Maintenance therapy in NSCLCBrodowicz, Thomas
2012 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-012-0062-8
The current gold standard of care for first-line therapy in patients with nonsmall cell lung cancer (NSCLC) is a platinum-based doublet chemotherapy, which is recommended for a maximum of six cycles. Since the prolongation of the first-line regimen does not translate into improved survival, and most patients experience progression within 3–4 months after first-line therapy, new treatment strategies have been explored to delay disease progression and prolong survival. Maintenance therapy has been proposed as either continuation maintenance with one part of the induction treatment or as switch maintenance with a different agent not used in first-line therapy. There is an accumulating body of evidence that both strategies administered immediately after induction therapy could improve survival in patients with good performance status. In this review, recent results of pivotal studies are summarized, since some studies have shown impressive benefits in terms of survival and their strategy should be considered as a new treatment option in selected patients.
The pathology of low and intermediate neuroendocrine lung tumorsPopper, Helmut H
2012 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-012-0047-7
Neuroendocrine lung tumors can be grouped into four epithelial and one mesenchymal tumor. The epithelial neuroendocrine tumors are further divided into two high-grade carcinomas, large and small cell neuroendocrine carcinomas, and into low-grade typical and intermediate grade atypical carcinoid. The only non-epithelial neuroendocrine tumor of the lung is pulmonary paraganglioma. In this short review, we will focus on the low and intermediate grade neuroendocrine tumors only. The review will touch on history, terminology, epidemiology, morphology, biology, and prognosis, and very briefly discuss therapeutic aspects. This review does not intend to completely discuss the vast amount of literature written on this subject, but will only cite the most relevant literature data.
Development of treatment and clinical results in childhood acute myeloid leukemias in HungarySzegedi, István; Jakab, Zsuzsanna; Masát, Péter; Kiss, Csongor
2012 memo - Magazine of European Medical Oncology
doi: 10.1007/s12254-012-0054-8
Acute myeloid leukemias (AML) comprising approximately 15 % of pediatric leukemias account for 30 % of all leukemic deaths in children worldwide. The 5-year overall survival (OS) rate now reaches 60–65 % in Western Europe, North America, and the developed countries of Australasia due to risk-tailored chemotherapy and vigorous supportive care. According to data of the Childhood Cancer Registry of the Hungarian Pediatric Oncology-Hematology Group (HPOG), 234 children with AML were treated using the AML-IGCI-90, the AML-BFM-93 (1990–2000), and the AML-BFM-98 (2001–2011) protocols in Hungary. Four-year OS of patients was 34.5 % with the IGCI-90 and 47.9 % with the BFM-98 protocol. Mortality in AML is mainly associated with progressive disease; however, 5–15 % of patients die from treatment-related complications. We have retrospectively analyzed in detail the causes of death in a cohort of patients diagnosed between 2001 and 2011. There were 59 of 112 (52.6 %) fatal events registered until December 31, 2011. The main causes of deaths were progressive disease in 28 patients (47.4 %), infection in 21 patients (35.5 %), bleeding in 6 patients (10.4 %). Hematopoietic stem cell transplantation (HSCT) was carried out in 30 patients and there were 12 (12/59; 20.3 %) transplantation-related deaths of that transplantation-related graft-versus-host disease (GVHD) was seen in 3 patients (5.0 %). Second malignancy (a medulloblastoma) in 1 patient (1.7 %) occurred. HPOG follows the advanced diagnostic and treatment methods of the International BFM Study Group (I-BFM-SG). Unfortunately, treatment outcome measures do not reach that of working groups participating in I-BFM-SG AML clinical trials. The key for improving cure rates in Hungary is to decrease treatment-related mortality (TRM) by applying more vigorous supportive care for children with AML preferably within the frames of clinical studies.