European Journal of Cancer: Highlights of Issue 37:11

Launch of the Paediatric Update Series 2!

The Paediatric Update Series 2 on 'Supportive care, follow-up and late effects' is launched in this issue. In the first of fifteen papers, Estlin and Ablett discuss the practicalities of running clinical trials from a UK perspective. They outline the organisation, ethics and procedural challenges that face the paediatric oncologist that result in the whole process becoming both complex and often burdensome. There has been little research carried out in this area despite, as Professor Bleyer points out in his commentary, the important fact that 'virtually all the progress made to date in paediatric cancer therapy has been achieved through clinical trials'- a compelling reason to conduct such trials. The formation of a new, single cooperative group, the Children's Oncology Group (COG), will allow rare tumours to be studied in North America and should help overcome some of the problems associated with planning and conducting clinical trials with collaborative Groups, such as the International Society of Paediatric Oncology (SIOP), in other continents. However, as Estlin and Ablett point out 'running clinical trials across national boundaries is not easy. It requires a considerable understanding of other cultures, tact, diplomacy and, at times, a willingness to compromise'

Another agent for the treatment of locally recurrent/metastatic breast cancer patients?

Several drugs have been shown to produce responses in metastatic breast cancer patients. However, many of these patients develop resistance and thus different agents are being tested for efficacy in the metastatic setting. One such agent is pemetrexed disodium (LY 231514), a multitargeted antifolate. In this issue, Miles and colleagues, in a phase II study, have determined the efficacy of pemetrexed disodium (600mg/m2 given as a 10 minute intravenous (i.v.) infusion every 3 weeks) in n=38 patients with locally recurrent/metastatic breast cancer. 33/38 had received prior chemotherapy. The overall response rate in the 36 evaluable patients was 28% (95% confidence interval (CI) 14.2- 45.2%) and the toxicity was manageable. The authors conclude that this regimen is feasible in the treatment of advanced breast cancer patients who had previously received anthracyclines and taxoids.

MGI-114 shows in vivo efficacy in human tumour xenograft models.

MGI-114, a semi-synthetic analogue of the cytotoxic sesquiterpenoid illudins, was tested by Sato and colleagues in this issue for in vivo activity in a variety of tumour xenograft models. The agent showed high activity against a wide spectrum of human cancers, including lung, gastric, breast, colon and nasopharyngeal tumours, as well as against melanomas. Daily administrations were found to be more effective than intermittent regimens, but intravenous (i.v.) and intraperitoneal (i.p.) routes resulted in a similar efficacy. In a comparison with other anti-tumour drugs, including paclitaxel, cisplatin, irinotecan, 5-fluorouracil (5-FU), doxorubicin, etoposide and vindesine, MGI-114, in general, showed a higher or equivalent efficacy. This agent could therefore be an important addition to the chemotherapy armamentarium for the treatment of cancers where there is a shortage of effective agents or where resistance against other anti-tumour agents has developed. MGI-114 has already entered phase II trials in the United States.

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