Tumori
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Randomized Controlled Trial Clinical Trial
[Topotecan: prospects for using it in combination therapy for ovarian carcinoma].
Topotecan is a semi-synthetic, water soluble topoisomerase I inhibitor which has recently been approved for the treatment of ovarian cancers after failure of first-line therapy. A number of different dosing schedules are being investigated in clinical trials including oral administration, a daily infusion on 5- or 3-consecutive days and a continuous infusion for 21 days. A 30-minute infusion of topotecan 1.5 mg/m2 on 5 consecutive days every 3 weeks, as standard schedule, produced response rates of 13.8 to 20.5% in the 3 largest phase II/III studies in women with advanced ovarian cancers who had either failed to respond or had relapsed after an initial response to platinum-based chemotherapy (N = 92 to 139), continuous 21-day infusion of topotecan 0.3 to 0.5 mg/m2 has shown efficacy in 2 small phase II studies. ⋯ Preliminary data suggest interesting results in terms of efficacy, manageable toxicity and new schedules of treatment for topotecan. Low dosages of drug in combination with other agent do not seem to influence the well-known data of efficacy or safety of topotecan literature. Probably the 3-day schedule allows a combination treatment, otherwise not feasible with the standard 5-day administration.
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Topotecan is a new active drug in the treatment of lung cancer. In advanced non small cell lung cancer (NSCLC) it showed 0-15% of objective response (OR) with 15% in the largest phase II study performed on 40 patients at the M. D. ⋯ The activity on brain metastases also must be developed. Oral formulation is interesting because it is less toxic and could be considered in less toxic regimens in particular in outfit or elderly patients. However in the next years the role of topotecan will be better defined performing phase III randomized trials.
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To follow a cohort of patients who had undergone polypectomies in order to assess the overall risk of subsequent colorectal cancer in relation with various adenomas characteristics. ⋯ High-grade dysplasia, number and size of adenomas were confirmed as the major cancer predictors. Based on this conclusion, a subgroup of patients, who may benefit from intensive surveillance colonoscopy, can be identifiable.