No abstract

No abstract

Cetuximab can be safely combined with CF chemotherapy and may increase the efficacy of standard CF chemotherapy.

No abstract

The expression of a v b 3 and glucose metabolism are upregulated in many malignant lesions, and both are known to correlate with an aggressive phenotype. We evaluated whether assessment of a v b 3 expression and of glucose metabolism with PET using 18 Fgalacto-RGD and 18 F-FDG provides complementary information in cancer patients. Methods: Eighteen patients with primary or metastatic cancer (non-small cell lung cancer [NSCLC], n 5 10; renal cell carcinoma, n 5 2; rectal cancer, n 5 2; others, n 5 4) were examined with PET using 18 F-galacto-RGD and 18 F-FDG. Standardized uptake values (SUVs) were derived by volume-of-interest analysis. 18 F-Galacto-RGD and 18 F-FDG PET results were compared using linear regression analysis for all lesions (n 5 59; NSCLC, n 5 39) and for primaries (n 5 14) and metastases to bone (n 5 11), liver (n 5 10), and other organs (n 5 24) separately. Results: The sensitivity of 18 F-galacto-RGD PET compared with clinical staging was 76%. SUVs for 18 F-FDG ranged from 1.3 to 23.2 (mean 6 SD, 7.6 6 4.9) and were significantly higher than SUVs for 18 F-galacto-RGD (range, 0.3-6.8; mean 6 SD, 2.7 6 1.5; P , 0.001). There was no significant correlation between the SUVs for 18 F-FDG and 18 F-galacto-RGD for all lesions (r 5 0.157; P 5 0.235) or for primaries, osseous or soft-tissue metastases separately (P . 0.05). For the subgroup of lesions in NSCLC, there was a weak correlation between 18 F-FDG and 18 F-galacto-RGD uptake (r 5 0.353; P 5 0.028). Conclusion: Tracer uptake of 18 F-galacto-RGD and 18 F-FDG does not correlate closely in malignant lesions. Whereas 18 F-FDG PET is more sensitive for tumor staging, 18 F-galacto-RGD PET warrants further evaluation for planning and response evaluation of targeted molecular therapies with antiangiogenic or a v b 3 -targeted drugs.

BACKGROUND: Cetuximab enhances the efficacy of chemotherapy in several cancer types. This trial assessed the activity of cetuximab and chemotherapy in advanced gastric cancer. METHODS: Patients with previously untreated, metastatic, gastric cancer received cetuximab 400 mg m À2 at first infusion followed by weekly infusions of 250 mg m À2 combined with FUFOX (oxaliplatin 50 mg m À2 , 5-FU 2000 mg m À2 , and DL-folinic acid 200 mg m À2 d1, 8, 15 and 22 qd36). The primary endpoint was tumour response. RESULTS: Overall, 52 patients were enrolled. The most common grade 3/4 toxicities were diarrhoea (33%), and skin toxicity (24%). Efficacy was evaluable in 46 patients who showed a response rate of 65% (CI 95%: 50 -79%) including four complete responses. Time to progression (TTP) was 7.6 months (CI 95%: 5.0 -10.1 months) and overall survival (OS) was 9.5 months (CI 95%: 7.9 -11.1 months). Epidermal growth factor receptor (EGFR) was detectable in 60% of tumours but showed no correlation with treatment outcome. A KRAS mutation was found in only 1 of 32 (3%) tumour samples analysed. CONCLUSION: Cetuximab plus FUFOX showed an interesting high response rate in metastatic gastric cancer. Cetuximab plus platinum -fluoropyrimidine chemotherapy is at present being investigated in a phase III randomised controlled trial.

Introduction: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective internationalstudy for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma. Methods: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study. Results: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity.

NAC for patients with positive cytology could lead to FPTC negativity in a subset of patients and improve their prognosis. However, NAC might be a risky strategy for almost one-quarter of patients whose disease develops positive cytology.