Our data suggest that FOLFOX4 has a high response rate (complete response, partial response, or reduction) in patients with liver-only metastases from colorectal cancer, allowing for successful resection of disease in a portion of patients initially not judged to be optimally resectable. However, a high recurrence rate after surgery was observed, which, in 73% of patients, involved the liver. Further trials are indicated based on the promising results observed in this trial.

Objectives-Early testing of aerosolized sargramostim therapy demonstrated anecdotal clinical responses in patients with metastatic melanoma associated with emergence of systemic anti-tumor immunity. In order to improve the clinical and immunological efficacy of therapy without compromising patient safety, we performed a further dose escalation trial in patients with metastatic melanoma.Methods-We conducted a dose-escalation clinical trial of HLA-A2 + patients with metastatic melanoma to the lung treated with aerosolized GM-CSF (500-2000ug/dose, with increments of 250ug/dose/cohort) twice/day on days 1-7 & 15-21 every 28 days until progression or severe toxicity to find a dose where majority of patients develop anti-tumor immunity. Five patients were treated per each dose level. Clinical, immune, and safety parameters were examined.Results-The study accrued 40 patients. Toxicity was acceptable. All doses levels were exhausted without identifying a dose of GM-CSF at which majority of patients (≥ 3 of 5) demonstrated significant up-regulation of anti-tumor immunity. Three of 16 patients that were tetramer positive for at least one melanoma antigen (e.g. MART-1) pre-treatment developed an immune response (IR) to different tumor antigens. Two of 9 patients who were tetramer negative to all melanoma antigens pre-treatment developed an IR against gp100. The greatest changes in anti-tumor immunity occurred at the highest dose levels.Conclusions-A dose of aerosolized GM-CSF capable of inducing anti-tumor immunity in the majority of patients was not reached. All tested doses were well tolerated. The greatest increase in anti-tumor T cell immune responses was achieved at the highest doses of GM-CSF.

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Alkali (pH 11.5) treatment of a washed, ammonium sulfate-precipitated residue derived from a triton-X-100 extract of a 30,000 X g particulate diglyceride kinase preparation of E. coli converts much of the enzyme to a 100,000 X g soluble, detergent free state. This procedure improves the enzyme as an analytical tool for the structural analysis of triglycerides, and may be applicable for the solubilization of the many other glyceride-and phosphoglyceride-forming enzymes which have all resisted further purification because of insoluble, particulate properties.

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The purpose of this study was to investigate the patterns of care in women over the age of 65 years presenting with breast cancer. Tumor registry data from three different sized and geographically located hospitals in northwest Ohio were reviewed and analyzed. Three hundred forty-five patients were eligible for analysis. An age difference was noted between those patients receiving lumpectomy only compared to those patients receiving mastectomy or lumpectomy and radiation. The majority of patients with regional disease received hormonal therapy. Only two of six patients with positive lumpectomy margins experienced a local recurrence. The tumor volume was statistically significantly higher in patients who experienced a local recurrence. In conclusion, treatment for elderly patients with breast cancer should be based on physiologic not chronologic age.