Search

Although many different treatments have been evaluated in the last thirty years, advanced renal cell carcinoma still has a poor prognosis, characterised by a survival rate which is less than 5% at 3 years from diagnosis. Many different therapeutic approaches have been carried out in addition to cytotoxic chemotherapy, which shows obvious limits such as an overall response rate that does not go above 10-15%. One of the more promising treatments that has been studied the most is undoubtedly immunotherapy. We present a literature review aimed at summing up all the results obtained until now with immunotherapy of renal cell carcinoma, whether alone or in combination with cytotoxic chemotherapy. Unanswered questions of major concern are stressed, such as treatment choice, dosage, the most convenient schedules with particular regard to the cost-benefit issue.

J Thorac Cardiovasc Surg 2003;125:428-9

Gemcitabine is a new antimetabolite that has shown activity in a wide range of solid tumours. Until 1994 to January 1996, 16 patients (pis) (M/F = 10/3 median age 57, range 41-73) with advanced NSCLC received Gemcitabine as single agent in an out-patient setting at the Medical Oncology Division of the European Institute of Oncology. Performance status was 0-1 in 15 of them and 2 in one case. Nine were chemonalve, and 7 were previously treated with cisplatin based chemotherapy (3 refractory and 4 responsive and relapsed). The planned schedule was to administer Gemcitabine as 30 minutes infusion on day 1, 8 and 15 q 4 weeks (one cycle) at the starting dose of 1250 mg/sqm in 10 pts, 1000 in 5 and 800 in 1. Overall 159 administrations (for a total of 61 cycles) were given. The worst reported toxicity was: Grade 3 hematological in 11 administrations (4 pts), grade 2 fever in 13 (4 pts), grade 2 nausea or vomiting in 2 (2 pts). The dose has been reduced by 25% in 4 administrations (3 pts). Among the 13 pts with measurable disease there were 3 partial responses, 7 stable diseases (SD) and 3 progressive diseases (PD). We confirm that Gemcitabine Is an active and well tolerated new drug for NSCLC. Further studies in combination with other agents are warranted.