levoleucovorin and Retroperitoneal-Neoplasms

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Drug Administration Schedule; Humans; Leucovorin; Liver Neoplasms; Lymphoma, B-Cell; Male; Methotrexate; Neoplasm Invasiveness; Pancreatic Neoplasms; Prednisone; Remission Induction; Retroperitoneal Neoplasms; Stomach Neoplasms; Vincristine

Programmed cell death 1 (PD-1) inhibitors have limited effect in pancreatic ductal adenocarcinoma (PDAC), underscoring the need to co-target alternative pathways. CXC chemokine receptor 4 (CXCR4) blockade promotes T cell tumor infiltration and is synergistic with anti-PD-1 therapy in PDAC mouse models. We conducted a phase IIa, open-label, two-cohort study to assess the safety, efficacy and immunobiological effects of the CXCR4 antagonist BL-8040 (motixafortide) with pembrolizumab and chemotherapy in metastatic PDAC (NCT02826486). The primary outcome was objective response rate (ORR). Secondary outcomes were overall survival (OS), disease control rate (DCR) and safety. In cohort 1, 37 patients with chemotherapy-resistant disease received BL-8040 and pembrolizumab. The DCR was 34.5% in the evaluable population (modified intention to treat, mITT; N = 29), including nine patients (31%) with stable disease and one patient (3.4%) with partial response. Median OS (mOS) was 3.3 months in the ITT population. Notably, in patients receiving study drugs as second-line therapy, the mOS was 7.5 months. BL-8040 increased CD8

Topics: Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Pancreatic Ductal; CD8-Positive T-Lymphocytes; Female; Fluorouracil; Humans; Irinotecan; Leucovorin; Liver Neoplasms; Lung Neoplasms; Lymph Nodes; Lymphatic Metastasis; Lymphocytes, Tumor-Infiltrating; Male; Middle Aged; Myeloid-Derived Suppressor Cells; Pancreatic Neoplasms; Peptides; Peritoneal Neoplasms; Receptors, CXCR4; Retroperitoneal Neoplasms; Survival Rate; T-Lymphocytes, Regulatory; Treatment Outcome

There is no known effective salvage chemotherapy for patients with refractory or relapsed urothelial tumors after methotrexate/cisplatin-based regimen. We report the results of a phase II trial with the FIFO regimen that includes from day 1 to 5: fluorouracil 350 mg/m2, folinic acid 20 mg/m2, and ifosfamide 1000 mg/m2, Q4W. Fifteen patients with metastatic measurable urothelial cancer were enrolled in this trial. Previous therapy included M-VAC regimen in 11 patients, CMV regimen in 3 patients, and both regimens in 1 patient. Thirty-one courses were delivered. Toxicity was moderate, including encephalopathy grade 2 in 2 patients and hematological toxicity grade 3 in 2 others. However, an early death occurred on day 1 in a patient who progressed rapidly and died from hepatic insufficiency after initial encephalopathy. No objective response was seen. Twelve patients progressed during FIFO therapy and 3 patients experienced a stable disease. Despite almost encouraging results of fluorouracil and ifosfamide in the literature, their combination according to our schedule is not active in urothelial cancer.

Topics: Adrenal Gland Neoplasms; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Carcinoma, Transitional Cell; Fluorouracil; Hepatic Encephalopathy; Humans; Ifosfamide; Leucovorin; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Retroperitoneal Neoplasms; Salvage Therapy; Treatment Failure; Urologic Neoplasms

A 71-year-old woman was referred to a surgical oncology clinic after CT raised suspicion for a bladder neoplasm. She had previously undergone right hemicolectomy and received adjuvant chemotherapy for pT3N1MX cancer of the cecum. A retroperitoneal recurrence had been deemed unsuitable for surgical resection, and had instead been treated with chemoradiation therapy. Follow-up CT raised suspicion for a possible bladder neoplasm.. CT, physical examination, urinalysis, cystoscopy with biopsy, pathological analysis and immunohistochemical analysis.. Adenocarcinoma of the cecum metastatic to the bladder.. The patient underwent open bladder resection with total excision of the neoplasm and was administered adjuvant chemotherapy consisting of irinotecan and cetuximab. Subsequent recurrences at the same site were treated with transurethral resection, while chemotherapy was still in progress. At 7 months' follow-up, the patient remained alive, with no evidence of further recurrence.

Topics: Adenocarcinoma; Aged; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antimetabolites, Antineoplastic; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Cecal Neoplasms; Cetuximab; Chemotherapy, Adjuvant; Colectomy; Female; Fluorouracil; Humans; Immunohistochemistry; Irinotecan; Leucovorin; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Organoplatinum Compounds; Quinazolines; Retroperitoneal Neoplasms; Sacrum; Thiophenes; Tomography, X-Ray Computed; Urinary Bladder Neoplasms

Some patients with initially unresectable hepatic colorectal cancer metastases can be effectively treated with neoadjuvant chemotherapy to allow operative resection in curative intent. Here, we report on a patient with unresectable locoregional recurrence of colon cancer, which was down-staged using combination chemotherapy with infusional 5-fluorouracil, folinic acid, oxaliplatin and cetuximab. After 12 weeks of therapy a partial response was documented and 3 weeks later the tumor was completely resected without increased perioperative morbidity. Therefore, neoadjuvant treatment with molecular targeted agents in combination with chemotherapy can also be an option to enable selected patients with locoregional recurrence to undergo surgical resection in curative intent.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Cetuximab; Colectomy; Colonic Neoplasms; Combined Modality Therapy; Fluorouracil; Humans; Leucovorin; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Staging; Neoplastic Cells, Circulating; Reoperation; Retroperitoneal Neoplasms

Topics: Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Digestive System Surgical Procedures; Docetaxel; Female; Fluorouracil; Humans; Leucovorin; Liver Neoplasms; Male; Middle Aged; Neoplasm Staging; Radiography; Remission Induction; Retroperitoneal Neoplasms; Stomach Neoplasms; Taxoids; Treatment Outcome

This retrospective study aimed to ascertain the expression of erbB2 in relation to topoisomerase II alpha (T2 alpha) and thymidylate synthase (TS) markers in 30 consecutive metastatic gastric cancer patients with a specimen available for study.. All patients had been entered on consecutive chemotherapeutic clinical trials that were all 5-fluorouracil based. The specimens were evaluated by fluorescence in situ hybridization to ascertain erbB2 and T2 alpha gene amplification, and by immunohistochemical staining for T2 alpha and TS protein expression.. erbB2 amplification was detected in 16.7% of specimens, with co-amplification of the T2 alpha gene in 40%, and 44% had undetectable TS protein expression. Kaplan-Meier survival curves showed significantly prolonged overall survival in patients with erbB2 and T2 alpha gene amplification, T2 alpha protein overexpression and absence of TS protein expression (P = 0.0011, P = 0.0048, P = 0.0061 and P = 0.0267, respectively, by log rank test). There was a positive correlation between erbB2 amplification and T2 alpha amplification, T2 alpha protein overexpression, and a trend towards absence of TS expression (P = 0.0001, P = 0.003 and P = 0.066 by Fisher's exact test).. High dose fluorouracil/leucovorin-based chemotherapy may have the potential to reverse the adverse effects resulting from erbB2 gene amplification in gastric cancer.

Topics: Adult; Aged; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; DNA Topoisomerases, Type II; DNA-Binding Proteins; Female; Fluorouracil; Gene Amplification; Humans; In Situ Hybridization, Fluorescence; Leucovorin; Liver Neoplasms; Male; Middle Aged; Prognosis; Receptor, ErbB-2; Retroperitoneal Neoplasms; Retrospective Studies; Stomach Neoplasms; Thymidylate Synthase