Bulletin du cancer
-
Randomized Controlled Trial Meta Analysis Comparative Study Clinical Trial
[Taxotere (docetaxel) and CPT 11 (irinotecan): phase I trials].
Two new drugs from two new chemotherapy compound families were developed concomitantly: Taxoter (docetaxel), a taxane derivate and CPT 11 (irinotecan) a topoisomerase inhibitor. Six phase I trials of Taxoter were performed. The limiting toxicity is neutropenia. ⋯ These two drugs are under evaluation in a large spectrum of tumors. Their original mechanism of action suggests interesting therapeutic properties. Clinical studies in combination with other drugs are in progress to define the role of topoisomerase I inhibitors and taxane in cancer therapy.
-
Review Comparative Study
[Topoisomerase I inhibitors. Review of phase II trials with irinotecan (CPT-11) and topotecan].
Topoisomerase I inhibitors are a new therapeutic class whose clinical evaluation began a few years ago; Irinotecan (CPT-11) gave interesting results in colon cancer; side effects were neutropenia, diarrhea, vomiting and a cholinergic syndrome. Topotecan was useful in lung and ovarian cancer; side effects were mostly hematologic. Undergoing studies concern dose optimization, mode of administration and therapeutic associations.
-
Review Comparative Study
[Paclitaxel (Taxol) and docetaxel (Taxotere): results of phase II trials in monochemotherapy].
The taxanes, paclitaxel and docetaxel, are the two presents clinically available representatives of a cytotoxic class with a new mechanism of action: they enhance microtubule assembly and inhibit their depolymerization. Their activity has been demonstrated in ovarian, breast and lung cancers. ⋯ Currently, use of premedication allows to circumvent hypersensitivity reactions encountered earlier with paclitaxel. For docetaxel, measures to prevent fluid retention are essential.
-
Arguments for the use of high-dose chemotherapy followed by autologous bone marrow transplantation in pediatric solid tumors are discussed. The dose effect relationship in pediatric oncology conventional chemotherapy is emphasized. Results of high-dose chemotherapy followed by autologous bone marrow transplantation are encouraging in metastatic neuroblastoma and Ewing's sarcoma. ⋯ This therapeutic approach could be of value in other pediatric solid tumors, particularly in some poor prognosis forms of Wilm's tumors. However, until now, the results remain preliminary. On the other hand, the role of this strategy in chemoresistant tumors, such as malignant gliomas, remains under investigation.
-
Review Comparative Study
Intensive chemotherapy with stem cell support-experience in pediatric solid tumours.
A recent Consensus Conference in Lyon reviewed the role of high-dose therapy with stem cell rescue in a variety of malignancies including childhood tumours. The conclusion was that with the exception of metastatic neuroblastoma there is still no proven role for this treatment strategy. It is more than 10 years since this approach was used in neuroblastoma and it has subsequently been applied to most of the common childhood solid tumours. ⋯ In this group of diseases which are inherently chemosensitive, the poor results from chemotherapy in the past have resulted from a failure to achieve appropriate drug levels at the tumour site and this may be potentially overcome by dose escalation. In Wilms' tumour, although the overall cure rate is very high, there appears to be a useful role for megatherapy in certain high-risk relapsed patients who have little chance of cure with conventional salvage therapy. There is an urgent need for international collaboration to design randomised studies which will as rapidly as possible address the issue of the role of these expensive and high morbidity procedures in childhood cancer.