ABSTRACT
Colorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patients profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment (AU)
Subject(s)
Humans , Angiogenesis Inhibitors/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Colorectal Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols , Bevacizumab/therapeutic use , Clinical Trials, Phase III as Topic , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Fluorouracil/therapeutic use , Leucovorin/therapeutic use , Age FactorsABSTRACT
Colorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient's profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Colorectal Neoplasms/drug therapy , Drug Substitution , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Recombinant Fusion Proteins/therapeutic use , Age Factors , Antineoplastic Agents, Immunological/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bevacizumab/therapeutic use , Camptothecin/analogs & derivatives , Camptothecin/therapeutic use , Clinical Trials, Phase III as Topic , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Fluorouracil/therapeutic use , Genes, ras , Humans , Leucovorin/therapeutic use , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Lung Neoplasms/secondary , Lung Neoplasms/surgery , Mutation , Neovascularization, Pathologic/drug therapy , Organoplatinum Compounds/therapeutic use , Proto-Oncogene Proteins B-raf/genetics , Vascular Endothelial Growth Factor A/antagonists & inhibitorsABSTRACT
Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiation therapy is an essential component of curative-intent of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time (AU)
No disponible
Subject(s)
Humans , Nasopharyngeal Neoplasms/therapy , Carcinoma, Squamous Cell/therapy , Practice Guidelines as Topic , Neoplasm Metastasis/therapy , Neoplasm Recurrence, Local/therapy , Risk FactorsABSTRACT
INTRODUCTION: Bioimmunochemotherapy (BCT) is a combination of biological agents and cytostatics that has shown an increase in response rate (RR) in metastatic melanoma patients. The aim of the study is to evaluate RR, progression- free survival (PFS), overall survival (OS) and treatment toxicity. MATERIALS AND METHODS: Retrospective analysis of 11 metastatic melanoma patients treated from January 2002 to June 2008 with cisplatin 20 mg/m(2) i.v. days 1.4, dacarbazine 800 mg/m(2) i.v. day 1, vinblastine 1.5 mg/m(2) i.v. days 1.4, interleukin (IL)-2 9 MIU/m(2) s.c. 5.8 days and interferon (IFN)-alpha-2b 5 MIU/m2 s.c. days 5.9, 11, 13 and 15, with the support of granulocyte colony-stimulating factor (G-CSF) and antibiotics. Patients with ECOG 0, age < or = 65 years and with measurable disease were included. The planned number of courses was 4. RR was measured by Revised Evaluation Criteria in Solid Tumour (RECIST) criteria (computed tomography [CT]+/-proton emission tomography [PET]). Toxicity was measured according to the National Cancer Institute (NCI) common toxicity criteria. RESULTS: Observed RRs were 18% complete response (CR), 27% partial response (PR), 9% stable disease (SD) and 46% disease progression. The median PFS was 4 months (95% CI, 0.10 m), with a 23% one-year PFS. Median OS was 4.6 months (95% CI, 0.9.19 m), with a 29% one-year OS. Eighty-three percent of patients experienced grade 3-4 toxicity, mainly due to neutropenia, thrombocytopenia and flu-like syndrome. CONCLUSIONS: Treatment with BCT shows an increase in RR, some achieving durable CR; nevertheless it cannot be considered a standard treatment and should be employed only in selected patients (AU)
