Prospective assessment of XRCC3, XPD and Aurora kinase A single-nucleotide polymorphisms in advanced lung cancer.

PURPOSE: New therapeutic approaches are being developed based on findings that several genetic abnormalities underlying non-small-cell lung cancer (NSCLC) can influence chemosensitivity. The identification of molecular markers, useful for therapeutic decisions in lung cancer, is thus crucial for disease management. The present study evaluated single-nucleotide polymorphisms (SNPs) in XRCC3, XPD and Aurora kinase A in NSCLC patients in order to assess whether these biomarkers were able to predict the outcomes of the patients. METHODS: The Spanish Lung Cancer Group prospectively assessed this clinical study. Eligible patients had histologically confirmed stage IV or IIIB (with malignant pleural effusion) NSCLC, which had not previously been treated with chemotherapy, and a World Health Organization performance status (PS) of 0-1. Patients received intravenous doses of vinorelbine 25 mg/m(2) on days 1 and 8, and cisplatin 75 mg/m(2) on day 1, every 21 days for a maximum of 6 cycles. Venous blood was collected from each, and genomic DNA was isolated. SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 were assessed. RESULTS: The study included 180 patients. Median age was 62 years; 87 % were male; 34 % had PS 0; and 83 % had stage IV disease. The median number of cycles was 4. Time to progression was 5.1 months (95 % CI, 4.2-5.9). Overall median survival was 8.6 months (95 % CI, 7.1-10.1). There was no significant association between SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 in outcome or toxicity. CONCLUSIONS: Our findings indicate that SNPs in XRCC3, XPD or Aurora kinase A cannot predict outcomes in advanced NSCLC patients treated with platinum-based chemotherapy.

Outcome of treating advanced neuroendocrine tumours with radiolabelled somatostatin analogues.

OBJECTIVES: To evaluate the initial response and outcomes (quality of life and presence of side effects) in patients with advanced neuroendocrine tumours (NET) after treatment with radiolabelled somatostatin analogues: (90)Y-DOTATyr3- octreotide ((90)Y-DOTATOC) and (177)Lu-DOTA-Tyr3- octreotate ((177)Lu-DOTATATE). MATERIAL AND METHODS: The study included 5 patients with advanced NET referred to European centres for treatment with (90)Y-DOTATOC and (177)Lu-DOTATATE after lack of response to conventional treatment. The mean age was 45.6 years (29-68 years). Response to therapy was assessed according to: (1) RECIST criteria, as complete response, partial response, stable disease or disease progression, (2) post-treatment survival time and (3) quality of life, using the Karnofsky performance index. RESULTS: All patients survived for >20 months after treatment; mean survival time was 28 months. At the time of writing, three of the patients are alive after 20, 26 and 37 months. Partial response was observed in one patient, stable disease in three and disease progression in the fifth patient. A good-to-excellent post-treatment quality of life was observed in all patients. CONCLUSION: Therapy with radiolabelled somatostatin analogues showed promising results in patients with advanced NET, with a partial response or disease stabilisation in four of the five patients, who have enjoyed an extended survival period and an improved quality of life.

Outcome of treating advanced neuroendocrine tumours with radiolabelled somatostatin analogues

OBJECTIVES: To evaluate the initial response and outcomes (quality of life and presence of side effects) in patients with advanced neuroendocrine tumours (NET) after treatment with radiolabelled somatostatin analogues: (90)Y-DOTATyr3- octreotide ((90)Y-DOTATOC) and (177)Lu-DOTA-Tyr3- octreotate ((177)Lu-DOTATATE). MATERIAL AND METHODS: The study included 5 patients with advanced NET referred to European centres for treatment with (90)Y-DOTATOC and (177)Lu-DOTATATE after lack of response to conventional treatment. The mean age was 45.6 years (29-68 years). Response to therapy was assessed according to: (1) RECIST criteria, as complete response, partial response, stable disease or disease progression, (2) post-treatment survival time and (3) quality of life, using the Karnofsky performance index. RESULTS: All patients survived for >20 months after treatment; mean survival time was 28 months. At the time of writing, three of the patients are alive after 20, 26 and 37 months. Partial response was observed in one patient, stable disease in three and disease progression in the fifth patient. A good-to-excellent post-treatment quality of life was observed in all patients. CONCLUSION: Therapy with radiolabelled somatostatin analogues showed promising results in patients with advanced NET, with a partial response or disease stabilisation in four of the five patients, who have enjoyed an extended survival period and an improved quality of life (AU)

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Tumor de colisión renal: un caso inusual de carcinoma de células renales y leiomiosarcoma renal / Kidney collition tumor: an unusual case of renal cell carcinoma and renal leiomyosarcoma

Propósito: En el tumor de colisión coexistendos tumores histológicamente diferentes sin mezclaen la interfase. Los tumores de colisión que afectanal riñón son extremadamente raros.Material y métodos: Presentamos el caso deuna paciente con un tumor de colisión renal formadopor un carcinoma de células renales y un leiomiosarcomarenal.Resultados: El manejo clínico de este caso fuecomplejo debido a la escasa experiencia en el tratamientode este tipo de tumores y los pobres resultadosque se obtienen con el tratamiento sistémico enambos tipos de tumores.Conclusiones: Existen muy pocas comunicacionessobre tumores de colisión renales. Consideramosde interés el conocimiento sobre la existenciade estos tumores así como su complejidad clínica

Purpose: A collition tumor is characterized bythe coexistence of two histologically differentneoplasms that are independent of any interfacemixing. Kidney collition tumors are extremely rare.Material and methods: We present the caseof a patient diagnosed of a kidney collition tumorconsisting of renal cell carcinoma and renalleiomyosarcoma.Results: The clinical management of thispatient was complex due to the limited experiencein the treatment of his kind of tumors, and to thepoor results obtained with systemic treatment of thetwo types of tumors involved.Conclusions: There are very few communicationsabout collition tumors of the kidney, andwe consider interesting to repot the existence ofthese tumors as well as their clinical complexity

ProMACE-C-MOPP in aggressive non-Hodgkin's lymphoma. Long-term results in 45 patients treated in a single institution.

Forty-five previously untreated patients with intermediate or high-grade non-Hodgkin's lymphoma were treated with the Pro-MACE-C-MOPP regimen (flexitherapy). The median age of the patients was 51 years, 51% had constitutional symptoms, 78% were in Ann Arbor stage III-IV, 40% had two or more involved extranodal sites and 87% had serum lactate dehydrogenase (LDH) above 225 U/l. Twenty-two (49%) patients had immunoblastic lymphoma (Working Formulation). Overall, 40% of the patients attained complete response (CR) and there were no relapses. The dose-limiting toxicity was myelosuppression (69% of the patients with WBC less than 1.9 x 10(9)/l). Three deaths were attributed primarily to chemotherapy, but another two patients died of long-term complications of therapy. After a median follow-up of 50 months (18-80), 15 patients (33%) were alive without lymphoma. Only histologic subtype (intermediate vs. high) and abdominal involvement were prognostic factors for CR rate. Our results indicate that ProMACE-C-MOPP is an effective regimen for intermediate-grade lymphomas. However, in high-risk patients the regimen seems to be less effective than originally reported.

[Very late recurrence (14 years) of a lymphoblastic leukemia-lymphoma]. / Recidiva muy tardía (14 años) de un linfoma linfoblástico leucemizado.

We report a two and a half years old girl diagnosed in 1972 of lymphoblastic leukemia-lymphoma with pleural, mediastinal and bone marrow involvement. Clinical remission developed with chemotherapy (induction and maintenance). This situation persisted until June 1986 (14 years after the diagnosis and 11 years after cessation of any therapy), when mediastinal mass, pleural effusion and bilateral renal infiltration developed again, and also peripheral lymphadenopathy; bone marrow involvement is now absent. This case is considered as an exceptionally late relapse. Other possibilities are discussed, while the difficulty to define "cure" in these patients is emphasized.