Michele Reni

..This randomized phase II trial aimed to identify the most promising regimen warranting phase III evaluation...

..The need for more active and effective systemic treatments, for a better knowledge of the disease biology, for new therapeutic agents and predictors of pattern of recurrence is evident...

..To better characterize a standard radiotherapy in glioblastoma multiforme, the impact on survival of different fields and doses was analyzed in a retrospective single center series...

..There is no proof that postoperative chemotherapy improves the outcome. At recurrence, platinum-, nitrosourea- or temozolomide-based chemotherapy can be administered, although there is no evidence of efficacy...

..Although some patients had a poor PS and had been heavily pre-treated, temozolomide yielded 26% objective responses and was well tolerated without any major toxicity...

..Results of other recent trials comparing gemcitabine-erlotinib, gemcitabine-capecitabine and gemcitabine-oxaliplatin combinations to single agent gemcitabine are briefly commented from a clinical perspective...

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..High-dose chemotherapy supported by stem cell autotransplant and intrathecal chemotherapy in meningeal failure have to be further investigated in prospective trials...

..Limited information on second-line treatment in patients with pancreatic adenocarcinoma is available. At time of first-line treatment failure, approximately half of the patients are candidates for further treatment...

..Toxicity was negligible. We conclude that temozolomide is active in recurrent primary brain lymphomas and should further be evaluated in this disease, perhaps in combination with MTX as initial treatment...

..This study evaluates the maximum tolerated dose (MTD) and activity of mitomycin, docetaxel, and irinotecan (MDI) regimen on metastatic pancreatic adenocarcinoma, previously treated with gemcitabine-containing chemotherapy...

..The analysis of treatment impact on quality of life (QOL) is reported...

..Results of a consecutive series treated by dose-intense PEFG regimen are herewith reported...

..Previous PFS interval may allow the identification of patients who are more likely to benefit from salvage treatment...

..We aimed to assess whether a four-drug regimen could improve 4 month progression-free survival compared with gemcitabine alone...

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..The activity and safety of this combination regimen were assessed by means of an observational study in a population of patients with progressive or recurrent pancreatic adenocarcinoma after gemcitabine-containing chemotherapy...

..The objective of this study was to evaluate the correlation between a decline in carbohydrate antigen 19-9 (CA 19-9) and survival in patients with advanced pancreatic cancer who received upfront chemotherapy...

..Some important therapeutic issues like the irradiation dose and volume are also analyzed. Finally, the main open questions as well as current and expected investigation trends are discussed...

..The current trial was aimed at assessing whether the replacement of E with docetaxel (D) may improve 6 months PFS (PFS6)...

..Since gemcitabine became the standard treatment for metastatic pancreatic adenocarcinoma, combination chemotherapy obtained conflicting impact on survival (OS)...

..To assess the impact on local control and survival of intraoperative radiotherapy (IORT) in resectable pancreatic adenocarcinoma...

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..To evaluate the optimal dose of methotrexate (MTX) and the efficacy of other drugs, intrathecal chemotherapy (CHT), and radiotherapy (RT) in primary brain lymphomas...

..Finally, the inclusion of relapsing or progressive PCNSL patients into second-line prospective clinical trials for testing therapeutic agents should be strongly encouraged...

..The role and timing of chemotherapy and radiation for treating stage III pancreatic adenocarcinoma remains controversial...

..Finally, the main open questions as well as current and expected investigation trends are discussed...

..Postoperative management of patients with pancreatic adenocarcinoma (PA) is controversial...

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..With respect to MTX-araC combination, araC dose was halved to minimize toxicity. Herein, we report tolerability, activity, and efficacy of MAT regimen and compare these results to those previously reported with MTX/ara-C combination...

..More than half of patients with pancreatic adenocarcinoma (PA) are candidates for further treatment when they experience upfront treatment failure...

..At the time of upfront treatment failure, over half of the patients with advanced pancreatic cancer are candidates for further treatment...

..Nevertheless, no study has focused on the survival impact of radiation parameters, as far as we know, and the optimal radiation schedule remains to be defined...

..The overall outcome for PCNSL patients is unsatisfactory and several therapeutic questions remain open. Modest progress in outcome reflects difficulties in conducting randomized trials and scarce molecular and biological knowledge...

..We assessed the effect of adding high-dose cytarabine to methotrexate in patients with newly diagnosed primary CNS lymphoma...

..In this study, the authors assessed the activity and safety of this combination regimen in patients with advanced BTA...

..To identify survival predictors and to design a prognostic score useful for distinguishing risk groups in immunocompetent patients with primary CNS lymphomas (PCNSL)...

..In resected patients, IORT is effective in decreasing local recurrences but has little impact on survival. To obtain more satisfactory results, new and more effective adjuvant therapies and better abdominal prophylaxis should be tested...

..To evaluate the efficacy and toxicity of a cisplatin, epirubicin, gemcitabine, and fluorouracil (PEF-G) schedule on stage IV pancreatic adenocarcinoma...

..If confirmed in prospective trials on PCNSL treated with HD-MTX alone, these data may suggest the necessity for alternative strategies in M-PCNSL considering the increased risk of MTX resistance by tumour cells...

..New treatment and follow-up strategies are needed to reduce the risk of BM and to diagnose them early enough for effective treatment...

..This critical review is focused on the analysis of published experiences on HDC/ASCT in PCNSL in order to provide preliminary answers to the most pressing questions in this field...

..In the years ahead, a well-established prognostic score will allow the separation of patients into risk groups, which could result in the application of risk-tailored therapeutic strategies...

..Age and type of failure had no predictive value. Salvage therapy significantly improves outcome and, possibly, quality of life. As many different treatments were used conclusions cannot be made regarding an optimal treatment schedule...

..The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection...

..No longitudinal data on hypothalamic-pituitary (HP) function are available in patients who had received cranial radiation therapy (CRT) for primary extrasellar brain tumors (PBT)...

..to study the impact of the 4DCT imaging technique on radiotherapy planning for pancreatic carcinoma. To evaluate the possibility of IMRT/IGRT to increase the dose to PTV subvolume...

..5 months (range 1-3.5 months); median survival was 4.0 months (range 2.0-7.5). Weekly administration of single-agent docetaxel does not seem to have any activity in the treatment of gemcitabine-resistant metastatic pancreatic cancer...

..In conclusion, a clear correlation between structural/genetic features and function could not be detected, suggesting the weakness of a "morphological" classification for the in vitro studies of pancreatic cancer...

..We assessed the efficacy of treatment with temozolomide, an oral second-generation alkylating agent, in a consecutive series of six patients with aggressive pituitary adenomas...

..Although studies published on PCNSL are increasing, several therapeutic questions still remain unanswered after a decade of research...

..To investigate the interobserver variability of intracranial tumour delineation on computed tomography (CT) scans using pre-operative MR hardcopies (CT+MR(conv)) or CT-MR (pre-operative) registered images (CT+MR(matched))...

..The procedure allows good quality images to be obtained over the whole patient's breathing cycle in terms of anatomical details, pancreatic enhancement and vessel definition...

..Reported data regarding intraocular lymphoma (IOL) management are anecdotal. Cases of IOL included in an international multicentre series of 378 immunocompetent patients with primary central nervous system lymphomas (PCNSLs) were reviewed...

..The assessment of impact of treatment on neuropsychological functions and quality of life is a mandatory endpoint in clinical trials...

..To assess the impact on survival of consolidation radiotherapy to bulky or semibulky lesions in patients with advanced diffuse large B cell lymphoma (DLCL) in complete remission after primary chemotherapy...

..Patients with multiple adjacent lesions that can be included within a single radiation field with acceptable toxicity should be treated as cases of monostotic PLB...

..The prognostic role of biological factors such as cytometry and genetic markers requires further investigation before any definitive conclusions can be drawn...

..Patients who achieved a complete remission were referred to RT, those with progressive disease were excluded from further study; all the remaining patients received a third course of CHT followed by RT...

..To characterize the therapeutic variables correlated to outcome in 370 patients with primary CNS lymphoma...

..MTX dose adjustments in patients with fast CL(crea) should be investigated...

..Myelosuppression was the dose-limiting toxicity, with 9.5% of lethal complications. After a median follow-up of 49 months, a plateau in the survival curve (5-year overall survival: 41 +/- 7%) was obtained...

..In conclusion, the presence of RPVI is independently associated with survival in PCNSL. This parameter can be easily and routinely assessed at diagnosis on histopathological specimens...

..New therapies are needed for pancreatic cancer...

..Thus, blocking TSLP production by CAFs might help to improve prognosis in pancreatic cancer...

..Rather, we underline the complexity of tumor-stroma interactions in the advanced stage of cancer and the need of further study...

..Accordingly, taxanes, and above all, new generation taxanes, appear to be suitable candidates for further testing to assess their role against pancreatic cancer in various clinical settings...

..Well-designed multi-institutional randomized trials are necessary to clarify the role of adjuvant therapy. Two ongoing phase III trials may provide relevant information...

..The PMX and CPT-11 combination displays a strong schedule-independent synergistic cytotoxic activity against pancreatic cancer, providing experimental basis for its clinical testing as salvage chemotherapy in pancreatic cancer patients...

..In Institute A, the goal of minimizing small bowel irradiation and prostate motion through the aforementioned technique, which makes patient position less comfortable, did not seem to considerably increase daily setup uncertainty...

..In recurrent disease, chemotherapy with temozolomide has been proven to be active and well-tolerated in phase II trials, but no comparative phase III trials of other cytotoxic drugs have been conducted...

..Adjuvant PCV chemotherapy increased progression-free survival but does not improve survival as compared to PCV given at recurrence. Chemotherapy with either PCV or temozolomide constitutes a standard for recurrent/progressive disease...

..Even if no survival advantage has been demonstrated for temozolomide versus PCV, we conclude that temozolomide should be preferred because of its greater tolerability...

..We evaluated in this trial whether the recursive partitioning analysis (RPA) retains its overall prognostic value and what the benefit of the combined modality is in each RPA class...

..The aim of the present multicenter phase II trial, therefore, was to ascertain the efficacy of second-line carmustine (BCNU) and irinotecan chemotherapy...

..The aim of this study was to evaluate correlations between 1p/19q deletions, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation, and response rate to TMZ in this setting...

..The primary end point of the present multicenter phase II study was progression-free survival (PFS) at 6 months (PFS-6); secondary end points included response, toxicity, and overall survival...

..Andres Ferreri) as well as controversies in the use of whole brain radiotherapy (WBRT) after chemotherapy (Dr. Michele Reni). The topics covered with discussants at the workshop are also summarised...

..No data on the role of chemotherapy in recurrent ependymal tumors are available in adults. The aim of the current study was to investigate outcomes after salvage chemotherapy in this setting...

..Hormonal therapy with progesterone antagonists has shown modest results, while chemotherapy with hydroxyurea appears moderately active...

..At time of recurrence/progression, a nitrosourea-based chemotherapy constitutes a reasonable option, as well as a temozolomide re-challenge for patients without progression during prior temozolomide treatment...