Ian Smith

..These results indicate that letrozole is more active than tamoxifen both as neoadjuvant therapy and as first-line treatment in advanced disease. They support the importance of current adjuvant trials comparing the two treatments...

..This review will examine the published data, discuss ongoing trials, and address the question of how to best integrate the aromatase inhibitors into adjuvant treatment...

..Ongoing and future studies will establish optimal dosing regimens of pemetrexed and potential benefits of vitamin supplementation in the settings of metastatic breast cancer and gynecologic malignancies...

..We have carried out a multicenter randomized trial comparing three versus six courses of chemotherapy...

..Thus, Herceptin represents a significant development in the management of HER2-positive breast cancer...

..Recently, benefits for trastuzumab have also been shown in the neoadjuvant and adjuvant setting...

..To compare the efficacy of continuous infusional 5-fluorouracil (5-FU)-based chemotherapy against conventional bolus chemotherapy in the preoperative treatment of patients with large operable early breast cancer...

..This would lead to individualised treatment for each patient, and would allow much more rapid assessment of new drugs than is currently possible with adjuvant therapy trials...

..The UK TACT study (CRUK01/001) investigated whether sequential docetaxel after anthracycline chemotherapy would improve patient outcome compared with standard chemotherapy of similar duration...

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..It provides a unique opportunity for detailed study of the determinants of response and resistance to estrogen deprivation as well as testing the role of presurgical therapy for improved biomarker-based estimates of prognosis...

..This article reviews the pre-clinical rationale for this strategy and the clinical trials in this area...

..CONCLUSIONS: Neoadjuvant VE is as effective as AC in early breast cancer and was better tolerated except for thrombophlebitis and neuropathy...

..Issues including the timing of administration (up-front or sequential), the duration of the therapy and the role of biomarkers such as PgR and HER2 in optimal selection remain unresolved...

..We investigated the drug's effect on overall survival after a median follow-up of 2 years in the Herceptin Adjuvant (HERA) study...

..Pre-operative MVP chemotherapy is feasible in early stage NSCLC, and this study has now been initiated as a UK-wide Medical Research Council phase III trial...

..We present our long-term results with platinum-based chemotherapy for TN breast cancer...

..The schedule should also be assessed as primary (neoadjuvant) chemotherapy before radical radiotherapy for locally advanced NSCLC in a randomised trial...

..More clinical trials for older women are needed, if the benefits of recent advances in the management of this disease are to be extended to the over 70s. These data should, however, act as a benchmark for future audits...

..Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospective trial...

..Confirmation of this effect and further investigation is underway in a randomized phase III trial and in laboratory models...

..Patients who do not respond to the first two lines of chemotherapy should be considered for clinical trials or supportive care...

..The potential for biological surrogate markers of response to predict for long-term outcome may allow individualisation of systemic treatment and the rapid assessment of new drugs in early breast cancer...

..We have reviewed a series of patients with early breast cancer treated with accelerated 2-weekly paclitaxel without routine GCSF to assess its need...

..The findings provide in vivo evidence in human breast cancer that chemotherapy induces an apoptotic program characterized by up-regulation of Bax and cleavage of caspase substrate DFF40...

..Collection of resistant biopsy tissues from patients is important to determine if this mechanism is clinically relevant...

..To evaluate acute toxicity induced by chemotherapy for breast cancer in a retrospective study of 62 BRCA1/2 mutation carriers matched 1:1 with women who had treatment for sporadic disease in the United Kingdom between 1983 and 2003...

..SRL172 can be given safely into tumour deposits and the pleural cavity in patients with malignant mesothelioma and we have established the dose for phase II testing...

..Excluding pathological subtype, the prognostic significance of poor PS and weight loss were retained in multivariate analysis. CONCLUSIONS: Palliation of symptoms in MM is achievable with current cisplatin-based treatments...

..MVP, an effective palliative regimen for NSCLC, is also active against SCLC with low toxicity and merits comparison with more toxic conventional schedules...

..Biological predictors reflecting changes in apoptosis and/or proliferation may in the future offer the best surrogate markers for long-term outcome, and trials have recently begun in this area...

..3). Toxicity profile was mild. This platinum-based chemotherapy is an effective, well-tolerated and low-cost regimen for patients with MBC, including those pretreated with anthracyclines...

..Accelerated AC and EC with pegfilgrastim are safe and feasible regimens in the treatment of early breast cancer with less neutropenia than conventional 3 weekly schedules...

..A 50% increase in relative dose intensity of epirubicin and cyclophosphamide is achieved, while overall treatment time is reduced by 33%...

..The high incidence of symptomatic relief seen in this study, even in the absence of objective response, suggests that moderate dose chemotherapy may have a role in the palliation of NSCLC...

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..Given to patients with primary breast cancer, clodronate might reduce the subsequent incidence of bone metastases...

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..This can result in substantial morbidity and mortality. Chest wall resection is well-documented for palliation and local control in chest wall relapse; an extension of this surgery is parasternal or sternal resection...

..The MVCarbo regimen resulted in response rates and survival rates equivalent to those seen with standard MVP and, as such, provides an acceptable outpatient alternative to this treatment...

..In this series the thoracic CT led to a diagnosis of lung primary in 34% of the cases. Other radiological examinations and bronchoscopy were unhelpful. Chemotherapy achieved symptom relief in 78% of patients...

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..These results suggest that pemetrexed has significant antitumour activity in advanced breast cancer with responses in patients who had previously received anthracyclines and taxoids...

..Analysis of multiple gene expression changes over a short treatment period may also have potential clinical utility for prediction of response...

..01). No other differences were seen between the two groups in terms of the use of resources. CONCLUSION: Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes...

..A key question for all forms of endocrine therapy remains optimal duration. Evidence is emerging to suggest that, for some women, treatment should be continued for many years and perhaps lifelong...

..Pretreatment proliferation and GI are however predictive of response to chemotherapy in breast cancer...

..This study suggests that dox confers advantages on all of these endpoints and that the size of such benefits needs to be taken into account when deciding whether to use dox...

..MMM is an active, well tolerated new chemotherapy regimen for advanced/metastatic breast carcinoma with an efficacy and toxicity spectrum very similar to CMF...

..Standard adjuvant chemotherapy seems to be less effective in these tumours and new therapeutic approaches are indicated...

..03, RR=1.92) and an independent predictor of progression-free survival in patients with SCLC (P=0.01, RR=1.43). In conclusion, weight loss as a symptom of lung cancer predicts for toxicity from treatment and shorter survival...

..The improved rate of radical treatment could lead to an improved survival rate...

..The EPIC regimen has equivalent activity to other reported cisplatin based regimens used in the treatment of recurrent lymphoma, but is associated with lower treatment related morbidity and mortality...

..Infusional ECarboF is a highly active, well-tolerated, outpatient regimen effective against advanced/metastatic breast cancer and now warrants evaluation against conventional chemotherapy in high-risk early breast cancer...

..02) and overall survival (P = 0.03) when measured by this immunohistochemical assay, but was not significant when measured by ligand-binding assay...

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..14-2.58) in those without the antibody (P = 0.02). This study, the largest homogeneous group so far looking at p53-Ab in SCLC, suggests that p53 antibody detection may have a role in predicting outcome in this type of cancer...

..4). CONCLUSION: We have been unable to identify any significant survival benefit from starting adjuvant chemotherapy early after surgery, either overall or in any subset of patients...

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..Lonidamine appears to be active against advanced breast cancer and its low toxicity would allow combination studies with chemotherapy...

..CONCLUSION: Anastrozole did not have a detrimental effect on lipid profiles following 3 months of therapy. There was a significant increase in CTx with anastrozole in contrast to tamoxifen...

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..We conclude that the slow release formulation of leuprorelin is effective in breast cancer treatment and that there is no major detriment to the use of the 3.75 rather than 7.5 mg dose...

..This can be done using simple, widely available technology and provides the opportunity to perform large-scale retrospective analyses of archival materials...

..Therefore D-Phe5SP appears to have more potent antiproliferative effects in tumour cells than normal cells, suggesting a role for this analogue in tumour treatment...

..The use of biotinylated nucleotides to identify DNA strand breaks is a commonly reported method of estimating cells numbers undergoing apoptosis; however, investigators report inconsistent results for a variety of reasons...

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..001) or IMS (83 vs 48%, P<0.001).The use of a multimarker real-time RT-PCR assay was therefore found to be the most sensitive technique for the detection of circulating epithelial cells in the blood of patients with breast cancer...

..Here we report a case of a male patient with metastatic breast cancer treated with letrozole who achieved clinical response associated with a decrease in blood oestradiol levels...

..2-11p15.5. The modest chemotherapy-driven genomic changes, despite profound loss of cell numbers, suggest that there is little therapeutic selection of resistant non-modal cell lineages...

..In summary we saw little correlation between SSR expression and growth inhibition by octreotide, either in vitro or clinically...

..Most deaths were due to disease progression in the palliative setting. We practice this form of audit each quarter and feed back to the treating teams so that deaths are discussed and practice monitored...

..CONCLUSIONS: Data from prospective databases that are currently recruiting will provide further important information concerning the management of this condition, and in particular the long-term sequelae for mother and fetus...

..Early HER-2 directed therapy (such as the monoclonal antibody trastuzumab) as a part of multimodal treatment may improve outcome in this poor prognosis cancer...

..The drug's reduced agonist activity may, in part, explain these observations and indicate a preferable biochemical profile for breast cancer treatment...

..These observations support the need for further evaluation of these markers in breast tumors as predictors of TAM resistance...

..3-11.3% by flow cytometry) and between different phases of treatment, and should provide a useful tool for further research on this process in solid tumours...

..We have therefore investigated whether neoadjuvant gefitinib, an EGFR inhibitor, might overcome biologic and clinical resistance to neoadjuvant anastrozole in a phase II placebo-controlled trial...

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..We report an audit of our experience with the luteinising hormone-releasing hormone agonist, goserelin, to achieve transient ovarian suppression during chemotherapy as a means of preserving ovarian function...

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..While all three aromatase inhibitors as adjuvant therapy were well tolerated, long-term effects on bone health and lipids are being monitored. Ongoing trials will better define the optimum use of aromatase inhibitors as adjuvant therapy...

..To review the state of the science with respect to preoperative systemic therapy and pathologic assessment in operable breast cancer...

..To explore potential differences in efficacy, treatment completion, and adverse events (AEs) in elderly women receiving adjuvant tamoxifen or letrozole for five years in the Breast International Group (BIG) 1-98 trial...

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..We investigated the effects of anastrozole and tamoxifen over time on serum VEGF and sVEGFR-1...

..These assessments also clearly indicated the eagerness of patients to participate actively in treatment decisions..

..Cross-talk' between the oestrogen receptor and HER2 pathway has stimulated interest in using trastuzumab in combination with endocrine therapy. Current clinical trials are investigating the role of this agent in the adjuvant setting...