© 2007 European Society for Medical Oncology
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Impact of FDG-PET in staging breast cancer |
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 Top Impact of FDG-PET in... Docetaxel and oxaliplatin in...VAD-doxil vs. VAD-doxil plus...Prognosis for long-term...Quote |
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Positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) has proven to be accurate for the staging of breast cancer with sensitivities and specificities of 93% and 75%, respectively, for primary staging, and 89-100% and 72-88%, respectively, for detection and restaging of recurrent breast cancer. However, data regarding the clinical impact of PET in the primary staging of breast cancer are rare. In this issue, Klaeser et al. report on a study that aimed to assess the potential therapeutic impact of pre- and postoperative FDG-PET in patients with clinically intermediate or high-risk breast cancer. These authors report that in 114 patients with newly diagnosed breast cancer examined before (73) or after (41) surgery, FDG-PET changed the planned treatment in 32%. They conclude that FDG-PET, as a staging procedure in patients with newly diagnosed clinically intermediate or high-risk breast cancer examined pre- and postoperatively, may have a substantial therapeutic impact on treatment planning.
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Docetaxel and oxaliplatin in ovarian cancer |
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TopImpact of FDG-PET in...Docetaxel and oxaliplatin in...VAD-doxil vs. VAD-doxil plus...Prognosis for long-term...Quote |
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A pooled analysis of phase III trials has recently demonstrated the improvement in time to progression and overall survival associated with platinum/paclitaxel re-challenge in patients with recurrent ovarian cancer. However, considerable toxicity in terms of sensory neuropathy and alopecia has been documented with this regimen. A phase II trial in platinum-sensitive recurrent ovarian cancer patients with the combination oxaliplatin/paclitaxel recently reported a high level of activity, but with considerable toxicity. In this issue, Ferrandina et al. report on a prospective phase II study that aimed to evaluate the efficacy and toxicity of the combination docetaxel (DTX) and oxaliplatin (OXA) in ovarian cancer patients recurring after a platinum-free interval >12 months. These authors report that in 43 enrolled ovarian cancer patients 17 complete responses and 12 partial responses were registered, for an overall response rate of 67.4%. The median response duration was 10 months. Grade 3-4 leukopenia was documented in 32.5% of the patients; grade 3-4 neurotoxicity and grade 2 alopecia were observed in 9.3% and 34.9% of patients, respectively.
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VAD-doxil vs. VAD-doxil plus thalidomide for multiple myeloma |
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TopImpact of FDG-PET in...Docetaxel and oxaliplatin in...VAD-doxil vs. VAD-doxil plus...Prognosis for long-term...Quote |
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In a phase II study, the addition of thalidomide to the combination of vincristine, liposomal doxorubicin and dexamethasone (VAD-doxil) has proved feasible as a first line treatment of multiple myeloma and increased the response rate to 74%. In this issue, Zervas et al. report the results of a multicenter prospective randomized clinical trial that aimed to compare the efficacy and toxicity of VAD-doxil with thalidomide and VAD-doxil in previously untreated multiple myeloma patients. 232 newly diagnosed multiple myeloma patients aged less than 75, were randomized to receive VAD-doxil (115 patients; arm A) or thalidomide and VAD-doxil (117 patients; arm B). These authors report that at least a partial response was observed in 62.6% and in 81.2% of patients randomized to arms A and B, respectively (P=0.003). Progression-free survival at 2 years was 44.8% in arm A and 58.9% in arm B (P=0.013). Overall survival at 2 years was 64.6% and 77%, in arms A and B respectively (P=0.037). Constipation, peripheral neuropathy, dizziness/somnolence, skin rash and edema were significantly higher in arm B (P< 0.01), but grade 3-4 toxicities were low and similar in both arms.
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Prognosis for long-term survivors of cancer |
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TopImpact of FDG-PET in...Docetaxel and oxaliplatin in...VAD-doxil vs. VAD-doxil plus...Prognosis for long-term...Quote |
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Patients who have survived for a certain amount of time after cancer diagnosis often want to know about their prognosis at that time. Standard survival curves at diagnosis of cancer are too negative, because these include patients who die within the first years. Conditional survival analysis is a method for estimating the survival rate, given the pre-condition of having already survived a certain length of time. In this issue, Janssen-Heijnen et al. present conditional 5-year relative survival rates for contemporary cancer patients. These authors report that for patients with colorectal cancer, cutaneous melanoma or stage I breast cancer, conditional 5-year relative survival was greater than 95% after having survived 3-15 years, while for stomach, lung, stage II or III breast, prostate cancer or Hodgkin lymphoma, conditional 5-year relative survival did not exceed 75-94%.
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TopImpact of FDG-PET in...Docetaxel and oxaliplatin in...VAD-doxil vs. VAD-doxil plus...Prognosis for long-term...Quote |
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"Go hang yourself, you old M.D,!You shall not sneer at me.
Pick up your hat and stethoscope,
Go wash your mouth with laundry soap;
I contemplate a joy exquisite
In not paying you for your visit."
Ogden Nash contemplates his revenge in Common Cold
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