Presse Med
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MODEST RESULTS TILL NOW: Despite progress in the treatment of bronchial cancer (BC) over the last 20 years, notably with platinum-based chemotherapy, results in terms of survival have been modest and prognosis of the tumor generally remains unfavorable. CLASSICAL CHEMOTHERAPY: In non-small cell BC, 5 new cytotoxic agents: vinorelbine (a new mitotic inhibitor), gemcitabine (an antimetabolic), docetaxel and paclitaxel (of the taxane family), irinotecan (DNA repair enzyme inhibitor) have shown interesting results. ⋯ ONGOING CLINICAL ASSESSMENT OF NEW MOLECULES: Exploration of new drugs is an absolute priority. In parallel with the development of new traditional cytotoxics (trapazamin, oxaliplatin, ALIMTA a new antifolate, UFT and epothilone); studies on agents with biological or molecular effects: thyroxin-kinase inhibitors, trastuzumab--a monoclonal antibody--a metalloprotease inhibitor and marimastat are presently ongoing.
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TO PROLONG SURVIVAL: Systemic neo-adjuvant chemotherapy attempts to reduce the development of metastases. Data available on neoadjuvant chemotherapy of NSCLC come from three types of clinical trials. NEO-ADJUVANT CHEMOTHERAPY PHASE II TRIALS: Many trials have demonstrated that the neo-adjuvant approach is feasible, that it leads to a high rate of response, to the order of 50 to 70%, that it does not compromise surgery, and exhibits acceptable toxicity. ⋯ RANDOMIZED PHASE III TRIALS: Gave varying results: two of them only concerned small series of patients (60 in all) with stage IIIA NSCB, with positive results. The third study concerned 373 patients with stage I, II and IIIA cancers: survival at 3 years was increased by 11%, but this difference is not yet significant. Benefits were essentially apparent for stage I and II patients.
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Letter Case Reports
[Renal toxicity with a gemcitabine-cisplatin combination in lung cancer].