Abstract:
:Approximately one third of patients diagnosed with early-stage colon cancer will present with lymph node involvement (stage III) and about one quarter with transmural bowel wall invasion but negative lymph nodes (stage II). Adjuvant chemotherapy targets micrometastatic disease to improve disease-free (DFS) and overall survival (OS). While beneficial for stage III patients, the role of adjuvant chemotherapy is unestablished in stage II disease. This likely relates to the improved outcome of these patients, and the difficulties in developing studies with sufficient power to document benefit in this patient population. However, recent investigation also suggests that molecular differences may exist between stage II and III cancers and within stage II patients. Validated pathologic prognostic markers are useful at identifying stage II patients at high risk for recurrence for whom the benefit from adjuvant chemotherapy may be greater. Such high-risk features include higher T stage (T4 v T3), suboptimal lymph node retrieval, presence of lymphovascular invasion, bowel obstruction, or bowel perforation, and poorly differentiated histology. However, for the majority of patients who do not carry any of these adverse features and are classified as "average-risk" stage II patients, the benefit of adjuvant chemotherapy remains unproven. Emerging understanding of the underlying biology of stage II colon cancer has identified molecular markers that may change this paradigm and improve our risk assessment and treatment choices for stage II disease. Assessment of microsatellite stability (MSI), which serves as a marker for DNA mismatch repair (MMR) system function, has emerged as a useful tool for risk stratification of patients with stage II colon cancer. Patients with high frequency of MSI have been shown to have increased OS and limited benefit from 5-fluorouracil (5-FU)-based chemotherapy. Additional research is necessary to clearly define the most appropriate way to use this marker and others in routine clinical practice.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Dotan E,Cohen SJdoi
10.1053/j.seminoncol.2011.05.005subject
Has Abstractpub_date
2011-08-01 00:00:00pages
511-20issue
4eissn
0093-7754issn
1532-8708pii
S0093-7754(11)00151-5journal_volume
38pub_type
杂志文章,评审abstract::Knowledge of the pharmacokinetics of a drug is essential to the optimal design of the dose and schedule of chemotherapy protocols. As an extension, an understanding of the mechanism of drug action is necessary to construct the optimal strategy for combination chemotherapy. Nucleoside antimetabolites such as fludarabin...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) appears to be one of the most active drugs in the treatment of advanced head and neck cancer. The maximum tolerated dose of paclitaxel in combination with carboplatin is currently being evaluated in phase I/II studies. We designed a phase II study to eval...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::Metastatic germ cell cancer is a very heterogeneous group with respect to prognosis under cisplatinum-based chemotherapy. The main determinants of complete response and survival are not only the extension of the metastases but much more the biology of the underlying tumor which is represented by the location of the me...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-04-01 00:00:00
abstract::Navelbine (NVB) or 5' nor-anhydro-vinblastine was shown to present a broader antitumor activity and to induce fewer side effects than vinblastine (VBL) or vincristine (VCR). The possible mechanisms of these differences were analyzed with in vitro methods. At substoichiometric concentrations, the three drugs inhibit mi...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::Gemcitabine is a novel nucleoside analogue that has demonstrated activity against several solid tumors. A large phase II study has been performed in Europe and Canada with a total enrollment of 161 non-small cell lung cancer patients, 26 of whom were from the Institut Gustave-Roussy. Patient characteristics were the s...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1997-04-01 00:00:00
abstract::Inflammatory breast cancer (IBC) is an extremely aggressive disease that progresses rapidly and carries a very grim prognosis. It is characterized by erythema, rapid enlargement of the breast, skin ridging, and a characteristic peau d'orange appearance of the skin secondary to dermal lymphatic tumor involvement. Altho...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2007.11.010
更新日期:2008-02-01 00:00:00
abstract::Anemia is a multi-symptom syndrome involving both physical and emotional problems that can be evaluated for their impact on quality of life. Fatigue is the cardinal symptom of anemia, reported by three of four cancer patients using the general version of the Functional Assessment of Cancer Therapy (FACT-G) questionnai...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract::Activation of mammalian target of rapamycin (mTOR) signaling occurs in a wide variety of human tumors and can lead to increased susceptibility to mTOR inhibitors. Temsirolimus, a novel analog of rapamycin, has shown promising preclinical and early clinical anti-tumor activity in various solid and hematologic tumor typ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2009.10.010
更新日期:2009-12-01 00:00:00
abstract::Remarkable strides have been made in the management of infectious complications after bone marrow transplantation. Improved understanding of patterns of infection, the introduction of new antimicrobials, the advent of cytokines to enhance immune recovery, the development of better strategies to control graft-versus-ho...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::HER2 is a transmembrane growth factor receptor found in normal and malignant breast epithelial cells. Phosphorylation of the intracellular tyrosine kinase results in intracellular signaling and activation of genes involved in cell growth. Overexpression of HER2 has independent prognostic significance in early breast c...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:2001-12-01 00:00:00
abstract::Platelet-derived microparticles (PMPs) represent the most abundant microparticle (MP) subtype. Their presence reflects platelet activity, physiopathology, and the thrombotic state of cancer patients. The quantity and composition of PMPs strictly depends on the way MPs were generated. Because platelets play a key role ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.04.010
更新日期:2014-06-01 00:00:00
abstract::The availability of subcutaneously (SC) administered amifostine may present an advantage for radioprotectant therapy in head and neck cancer patients. In a randomized phase II trial comparing SC amifostine versus no amifostine in 140 patients undergoing radiation therapy for head and neck, thoracic, or pelvic cancers,...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/sonc.2002.37350b
更新日期:2002-12-01 00:00:00
abstract::The activity of single-agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has been documented in untreated and previously treated metastatic breast cancer, including both patients with anthracycline-resistant disease and those with extensive pretreatment. Such activity has prompted investigations of...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract::Approximately 25% of all lung cancer cases diagnosed in 1993 were due to small cell lung cancer (SCLC). Approximately one third of all SCLC patients present with limited disease. Efforts to improve treatment results for patients with limited-stage SCLC include two recent meta-analyses of combined-modality treatment in...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-02-01 00:00:00
abstract::The outcome of chemotherapy for patients with stage IV melanoma is unsatisfactory, since durable responses are rarely achieved. More experimental treatments, such as vaccine approaches, antibody treatments, and gene therapy are being developed and are of high scientific interest; however, their efficacy in advanced me...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.35240
更新日期:2002-10-01 00:00:00
abstract::Capecitabine is an orally administered fluoropyrimidine carbamate that is preferentially converted to 5-fluorouracil in tumors relative to normal tissue. Three different dosing regimens were investigated in phase I studies: continuous monotherapy, intermittent monotherapy, and intermittent therapy supplemented with le...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1016/s0093-7754(01)90251-9
更新日期:2001-02-01 00:00:00
abstract::Postmenopausal patients with advanced measurable and/or evaluable breast cancer entered a phase II trial of multiple agent cytotoxic therapy combined with endocrine therapy. Cycles of PNMF (prednimustine, novantrone, methotrexate, and 5-fluorouracil) were repeated every 4 weeks as follows: P, 100 mg/m2 PO on days 1 to...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::The outcomes in young adults aged 20-39 with sarcoma tend to be inferior compared to those in children and adolescents. There are differences in sarcoma histotype distribution with age, such that pediatric-type tumors predominate in the 20- to 25-year-old group while more adult-type sarcomas occur in those aged 35-39 ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2009.03.006
更新日期:2009-06-01 00:00:00
abstract::Cisplatin is recognized as an active chemotherapeutic agent in a broad variety of human tumors. The severe emetic effects of cisplatin, however, result in both acute and delayed emesis syndromes causing considerable morbidity. Over the last decade, the standard of therapy for control of cisplatin-induced emesis has be...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00
abstract::Cancer cells that express excessive levels of Bcl-2 pose a major problem in the delivery of curative therapy. Most treatments for such cancer involve chemotherapy to induce the apoptotic process. While these therapies often result in disease control for periods of time, failure to initiate apoptosis as a result of acq...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.10.014
更新日期:2004-12-01 00:00:00
abstract::The goal of this National Cancer Institute-sponsored phase I trial is to determine the feasibility, toxicity, and pharmacokinetics of continuous-infusion (24 hr/d, 7 d/wk, 7-week total) intravenous paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) combined with standard curative radiotherapy (RT) for pre...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::Advanced-stage mantle cell lymphoma (MCL) is a disease for which no curative treatment strategy exists. Results with standard combination chemotherapy, with or without an anthracycline, are disappointing, and new and better therapies are needed. High-dose therapy and autologous stem-cell transplantation (ASCT) have be...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:2002-02-01 00:00:00
abstract::Pharmacologic interventions for cancer risk reduction involve the chronic administration of synthetic or natural agents to reduce or delay the occurrence of malignancy. Despite the strong evidence for a favorable risk-benefit ratio for a number of agents in several common malignancies such as breast and prostate cance...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2015.09.014
更新日期:2016-02-01 00:00:00
abstract::Denileukin diftitox (ONTAK; Seragen Inc, San Diego, CA) is a fusion protein designed to direct the cytocidal action of diphtheria toxin to cells that overexpress the IL-2 receptor. The human IL-2 receptor exists in three isoforms: low (CD25), intermediate (CD122/CD132), and high (CD25/CD122/CD132) affinity. The high-a...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2005.12.017
更新日期:2006-02-01 00:00:00
abstract::Drug resistance is one of the most important problems in the treatment of cancer. Patients become resistant not only to the drugs used initially, but also those to which they have not yet been exposed. A number of factors influence the therapeutic outcome of patients with breast cancer, foremost of which is the tumor ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00
abstract::Robust pharmacodynamic assay results are valuable for informing go/no-go decisions about continued development of new anti-cancer agents and for identifying combinations of targeted agents, but often pharmacodynamic results are too incomplete or variable to fulfill this role. Our experience suggests that variable reag...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2016.06.006
更新日期:2016-08-01 00:00:00
abstract::Session IV of the Second International Colloquium on Cardio-Oncology held in Kraków, focused on the cardiovascular risks of using hormone replacement therapy in breast cancer and androgen deprivation therapy in prostate cancer and continued the theme from Session 3 with a discussion of risk reduction strategies. The d...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2019.01.006
更新日期:2019-12-01 00:00:00
abstract::Over the last 40 years the National Cancer Institute (NCI) has created a vibrant public-private partnership for the implementation of NCI-sponsored cooperative group (Network) clinical trials throughout the United States and Canada. Over these four decades, the cancer clinical trials process has become more complex mo...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2015.07.011
更新日期:2015-10-01 00:00:00
abstract::Although chemotherapy for advanced bladder cancer has historically been based on cisplatin-based combination regimens, the limitations of these regimens both in terms of efficacy and toxicity are now widely appreciated. In response to these limitations, other single agents have been studied, and a number have demonstr...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Among new patients with small cell lung cancer (SCLC), 20% to 25% are over 70 years of age and account for 8,000 cases annually in the United States. For such patients, intensive, aggressive, cytotoxic, combination chemotherapy is not often used because of its association with unacceptable morbidity and mortality rate...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00