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Irinotecan and Other Agents in Upper Gastrointestinal and Genitourinary Tumors

Irinotecan and Other Agents in Upper Gastrointestinal and Genitourinary Tumors

The 4th Investigators’ Workshop sponsored by The
University of Texas M. D. Anderson Cancer Center was held on July 25-29, 2001,
in Colorado Springs, Colorado. The purpose of these annual workshops has been to
review the latest data on new agents, with a particular focus on the broadly
used agent irinotecan (CPT-11, Camptosar).

Investigators from around the world were invited to present current research.
The forums were highly interactive and frank, thus allowing stimulation of new
ideas and directions. The meetings were more like a workshop rather than
didactic sessions. Six separate scientific sessions were held, and the
respective sessions covered colorectal carcinoma, upper
gastrointestinal/genitourinary carcinoma, lung carcinoma, and new combinations
and other tumor types.

In addition to stimulating research, another purpose of these workshops is to
develop enduring material for wider distribution to those who did not attend.
Thus, four publications are intended. This second volume is devoted to upper
gastrointestinal/genitourinary malignancies. Successive volumes will be devoted
to new combinations and other malignancies (volume 3) and lung malignancies
(volume 4). Last month, the first volume focused on colorectal
cancers
.

Gastric Carcinoma

In this volume, David Ilson and colleagues report on a phase I trial of
weekly irinotecan, cisplatin, and concurrent radiotherapy in patients with
locally advanced esophageal cancer—an aggressive cancer with a poor prognosis.
Among the 13 evaluable patients, there were 5 clinical complete responses (38%),
including 3 pathologic complete responses in 10 patients undergoing surgery
(30%). These data indicate that full doses of weekly irinotecan (65 mg/m²) and
cisplatin (30 mg/m²) can be combined safely with concurrent radiotherapy in
patients with locally advanced esophageal cancer.

Gastric carcinoma continues to be a significant health problem despite its
decreasing incidence, and it remains the second most common malignant disorder
in the world. In our article, my colleagues and I summarize our data from a
phase II study that assessed the response rate and toxicity profile of the
irinotecan/cisplatin combination administered weekly to patients who have had at
least one previous chemotherapy for advanced adenocarcinoma of the stomach or
gastroesophageal junction. A 29% response rate was achieved in the study.
Modifications in doses and schedule are warranted to increase the tolerability
of the regimen in further investigation.

Pancreatic Cancer

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