Colorectal cancer (CRC) is still one of the most common types of cancer in the world, and the gut microbiome plays an important role in its development. The microbiome is involved in the carcinogenesis, formation and progression of CRC as well as its response to different systemic therapies. The composition of bacterial strains and the influence of geography, race, sex, and diet on the composition of the microbiome serve as important information for screening, early detection and prediction of the treatment outcome of CRC.Microbiome modulation is one of the most prospective new strategies in medicine to improve the health of individuals. Therefore, future research and clinical trials on the gut microbiome in oncology as well as in the treatment of CRC patients are warranted to determine the efficacy of systemic treatments for CRC, minimize adverse effects and increase survival rates.

BackgroundPhase II studies have shown that the combination of capecitabine and irinotecan (the XELIRI regimen) is active in metastatic colorectal cancer (MCRC). There are, however, no data about the use of the XELIRI regimen in the neoadjuvant treatment.MethodsPatients with unresectable liver-only metastases of MCRC with ≤ 75 years of age were randomised to either the XELIRI (irinotecan 250 mg/m2 given on day one and capecitabine 1000 mg/m2 twice daily from day 2–15, every 21 days) or the FOLFIRI arm (irinotecan 180 mg/m2, 5-FU 400 mg/m2, LV 200 mg/m2, 5-FU 2400 mg/m2 (46-h infusion) – all given on day one, every 14 days). Primary end points were objective response rate (ORR) and rate of radical (R0) surgical resection. Secondary end points were progression-free survival (PFS), overall survival (OS) and safety.ResultsAltogether 87 patients were enrolled (41 pts in the XELIRI and 46 pts in the FOLFIRI arm). The median age was 63 years (63 years in the XELIRI and 62 years in the FOLFIRI arm) (p = 0.33). ORR was 49% in the XELIRI and 48% in the FOLFIRI arm (p = 0.76). The rate of radical R0 resection was 24% in both arms of patients. At the end of treatment, 37% of patients in the XELIRI and 26% of patients in the FOLFIRI arm were without evidence of the disease (CR+R0 resection) (p = 0.56). There were no statistical differences in grade 3 or 4 adverse events between both arms: diarrhoea 7% vs. 6%, neutropenia 5% vs. 13%, ischemic stroke 0 vs. 2%, acute coronary syndrome 2% vs. 4%, respectively. At the median follow up of 17 (range 1–39) months, the median PFS was 10.3 months in the XELIRI and 9.3 months in the FOLFIRI arm (p = 0.78), the median OS was 30.7 months in the XELIRI arm and 16.6 months in the FOLFIRI arm (p = 0.16).ConclusionThe XELIRI regimen showed similar ORR as the FOLFIRI regimen in the neoadjuvant treatment of patients with MCRC. In addition, the XELIRI regimen showed similar PFS and OS with acceptable toxicity compared to the FOLFIRI regimen.Trial RegistrationCurrent Controlled Trials ISRCTN19912492

A metastasis of hypernephroma was treated by electrochemotherapy with bleomycin. Electrochemotherapy consists of chemotherapy followed by local application of electric pulses to the tumor in order to increase drug delivery to the cells. In the course of a four-week treatment period, the subcutaneous metastasis of the hypernephroma was treated with three sessions of electrochemotherapy, each consisting of 9-10 runs of 8 electric pulses, 10 min after intravenous injection of bleomycin. This treatment resulted in stabilization of the tumor volume for 12 months, whereas the subcutaneous metastasis next to the electrochemotherapy-treated one that did not receive electric pulses progressed immediately.

We have evaluated the efficiency of electrochemotherapy with cisplatin on cutaneous tumor lesions of breast cancer and have compared its efficiency with the efficiency of intratumoral (i.t.) administration of cisplatin alone. The study was performed on six breast cancer patients with 26 cutaneous lesions in whom all standard treatment modalities were exhausted. Of 26 lesions, 12 were treated by electrochemotherapy, six by i.t. cisplatin application, while eight were controls. In all 12 lesions treated by electrochemotherapy and followed-up for up to 26 weeks at the most, the objective response was obtained [complete response in 33% with mean duration of 10 weeks and partial response (PR) in 67% with a mean duration of 5 weeks]. In six lesions treated with i.t. application of cisplatin and followed-up for up to 12 weeks at the most, objective response was obtained in 83% of lesions; none of these responses were complete, the mean duration of PR was 5 weeks. During electrochemotherapy, only minimal local side-effects were observed, whereas no systemic side-effects of the treatment were noticed. We conclude that electrochemotherapy with i.t. cisplatin application is effective in local treatment of cutaneous tumor lesions of breast cancer.