First experience of durable cytoreduction in chronic lymphoid leukemia with 177Lu-DOTATATE.

This is the first described case of effective and durable cytoreduction after PRRT with 177Lu-DOTATATE in a 75-year-old female, with B cell chronic lymphoid leukemia, and well-differentiated metastatic neuroendocrine tumor.

Self-reported compliance with capecitabine: findings from a prospective cohort analysis.

OBJECTIVES: While oral anticancer treatment has increased the convenience for patients with no risk of venous access complications compared to intravenous drug administration, a high level of compliance cannot always be assumed. The aim of the present report was to evaluate real-life drug adherence in a prospective cohort analysis of patients with gastrointestinal or breast cancer treated with capecitabine-based chemotherapy. METHODS: Twenty-nine Swiss oncologists recruited patients receiving capecitabine, either as monotherapy or in combination with other chemotherapeutic agents, in a prospective fashion. Patients recorded both their capecitabine intake and any adverse effects each day in patient diaries. RESULTS: A total of 177 patients were included, 143 (81%) with gastrointestinal tumours and 34 (19%) with breast cancer. Overall, 161 patients (91%) were considered as fully compliant, while 16 patients (9%) reported some kind of compliance error. Reasons for non-compliance included forgetting to take treatment (n = 9), side effects (n = 4) and misunderstanding instructions (n = 3). Self-reported compliance was not influenced by age or Eastern Cooperative Oncology Group performance status, but there was a trend towards better compliance with capecitabine therapy if fewer adverse effects occurred (p = 0.07, simple logistic regression). CONCLUSIONS: Self-reported compliance with capecitabine-based therapy in clinical practice is high and seems to be adversely affected by side effects.

Successful closure of anal cancer-related fistulas with upfront intra-arterial chemotherapy: a report of 8 cases.

BACKGROUND: Fistulas arising from the perforation of anal cancer into adjacent organs are a debilitating complication in the course of the disease. OBJECTIVE: We studied intra-arterial chemotherapy as a strategy to close such fistulas before the initiation of standard chemoradiation. DESIGN: This study was based on a retrospective chart review. SETTING: The investigation was conducted at Geneva University Hospital. PATIENTS: Eight patients with anal cancer-related fistulas were included in the study. INTERVENTION: Patients were treated at our institution from 2002 to 2009 with upfront chemotherapy consisting of 1 to 4 cycles of intra-arterial cisplatin, 5-fluorouracil, methotrexate, and mitomycin C, and intravenous bleomycin. Intra-arterial chemotherapy was followed by standard chemoradiation. MAIN OUTCOME MEASURE: Fistula closure was assessed by an expert proctologist. RESULTS: Complete closure of fistulas was documented in 7 of 8 patients. Toxicity was manageable and consisted mainly of thrombocytopenia, neutropenia, and febrile neutropenia as well as fatigue. LIMITATIONS: This is a retrospective, uncontrolled review of only 8 patients and thus a meaningful comparison with standard chemoradiation is not feasible. CONCLUSION: Upfront intra-arterial chemotherapy is a promising strategy to close anal cancer-related fistulas before initiating chemoradiation, potentially obviating the need for hazardous reconstructive surgery after radiotherapy.

[Thalidomide: (re)discovery of a not very dear old molecule]. / Thalidomide: (re)découverte d'une ancienne molécule peu chère.

The angiogenesis is an early event in tumorigenesis. Angiogenesis inhibitors have been developed and are now studied in clinical trials. Angiogenesis research has induced a renewal of thalidomide. Thalidomide inhibits tumoral angiogenesis, allowing a good palliative treatment for hematological malignancies, especially for multiple myeloma and myelodysplastic syndromes.