[Interdisciplinary recommendations for the treatment of metastatic renal cell carcinoma]. / Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms.

With the introduction of targeted drug therapies, a paradigm shift for the treatment of metastatic renal cell carcinoma has taken place. New compounds like sunitinib, sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards to replace the use of cytokines as standard therapy. Recently, these substances have been complemented by everolimus and pazopanib. An interdisciplinary consensus conference was held to discuss which criteria to consider when using these drugs (treatment sequence) and what questions remain unanswered based on the current study situation (open questions). Results from the 2009 conference provided the basis for the 2010 meeting. The results of the 2010 conference are presented as short theses.

[Interdisciplinary recommendations for the treatment of metastatic renal cell carcinoma]. / Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms.

With the introduction of targeted therapies, a -paradigm shift for the treatment of metastatic renal cell carcinoma has taken place. The use of cytokines as the long-standing standard therapy has declined. New compounds like sunitinib, -sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards. Since mid-2009, these substances have been complemented by everolimus. An interdisciplinary consensus conference was held to discuss what criteria to consider when using these drugs (treatment sequence) and what questions remain unanswered based on the current study situation (open questions). Results from the 2008 conference provided the basis for the 2009 meeting. The results of the 2009 conference are presented as short theses.

[Interdisciplinary recommendations for the treatment of metastatic renal cell carcinoma]. / Interdisziplinäre Empfehlungen zur Behandlung des metastasierten Nierenzellkarzinoms.

With the introduction of targeted therapies, a paradigm shift for the treatment of metastatic renal cell cancer has taken place. New compounds like sunitinib, sorafenib, bevacizumab and temsirolimus have become established as new therapeutic standards. An interdisciplinary consensus conference was held to discuss treatment sequences and open questions. Results from the 2007 conference provided the basis for the 2008 meeting. The results of the 2008 conference are presented as short theses.

[Current role for induction chemotherapy in head and neck tumors]. / Stellenwert der Induktionstherapie bei Kopf-Hals-Tumoren.

According to recent publications in the New England Journal of Medicine (TAX323, TAX324) of the study groups around Jan Vermorken and Marshall Posner induction chemotherapy in squamous cell carcinomas of the head-neck area (in the closer: Oro-hypopharynx, oral cavity and larynx) currently seems to generate a worldwide renaissance. Renaissance, because in the last few decades, induction chemo therapy in this group of tumors after lack of survival improvement in the vast majority of studies was again abandoned. The new data raise the question for which entities induction chemo therapy can be recommended (actually, a combination of docetaxel, cisplatin and 5-fluorouracil; TPF)? The unbroken high value of primary surgery with adjuvant radiation or chemo radiation was complementary to primary radio chemotherapy for non resectable tumors until today worldwide. Running studies are sorting out the role of induction chemotherapy in the current context of clarifying optimal multimodal treatment.

Endocrine function and bone metabolism 5 years after autologous bone marrow/blood-derived progenitor cell transplantation.

BACKGROUND: High dose chemotherapy with or without total body irradiation supported by autologous transplantation of hematopoietic progenitor cells is increasingly being used for hematologic and solid tumors. However, there is only limited information available on late toxicity. METHODS: The authors investigated endocrine function and bone metabolism in 29 patients with a median interval of 5 years after autografting. RESULTS: In accordance with an earlier report on this patient cohort, ovarian failure was observed to be unchanged, except for one woman with recovered ovarian function who gave birth to two healthy children. In two-thirds of the men, follicle-stimulating hormone levels were elevated, suggesting germinal aplasia. Determination of bone mineral density did not reveal osteopenia, despite several risk factors: prolonged immobilization, high dose corticosteroid treatment, and, in women, transient estrogen insufficiency. Frequent impairment of thyroid function has been reported in patients receiving single dose total body irradiation. Overt or subclinical hypothyroidism was not detected, most likely because the total body irradiation was hyperfractionated. CONCLUSIONS: With the exception of gonadal failure, no significant late effects on endocrine function or bone metabolism were observed in this patient cohort.

[Repetitive immuno-embolization of inoperative liver metastases of renal cell carcinoma. Method characterization and preliminary results]. / Repetitive Immunembolisation inoperabler Lebermetastasen beim Nierenzellkarzinom. Methodencharakterisierung und vorläufige Ergebnisse.

Interleukin 2 (IL2)-based immunotherapy is effective in a subgroup of patients with metastatic renal cancer, but cure from liver metastases is very rare and even the selection of patients to be treated is very much limited by the toxicity of IL2. To reduce this toxicity and to augment the efficacy of intrahepatic IL2 application, a protocol of combined rIL2 (3 mg/day) and Lipiodol (2-5 ml/day according to tumour size), via a catheter inserted percutaneously into the hepatic artery, was implemented. As an adverse reaction, moderate fever (WHO) grade I and II was noted. A partial remission was seen in one patient and stable disease in four patients over a period of 2-6 years (median 32.2 month). It seems that immuno-embolisation of otherwise intractable liver metastases of renal cancer is well tolerated and its efficacy may be augmented by optimisation of the therapeutic protocol.

Peripheral blood mononuclear cell collection from patients undergoing adoptive immunotherapy or peripheral blood-derived stem cell transplantation and from healthy donors.

The demand for collection of mononuclear cells from the peripheral blood of patients for therapeutic purposes is rapidly increasing. Automated blood cell separators are usually designed for collection of blood components from healthy donors. We reviewed safety and efficiency of collection data of a new procedure for the Fenwal CS 3000 blood cell separator in 125 collections from normal donors and 101 collections from patients after IL-2 pretreatment or chemotherapy. The new procedure set red blood cell spillovers to occur at 3.5 minute intervals, using procedure 1 with the interface detector set at 1,000 and the standard granulocyte and collection chambers. Despite significant anemia and thrombocytopenia in a large number of patients no serious procedure-related side effects occurred. The lymphocyte yield was 4.74 +/- 1.6 x 10(9) per 5 liters of blood processed in normal donors and 24.2 +/- 12.0 x 10(9) per 10 liters of blood processed after IL-2 treatment. After chemotherapy the lymphocyte yield was 4.5 +/- 3.1 x 10(9) per 10 liters of blood processed; the collection efficiency was found to be significantly lower in this group. The main problem was the platelet loss of 35.6 +/- 12% of the initial count in normal donors, 40.3 +/- 14.1% after IL-2 treatment, and 42.1 +/- 18.0% after chemotherapy. The platelet loss is, however, closely related to the preapheresis platelet count; patients with thrombocytopenia lose fewer platelets than normal donors. Therefore the procedure was found to be safe for patients with a platelet count as low as 20/nl. This report provides a basis for safe, effective mononuclear cell collection from patients with very abnormal peripheral blood counts.