Genito-urinary Cancers

Chemoradiation in bladder cancer – pro

A variety of therapeutic options are available to vital, elderly patients with invasive bladder cancer, including radical cystectomy and treatments that preserve the bladder. Radical cystectomy remains the gold standard for treatment of muscle-invasive bladder cancer, but has traditionally been avoided in elderly patients because this population was thought to be at higher risk of morbidity and mortality. A growing body of evidence, however, indicates

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Docetaxel for prostate cancer – pro

Chemotherapy has a definite role in the management of advanced androgen refractory prostate cancer. Mitoxantrone does not prolong survival over no chemotherapy but docetaxel has been shown to be more effective than mitoxantrone. There have been seven randomised controlled trials. One large well-conducted trial assessed docetaxel plus prednisone vs mitoxantrone plus prednisone; this showed statistically significant improvements with 3-weekly docetaxel

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Adjuvant chemo for prostate cancer – pro

There is no evidence to support adjuvant chemotherapy for prostate cancer after curative radiation. Results of several studies are being awaited. Recently completed randomized trials indicate a benefit from the use of hormonal therapy in patients with locally advanced prostate cancer treated with radiation therapy or node positive patients, post radical prostatectomy. While hormone-based combined modality trials have consistently shown improvements

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Taxotere/Carboplatin for Prostate Cancer – pro

Lay Summary: After Taxotere fails in hormone refractory prostate cancer, there are few good options. Adding Carboplatin to the Taxotere is a promising approach that is still being studied. Since 2004, the standard first-line chemotherapy for patients with metastatic prostate cancer that progresses despite androgen deprivation has been docetaxel. Docetaxel is the first (and, to date, only) treatment for metastatic castration resistant prostate cancer

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Testicular Choriocarcinoma – pro

Testicular choriocarcinoma is rare. In a literature review of 10,000 cases of germinal testicular cell tumors, Ramon y Cajal found 54 (0.5%) cases of pure choriocarcinoma. The tumors occurred mostly in men aged 20-30 years. Unlike classic seminoma or mixed GCTs, pure choriocarcinoma is more likely to present with symptoms from metastatic disease and is the most common element observed in brain metastases. Pure choriocarcinoma, an extremely rare variant

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Alimta for bladder cancer – pro

Alimta is supported by several studies for bladder cancer. A study presented at the Chemotherapy Foundation Symposium XXI showed that Alimta® appears to be an active single agent in the second-line treatment of transitional cell carcinoma (TCC) of the urothelium. Results indicate that more than one quarter of patients responded to the drug. This phase II study involved 47 patients with metastatic TCC, all of whom had only one prior treatment for

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Gemzar, Carbo, Taxol for bladder cancer – pro

The combination of gemcitabine, carboplatin and a platin drug has significant supporting literature. Hussain and associates from the Wayne State University had previously reported on the combination of carboplatin dosed to a targeted area under the concentration x time curve (AUC), gemcitabine, and paclitaxel, in which the objective response rate was 68%. In that study, 32% of patients experienced a complete response and the median survival was 14.7

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Revlimid for renal cell carcinoma – pro

Thalidomide is an agent with complex antiangiogenic and immunomodulatory properties. It has been demonstrated to reduce mRNA and protein expression of bFGF and VEGF with resulting inhibitory effects on endothelial cell proliferation. Several small studies of thalidomide as a single agent in RCC have reported no complete responses, partial responses ranging from 0-17%, and stable disease in 17-64% of patients. In these studies, thalidomide was generally

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ASCT for testicular cancer – pro

Testicular cancer usually responds well to front line chemohthrapy. Salvage therapy has been shown to induce long-term complete responses in about 25% of patients with disease that has persisted or recurred following other cisplatin-based regimens. Patients who have had an initial complete response to first-line chemotherapy and those without extensive disease have the most favorable outcome. However, the literature states that few, if any, patients

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Induction chemo for head and neck ca – pro

Lay Summary: Induction chemotherapy before chemoradiation is becoming standard for many types of head and neck cancer. The role of chemotherapy and radiation for advanced head and neck cancer has evolved considerably over the last 20 years. The landmark Veterans Affairs’ (VA) laryngeal cancer study,1 initially published in 1991, provided the best initial evidence to support cisplatin-based, induction chemotherapy as part of a larynx preserving

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