RESUMEN
Background and purpose: Renal-cell carcinoma (RCC) is susceptible to immune therapy including the use of the nonmyeloablative allogeneic transplantation(NAT). However, NST can produce severe toxicity, so it might not be appropriate for many patients with metastatic RCC. Other novel allogeneic immunotherapies have been designed to induce an autologous immune response directed against the malignancy. This study evaluated the efficacy and safety of infusions of partially HLA-matched irradiated allogeneic blood mononuclear cells for advanced renal-cell carcinoma. Methods: Patients with histologically proven diagnosis of advanced RCC received infusions of partially HLA-matched allogeneic blood mononuclear cells. Repeat infusions were given every 8 weeks. Treatment was continued until disease progressed, unacceptable toxicity, or patient (or donor) choice. Results: Eight patients were enrolled. After every infusion, 6 patients received an oral administration of thalidomide daily with 100-300 mg/d for 2 months. One patient had durable complete response. Five stable diseases and two progress diseases were observed. In eight patients, time to progression and survival were 320 and 879+days, respectively. Severe toxicity was not observed. Conclusion: Infusions of partially HLA-matcbed irradiated allogeneic blood mononuclear cells for advanced RCC may induce some antitumor effects and deserves further study.
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Relapse may occur in about 75% of patients who experienced the resection of hepatic metas-tases from coloreetal cancer. Perioperative chemotherapy with 5-fluorouraeil, leucovorin and oxaliplatin (FOLFOX) can reduce the risk of disease progression in eligible and reseeted patients compared with surgery a-lone. Pre-operative chemotherapy may cause vascular changes and steatohepatitis, which has the potential to in-crease the risks of surgery. A pooled analysis shows a trend of a longer median progression-free survival dura-tion among pest-operative patients who received adjuvant chemotherapy with 5-fluorouraeil and leueovorin-based regimen. Bevaeizumab in either pre-or pest-operative chemotherapy does not increase surgical complications.How to choose the best time and duration of the ebemotherapy needs to be further studied.
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The antiEGFR monoclonal antibodies cetuximab and panitumumab have been proven to be efficient in MCRC. The degree of EGFR expression (as confirmed by immunohistochemical analysis) did not correhte with the clinical response. In this review, we describe the current status of markers that might identify patients who are likely to benefit from treatment with cetuximab or panitumumab. These molecular markers include KRAS mutations, EGFR copy number, EGFR ligands (EGF, epiregulin), cyclin DI, IgG FcγR (FCGR2A-HI31R and FCGR3A-V158F), and nuclear factor-κB, that are crucial to avoid anti-EGFR treatment toxicity and reduce treatment cost.
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Single-agent gemcitabine, the standard chemotherapy for pancreatic cancer, has only mod-est effect. Gemcitabine has been combined with a variety of cytotoxic agents and targeted agents. Most phase Ⅲ studies, however, have failed to show improved survival compared with gemcitabine alone. One phase Ⅲ study has shown improved survival in advanced pancreatic cancer by adding erlotinib to gemcitabine. Studies evalua-ting non-gemcitabine-based regimens have showed considerable promise.