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The effects of continuous azacitidine cycles on response to higher risk patients with Myelodysplastic Syndromes: update
L.R. Silverman, p. Fenaux, g. j. Mufti, v. Santini, e. Hellström-Lindberg, n. Gattermann, g. Sanz, a. f. list, s. d. Gore, Seymour j. F, j. Backstrom, d. McKenzie, c. l. Beach
The international, multicenter phase III of AZA-001 demonstrated azacitidine (AZA) is the first treatment to greatly extend overall survival (OS) in patients with myelodysplastic syndrome (MDS) syndromes of higher risk (Fenaux, Blood 2007; 110: 817). The current paradigm of treatment which is based on a relationship between survival and complete remission (CR), is being increasingly called into question (Cheson, blood 2006; 108: 419). AZA-001 Results show that CR is sufficient but not necessary to prolong OS (List, 26: J Clin Oncol 2008; abstr 7006). In fact, the rate of AZA CR AZA-001 was modest (17%), while partial remission (PR, 12%) and improving haematologic (HI, 49%) were also predictive of prolonged survival.This analysis was conducted to evaluate the median number of cycles of treatment AZA associated with achievement of the first response, as measured by CR IWG 2000-HI, PR or defined (main + children). Also was measured the number of cycles of treatment before responding to the best response.
Volume: 2 article number: 118 DOI: 10.3332/ecancer. 2008 118 received: 29/10/2008 published: 08/12/2008
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The full response in the gallbladder cancer Erlotinib plus Gemcitabine receptor gene mutations does not require the epidermal growth factor: report
Gallbladder Cancer usually consists of an aggressive course with chemotherapy for advanced disease, the standard of care; the full benefits are rare. Epidermal growth factor receptor (EGFR) is a promising therapeutic target, however, the activities of an agent for oral EGFR tyrosine kinase is low. Previous reports of chemotherapy plus EGFR tyrosine kinase inhibitor (TKI) for the treatment of cancer, gall bladder or correlation of the reply with the mutation of the tyrosine kinase domain of EGFR gene have been reported.
67-year-old man with metastatic cancer of the liver and gallbladder abdominal lymph nodes was treated with Gemcitabine (1000 mg/m2) on day 1 of each 21-day and 8, as well as daily erlotinib (100 mg). After four cycles of therapy CA 19-9 normalized and PET/CT showed complete remission; The reaction was saved at the end of the 12 cycles of therapy. Gemcitabine then was discontinued and erlotinib one agent continued as supporting therapy. The disease remains in good control over the 18 months after the start of therapy, including 6 months for erlotinib. Only grade 3 toxicity is typical of EGFR skin rash.From the wonderful response to Gemcitabine plus erlotinib accomplised tumor gene genotyping, predicting response EGFR mutations in exons 18, 19 and 21. it is not disclosed to wild-type genotype with mutations found.
This report illustrates the patient with stage IV gallbladder cancer experienced rare full, long response after treatment with oral chemotherapy plus EGFR-TKI.In the absence of EGFR gene mutation occurred this answer these comments should inform the Design of clinical trials with EGFR-TKIs for treatment of gallbladder and biliary tract of other cancers; such processes do not select patients, based on the status of the EGFR mutations.
cancer3 