Lung cancer metastatic

Castaldo, G., Tomaiuolo, R Saduzi, A. et al. (1997) Lung cancer metastatic cells detected in blood by reverse-transcriptase polymerase chain reaction and dot-blot. 

Bevacizumab (Avastin) 2004 Humanized 149 2.66-3.25 L 20 days IV infusion (1.0) Vascular endothelial growth factor Colorectal cancer advanced nonsmall cell lung cancer metastatic breast cancer... 

Erlotinib (Tarceva ) competes with ATP in the HER1/EGFR ATP-binding pocket. It is used in the clinic in locally advanced or metastatic non-small cell lung cancer after failure of at least one chemotherapy regime [1, 3, 5]. 

Vinorelbine, a microtubule interactive agent, also has shown impressive response rates in metastatic breast cancer.60 Vinorelbine was approved by the FDA in 1994 for the treatment of non-small cell lung cancer. It is not approved for breast cancer, but response rates to vinorelbine range from 30% to 50%, with an overall 5% complete response rate in phase I and phase II studies in patients with advanced breast cancer. Importantly, paclitaxel, docetaxel, and vinorelbine do not appear to be cross-resistant with anthracyclines, which are arguably considered first-line treatment of metastatic breast cancer. 

The first step in treatment of NSCLC involves confirmation of the clinical stage and determination of resectability of the tumor. This decision always should be made by a thoracic surgeon who routinely performs lung cancer surgery. Treatment options depend on the advancement of disease (i.e., local, locally advanced, or metastatic). 

In phase I clinical trials 47 patients, all of whom had previously failed standard treatments for solid tumors, received the drug in the UK, Italy, and Switzerland on three different schedules.123,124 Dose-limiting toxicities have been defined as bone marrow depression and diarrhea. The latter is treatable with loperamide. Signs of biological activity were seen. Notably one patient with metastatic pancreatic cancer showed a partial response (for 4 months) and two further patients, one with metastatic melanoma and one with bronchoalveolar carcinoma, also showed partial responses. In a phase I trial in combination with 5-FU, a partial response in breast cancer was observed.125 Furthermore, a reduction in tumor marker levels was observed in two patients, one with ovarian cancer, and one with colon cancer. Phase II studies have shown partial responses in cisplatin-resistant ovarian and nonsmall-cell lung cancer.126,127 The indications are that the profile of clinical activity is different and complementary to the mononuclear platinum agents. 

While the work of Chen et al. (2001) broadly defined the expression of genes associated with metastatic potential in the lung cancer model, others have more narrowly focused upon relationships for specific genes. For example, Pinheiro et al. (2001) examined gene expression profiles from patients... 

Trastuzumab Metastatic breast cancer, non-small-cell lung cancer. 

Gemcitabine (Gemzar), an antimetabolite, undergoes metabolic activation to difluorodeoxycytidine triphosphate, which interferes with DNA synthesis and repair, ft is the single most active agent for the treatment of metastatic pancreatic cancer, and it is used as a first-line treatment for both pancreatic and small cell lung cancer. It is administered by intravenous infusion. The dose-limiting toxicity is bone marrow suppression. 

Lymphoma, breast and ovarian cancer, oat cell lung cancer Acute myelogenous and acute lymphoblastic leukemia, lymphomas Metastatic melanoma, sarcomas, Hodgkin s disease... 

Breast, ovarian, cervical, bladder and prostate cancer gastrointestinal adenocarcinomas Metastatic pancreatic cancer small cell lung cancer Leukemia Breast cancer... 

Metastatic stage IV non-small-cell lung cancer (NSCLC) has a grim outcome. The median survival does not exceed 11 months, with no differences according to different cisplatin-based regimens. However, this clinical observation is spurious from the molecular point of view, bewcausse DNA repair genes involved in several path-... 

Rosell R, Scagliotti G, Danenberg KD et al. Transcripts in pretreatment biopsies from a three-arm randomized trial in metastatic non-small-cell lung cancer. Oncogene 2003 22 3548-3553. 

In 2004, bevacizumab (Avastin) became the first antiangiogenesis drug to receive FDA approval. It is intended for combination use with standard chemotherapy for metastatic colon cancer. Approval for other indications as part of combination therapy followed non-small-cell lung cancer and breast cancer. The cost for bevacizumab s research and development was 2.25 billion. 

However, several types of cancer do not respond well to treatment. For example, the majority of metastatic cancers cannot be cured by current chemotherapeutic methods or by any other type of treatment.11 In addition, some of the most common forms of adult neoplastic disease are difficult to treat by using anticancer drugs. As indicated in Table 36-9, the number of deaths associated with colorectal, prostate, and breast cancer is unacceptably high, and the mortality rate for lung cancer and pancreatic cancer is well over 90 percent in both men and women. 

It has been used to treat leukemia. Other anticancer drugs have been modified from Camptotheca acuminata. Topotecan is used to treat ovarian and small-lung cancers. Irinotecan is used to treat metastatic colorectal cancer. 

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