Medical Oncology

A phase II study was performed to assess the efficacy and toxicity of UFT (tegafur-uracil in the molar ratio 1: 4) modulated with leucovorin (LV) in previously untreated patients with advanced colorectal carcinoma (CRC). 79 patients with measurable advanced colorectal cancer (CRC) and no prior chemotherapy were included. 75 patients were evaluable for toxicity and response. The regimen consisted of LV 500 mg/m2 administered intravenously on day 1, followed by oral UFT 390 mg/m2 on days 1–14. Patients received oral LV 15 mg every 12 h on days 2–14. Treatment was repeated every 28 days for a minimum of four courses per patient. Three hundred and ninety-eight cycles of chemotherapy were delivered (median five per patient). 7 patients (9%) had a complete response, and 22 a partial response for an overall response rate of 39%. Mild gastrointestinal toxicity was dose limiting: grade 3–4 diarrhoea appeared in 9% of patients. Other grade 3–4 toxicities were nausea/vomiting and mucositis in 4% of patients, gastric pain and leucopenia in 3%. Oral UFT modulated by oral LV is active in advanced CRC and can be administered on an outpatient basis with no significant toxicity requiring hospitalisation. Given its excellent tolerance profile and low toxicity, the regimen should be thoroughly studied and compared with 5-fluorouracil modulated by LV.

Objective.We assessed the response rate and the toxicity of cisplatin plus vinorelbine in patients with this condition.We assessed the response rate and the toxicity of cisplatin plus vinorelbine in patients with this condition.Patients and Method.Forty-two patients were included. Therapy consisted of cisplatin, 100 mg/m2 on day 1, and vinorelbine, 25 mg/m2 on days 1 and 8, given every 21 days. Therapy was continued up to six courses or progressive disease.Forty-two patients were included. Therapy consisted of cisplatin, 100 mg/m2 on day 1, and vinorelbine, 25 mg/m2 on days 1 and 8, given every 21 days. Therapy was continued up to six courses or progressive disease.Results.One hundred fifty-nine courses were given (median, three per patient). Dose reduction was applied in 13% of courses and 43% of patients. Grade 3 to 4 neutropenia appeared in 11% of courses and 35% of the patients. One patient died of febrile neutropenia. Ten percent of patients attained a complete response, and 23% attained a partial response (overall 33%, 95%CI 19%–47%). The median duration of response and median survival were 6 months. Twenty-four percent of patients remain alive at 1 year.One hundred fifty-nine courses were given (median, three per patient). Dose reduction was applied in 13% of courses and 43% of patients. Grade 3 to 4 neutropenia appeared in 11% of courses and 35% of the patients. One patient died of febrile neutropenia. Ten percent of patients attained a complete response, and 23% attained a partial response (overall 33%, 95%CI 19%–47%). The median duration of response and median survival were 6 months. Twenty-four percent of patients remain alive at 1 year.Conclusions.The combination of cisplatin and vinorelbine is moderately active in patients with recurrent or metastatic carcinomas of the head and neck and avoids the inconvenience of prolonged infusions of 5-fluorouracil. © 2002 Wiley Periodicals, Inc. Head Neck 24: 1054–1059, 2002The combination of cisplatin and vinorelbine is moderately active in patients with recurrent or metastatic carcinomas of the head and neck and avoids the inconvenience of prolonged infusions of 5-fluorouracil. © 2002 Wiley Periodicals, Inc. Head Neck 24: 1054–1059, 2002

We have reviewed 29 patients whose first sign of a tumour was a bone metastasis. Two primaries were identified, lung adenocarcinoma and uterine adenocarcinoma and in 2 cases a presumptive diagnosis of tumours of the breast and prostate was made. The mean survival time was 3 months. When bone metastases are found in the absence of a primary tumour, investigation must include a clinical history, physical examination, routine laboratory tests and chest radiographs. Mammography should be done in women, particularly when there are palpable axillary nodes. Abdominal CT scanning and bronchoscopy should only be undertaken when there is a clinical indication. Revue de 29 dossiers de malades chez qui le premier signe de néoplasie était une métastase osseuse. Deux des cancers primitifs ont pu être identifiés: l'un du poumon et l'autre de l'utérus, et dans deux cas on a posé le diagnostic présumé de tumeur du sein et de la prostate. Quand on découvre une métastase osseuse et que le cancer primitif n'est pas connu le bilan doit comporter une anamnèse, un examen clinique, les tests habituels de laboratoire et des radiographies pulmonaires. Une mammographie peut être demandée chez la femme, surtout s'il existe une adénopathie axillaire palpable. On ne pratiquera un examen tomodensitométrique de l'abdomen et une bronchoscopie que si des arguments cliniques les justifient.

Fanconi anemia (FA) family of proteins participates in the DNA repair pathway by homologous recombination, and it is currently formed by 13 genes. Some of these proteins also confer susceptibility to hereditary breast and ovarian cancer (HBOC), since FANCD1 is the BRCA2 breast cancer susceptibility gene, and FANCN/PALB2 and FANCJ/BRIP1 explain 2% of non-BRCA1/2 HBOC families. Thus, there is an important connection between FA and BRCA pathways. In a previous case–control association study analysing FANCA, FANCD2 and FANCL, we reported an association between FANCD2 and sporadic breast cancer (BC) risk (OR = 1.35). In order to know whether variants in other FA genes could also be involved in this association, we have extended our study with the rest of FA genes and some others implicated in the BRCA pathway. We have also analyzed the correlation with survival, nodal metastasis and hormonal receptors (ER− and PR−). A total of 61 SNPs in ten FA genes (FANC-B, -C, -D1, -E, -F, -G, -I, -J, -M, -N) and five FA related genes (ATM, ATR, BRCA1, H2AX and USP1) were studied in a total of 547 consecutive and nonrelated sporadic BC cases and 552 unaffected controls from the Spanish population. Association analyses reported marginal statistically significant results with the minor allele of intronic SNPs in three genes: BRCA1, BRCA2/FANCD1, and ATM. Survival association with SNPs on FANCC and BRCA2/FANCD1 genes were also reported. Sub-group analyses revealed associations between SNPs on FANCI and ATM and nodal metastasis status and between FANCJ/BRIP1 and FANCN/PALB2 and PR− status.