Cisplatin and gemcitabine with either vinorelbine or paclitaxel in the treatment of carcinomas of unknown primary site

Abstract

Recent advances have documented the development of lung vasculature before and after birth, but less is known of the growth and maturation of airway vasculature. We sought to determine whether airway vasculature changes during the perinatal period and when the typical adult pattern develops. On embryonic day 16.5 mouse tracheas had a primitive vascular plexus unlike the adult airway vasculature, but instead resembling the yolk sac vasculature. Soon after birth (P0), the primitive vascular plexus underwent abrupt and extensive remodeling. Blood vessels overlying tracheal cartilage rings regressed from P1 to P3 but regrew from P4 to P7 to form the hierarchical, segmented, ladder‐like adult pattern. Hypoxia and HIF‐1α were present in tracheal epithelium over vessels that survived but not where they regressed. These findings reveal the plasticity of airway vasculature after birth and show that these vessels can be used to elucidate factors that promote postnatal vascular remodeling and maturation. Developmental Dynamics 239:2354–2366, 2010. © 2010 Wiley‐Liss, Inc.

Evaluation of survival benefits by platinums and taxanes for an unfavourable subset of carcinoma of unknown primary: a systematic review and meta-analysis

“…There were seven RCTs (Shildt et al , 1983; Dowell et al , 2001; Assersohn et al , 2003; Culine et al , 2003; Palmeri et al , 2006; Huebner et al , 2009; Hainsworth et al , 2010) and one non-randomised trial (Saghatchian et al , 2001) where two treatment arms were evaluated. Six of the included clinical trials primarily explored or estimated the treatment outcome separately; only one phase III trial had a primary objective of directly comparing the two treatment regimens (Hainsworth et al , 2010).…”

Clinical outcomes in patients with cancer of unknown primary site treated by gastrointestinal oncologists

“…Phase II studies evaluating these agents combined with a platinum compound, including clinical trials in patients with CUP, were successively performed and reported. [18][19][20][21][22] Many of these studies obtained a response rate of about 30% and an overall survival of less than 10 months. [18,19] In these studies, an overall survival of longer than 10 months was obtained in patients who received combined chemotherapy with a platinum preparation plus taxane.…”

Gemcitabine and carboplatin in carcinoma of unknown primary site (CUP) in elderly patients: Analysis of a phase 2 Adelaide Cancer Trials and Education Collaborative (ACTEC) study

“…Clinical trials of regimens containing a platinum and gemcitabine for CUP since year 2000 have reported objective response rates of~50% and median OS of up to 13.6 months, which is comparable to the platinum-taxane combinations. 22,23 European investigators compared the effect of single-agent cisplatin with gemcitabine and cisplatin combination on survival in goodrisk patients with CUP. Although the results of this prospective trial were expected to clarify the role of combination chemotherapy in good-risk patients with CUP, the trial was stopped due to insufficient accrual, and the result showed a non-significant trend towards higher survival with gemcitabine plus cisplatin as compared to that with cisplatin alone.…”