Annals of Oncology 2006 17(7):1033; doi:10.1093/annonc/mdl160
© 2006 European Society for Medical Oncology
in this issue
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Docetaxel plus carboplatin in advanced NSCLC
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Non-small-cell lung cancer (NSCLC) remains the leading cause
of cancer-related death throughout Europe and the United States
and is responsible for approximately 1 million deaths worldwide
each year. Phase III studies have suggested that NSCLC patients
treated with cisplatin-docetaxel may have higher response rates
and better survival compared with other platinum-based regimens.
In this issue,
Booton et al. report the results of a randomized
phase III study, of 433 patients with advanced NSCLC, that aimed
to compare docetaxel plus carboplatin with mitomycin-ifosfamide-cisplatin
(MIC) and mitomycin-vinblastine-cisplatin (MVP). These authors
report that while after median follow up of 17.4 months there
was no significant difference in survival between the treatment
arms, the MIC/MVP arm did show significant worsening in overall
EORTC score and global health status compared with the cisplatin-docetaxel
arm.
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Stem cell transplantation in renal cancer
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In clinical allogeneic haematopoietic stem cell transplantation
(HSCT), an allogeneic graft-versus-tumour effect has been reported
for several solid tumors including breast cancer, renal cell
carcinoma, colon carcinoma and ovarian carcinoma. In this issue,
Barkholt et al. report an evaluation of the results of HSCT
for renal cell carcinoma (RCC) in 124 patients from 21 European
centers. These authors report that transplant-related mortality
was 16% at one year. Factors associated with survival included
chronic graft-versus-host disease GVHD [hazards ratio (HR) 4.12,
P < 0.001], post-transplant addition of donor lymphocyte
infusions (HR 3.39,
P < 0.001), <3 metastatic sites (HR
2.61,
P = 0.002) and a Karnofsky score >70 (HR 2.33,
P =
0.03). Patients (
n = 17) with chronic GVHD and given donor lymphocyte
infusions had a 2-year survival of 70%.
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Topotecan salvage therapy in primary CNS lymphoma
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An increasing incidence of primary CNS lymphoma has been reported
among non-immunocompromized individuals. High-dose methotrexate
chemotherapy prolongs overall survival to over 30 months, compared
with 12–18 months with whole brain irradiation (WBI),
but up to 35% of the patients are refractory to primary therapy,
and 35–60% of the responders will eventually relapse.
The prognosis of patients with refractory and relapsed primary
CNS lymphoma is poor, if left untreated, but there is no standard
approach in this setting. In this issue,
Fischer et al. report
the results of a prospective study that aimed to assess topotecan
chemotherapy in relapsed or refractory primary CNS lymphoma.
These authors report a response rate of 33% with five complete
and four partial remissions (PR) among 27 patients. The median
event-free survival was 2.0 months (9.1 months in responders)
and the overall survival was 8.4 months.
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Psychological impact of cancer in parents
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In recent years, genetic testing for a cancer predisposition
has become a standard component of clinical practice. The impact
of genetic testing on mental health has been well documented,
and it has been suggested that risk perception and distress
levels are influenced by experiences of cancer within the family.
In this issue,
van Oosterom et al. report on a study that aimed
to explore the impact of parental cancer and loss at several
developmental phases on psychological distress and cancer risk
perception during the genetic testing process. The developmental
phases focused upon were childhood and adolescence and specifically
the time of breast development (puberty) in women with breast
cancer affected mothers. These authors report that individuals
with experience of a parental cancer in childhood (under age
13) reported the highest level of cancer-related distress, worry
and risk perception.
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Quote
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"Farewell to the hexagonal structure: in the space of a few
instants the skein was unwound and became glucose again, and
this was dragged by the bloodstream all the way to a minute
muscle fiber in the thigh, and here brutally split into two
molecules of lactic acid, the grim harbinger of fatigue".
Primo Levi considers glycolysis as part of the biography of a carbon atom in The Periodic Table.
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