chemo radiotherapy with low dose Carboplatin could be a better choice in advanced stage of Head and Neck carcinoma in terms of survival, acceptable toxicities together with enhanced response and quality of life.

[Combination chemotherapy of [vip] [ifosfamide, carboplatin, and etoposide] for advanced hodgkin's lymphoma [relapse and resistant]]

Hodgkin's lymphoma [HL] is a disease of good response on initial radio-chemotherapy, but there is a ratio of 5-35% does not respond, and some relapses after initial chemotherapy [CT] appear to have a poor prognosis, especially if the duration of the first complete remission [CR] was short. So the aim was to improve the survival by use the combination of VIP. Prospective Study of patients with Hodgkin's lymphoma, of age more than 13 years, who had relapses after combination of ABVD, and the resistant cases. Diagnosed in Almouassat hospital, within 1/2004- 1/2oo9. Then the patients were treated with the combination of VIP. Evaluation of relapse and resistant depended on CT-scan, biopsy, and Gallium scanning. 32 patients were in first relapse or resistance. they were divided into 3 groups, group-1: included 15 patients [47%] without bad prognosis, the interval of end treatment- relapse is about 4,5 years, Treated with ABVD. result was complete remission in 12 patients [80%]. Group- 2; included nine relapsed patients with bad prognosis; the interval of end treatment- relapse is about 1 year, treated with combination of VIP and Radiation Therapy if It is necessary. Result was complete remission in 3 patients, partial remission in 3 patients, and resistance in 2 patients. The whole response is 78%. Group- 3; included 6 resistant patients, treated with combination of VIP combination CT followed by radiotherapy [RT], result was complete remission in 4 patients [78%], partial remission in 2 patients. There was a significant difference, especially in group-3. The protocol ABVD is still the treatment of choice in patients with far relapse and without bad prognosis. while The combination of VIP, followed by radiotherapy or no, is useful and efficacy in resistant and relapse Hodgkin's lymphoma.

Cáncer de mama triple negativo: características clínicas y moleculares / Triple negative breast cancer: clinical and molecular characteristics

El cáncer de mama es una enfermedad problema en Venezuela por su incidencia, prevalencia y alta mortalidad. Representa la segunda causa de muerte por cáncer en la mujer venezolana, superado escasamente por el cáncer de cuello uterino. Los carcinomas de mama "triple negativo" se definen por falta de expresión de receptores de estrógenos, progesterona y Her2-Neu. Representan aproximadamente el 15% de todos los cáceres mamarios. Es más frecuente en mujeres pre-menopáusicas jóvenes, en latinoamericanas y en mujeres de raza negra. La mayoría de estos tumores son de tipo ductal, tienen alto grado nuclear e histológico, mayor tasa de recaídas y metástasis y peor pronóstico. La mayoría de los tumores triple negativos pertenecen al tipo molecular de los cánceres de mama tipo basal. El perfil inmunohistoquímico del cáncer de mama triple negativo ha sido investigado extensamente y es altamente heterogéneo. Estos tumores no son tratables con hormonoterapia ni con Trastuzumab y solamente se puede usar quimioterapia en el manejo sistémico. Algunos esquemas de quimioterapia son más efectivos que otros en cáncer de mama triple negativo y hay diversas terapias "emergentes" en investigación clínica.

Breast cancer is a problematic disease in Venezuela bacause of its incidence, prevalence and high mortality rate. It represents the second cause of death by cancer in the venezuelan woman exceeded slighthly by the cervix uterine cancer. Triple negative breast cancers are defined by lack of expression of estrogen, progesterone, and Her2-Neu receptors. This subgroup accounts for 15% of all types of breast cancer and for a higher percentage of breast cancer arising in young pre-menopausal Latin-American women and those of African descent. Histologically, such cancer fall into the molecular type and the basal subgroup of the breast cancer. Most of them are ductal with a high nuclear and histological grade, a higher rate of replase and metastasis and a worse prognosis. The triple negative breast cancer immunohistochemical profile has been extensively investigated and is higly heterogeneous; it is not treated with hormone therapy or with Trastuzumab and only chemotherapy in the systemic way can be used. Some chemoterapy schemes are more effective for the treatment of triple negative breast cancer and there are also "emergent" therapies in clinical investigation.

Two Lung Masses with Different Responses to Pemetrexed

We described here a patient who had two lung masses. Although the two masses had the same histology and a similar good response to initial chemotherapy with gemcitabine and carboplatin, the response to pemetrexed as a second-line treatment was different after re-growth of the tumors. These two lung masses could have originated from different clones or they could have progressed through different paths of molecular pathogenesis after metastasis, which would lead to different tumor characteristics, including their chemosensitivity. Regardless of their pathogenetic mechanisms, it seems important to recognize that tumors with the same histology that develop in one patient can have different responses to drugs.

Secondary vaginal involvement following radical surgical treatment for a stage I ovarian adenocarcinoma arising in mature cystic teratoma.

BACKGROUND: Vaginal carcinoma represents 1-2% of all gynecologic malignancies. Most cases reported secondary involvement from adjacent organs including cervix, uterus, and colorectum. Vaginal involvement from adenocarcinoma arising in mature cystic teratoma (MCT) has never been reported. CASE: A 29-year-old female presented with postcoital vaginal bleeding. She had had a history of right ovarian adenocarcinoma arising in MCT, FIGO stage IC, for 18 months' duration. Incisional biopsy of the vaginal lesion revealed adenocarcinoma, morphologically and immunohistologically identical to the right oophorectomized specimen. She received three courses of paclitaxel and carboplatin chemotherapy; however, she developed massive right pleural effusion with superior vena cava syndrome and finally succumbed to the disease, three months later. CONCLUSION: Adenocarcinoma is rarely found in MCT. This is the first case of ovarian adenocarcinoma arising in MCT with secondary vaginal involvement, presenting as postcoital vaginal bleeding.

A phase II study of docetaxel and carboplatin in Thai patients with advanced non-small-cell lung cancer.

OBJECTIVE: This phase II study aimed to assess the effectiveness of the docetaxel plus carboplatin combination in chemotherapy-naive Thai patients with advanced non-small-cell lung cancer (NSCLC). MATERIAL AND METHOD: Forty patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1, stage IIIB/IV NSCLC were enrolled in a phase H study between August 2001 and April 2003. Docetaxel 75 mg/m2 and Carboplatin AUC = 6 were given every 3 weeks. Response to treatment and toxicity were graded using standard WHO criteria. The Thai Functional Living Index Cancer (T-FLIC) scale was used to assess the Quality of Life (QoL) of all treated patients. RESULTS: Forty patients (median age: 55 years, range, 39-68 years; PS:0-1) were enrolled: one had stage IIIB disease with effusion, while thirty-nine had stage IV disease. Five patients were non-evaluable due to death within the first cycle; two dying of febrile neutropenia and sepsis, two of pulmonary infection, and one of unknown etiology. Partial response (PR) was seen in 28.6% patients, stable disease (SD) in 25.7%, and progressive disease (PD) in 45.7%. The median survival time was 32 weeks and the 1-year survival rate was 30.7%. Body mass index (BMI) was the only factor associated with survival time (univariate analysis: p = 0.006; multivariate analysis: p = 0.004). Other factors (gender, age, histology, ECOG PS, and glomerular filtration rate) were not predict for survival. The major treatment-related toxicities were neutropenia (from 152 treatment cycles there were grade 4: 19.7%; grade 3: 23.7%), febrile neutropenia (from 152 treatment cycles there was 3.95%), and diarrhea (grades 3/4: 0.66%). The QoL scores improved significantly throughout the treatment period. CONCLUSION: The regimen of docetaxel and carboplatin is active in advanced NSCLC and may be considered for first-line therapy.

Small cell lung cancer: an update on therapeutic aspects.

Small cell lung cancer comprises approximately 20% of all lung cancers and continues to be a difficult management issue. More than two-thirds of cases present with extensive disease, which has spread beyond the himithorax and regional ipsilateral nodes. While response rates to chemotherapy are relatively high, durable responses are rare, and long-term survival rates are anecdotal. Although many attempts have been made to develop new therapies, a combination of etoposide with either cisplatin or carboplatin remains the most widely used first-line therapy for extensive disease. For those with limited disease, chemotherapy with concomitant radiotherapy (given with the first or second cycles of chemotherapy) is considered the standard of care. Over the last decade, several new drugs and targeted agents have been identified with the aim to improve outcome of this malignancy. In this review we highlight recent developments in the management of this tumour.

Caracterização de um novo modelo animal de retinoblastoma com acometimento vítreo e seu uso em testes de eficácia da quimioterapia local com carboplatina / Characterization of an animal model of vitreous seeding retinoblastoma and its use on efficacy tests of peri-ocular therapy with carboplatin

Desenvolver e caraterizar um modelo animal de retinoblastoma com acometimento vítreo usando células tumorais humanas. Usar, posteriormente este modelo para testes de eficácia da quimioterapia local do retinoblastoma através de injeções peri-oculares de carbopatina. Material e métodos: para desenvolver o modelo doença vítrea /Aims: To develop and charactrize a xenograft model of retinoblastoma with vitreous seeding using human humor cell. And to further use this model to test the efficacy of local chemotherapy of retinoblastoma with peri-ocular injections od carboplatin...