Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Currently, the four-drug combination of methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin (MVAC) or the two-drug combination of gemcitabine and cisplatin (GC) represents the standard of care for patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. Recently, there has been a plethora of data from other chemotherapeutic regimens. Promising new agents, such as the multitargeted antifolate pemetrexed (Alimta), and new drug combinations have demonstrated increased efficacy and/or decreased toxicity compared with current regimens. Currently, data are available from three phase II studies utilizing pemetrexed or the combination of pemetrexed/gemcitabine (Gemzar) in patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. Further investigation of combinations of pemetrexed and other active drugs in the treatment of patients with locally advanced and metastatic disease is warranted.
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PMID:Pemetrexed in transitional cell carcinoma of the urothelium. 1565 37

Gemcitabine (Gemzar) and paclitaxel are active drugs in the treatment of metastatic breast cancer. Phase I clinical trials data have suggested that the gemcitabine plus paclitaxel combination is safe in breast cancer patients. Two doses/administration schedules have been preferred in subsequent phase II and III trials: gemcitabine on days 1 and 8 plus a taxane on day 1, every 3 weeks; or gemcitabine plus a taxane on days 1 and 14, every 4 weeks. In phase II trials, 114 of 221 patients (52%) responded to gemcitabine/paclitaxel therapy. Response rates were lower among patients who received previous chemotherapy for metastatic disease (response rates: 45%, second line and 70%, first line). Toxicity of gemcitabine/paclitaxel regimens has generally been low, with few cases of neutropenia or nonhematologic toxicity. Results of the randomized phase III registration trial show a clear advantage for gemcitabine plus paclitaxel over paclitaxel alone in time to disease progression, objective response, and overall survival. Triplet combinations, in which an anthracycline is added to gemcitabine/paclitaxel, are being explored in the metastatic and neoadjuvant settings.
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PMID:Gemcitabine and paclitaxel in metastatic breast cancer: a review. 1568 19

Inoperable pancreatic adenocarcinoma is a dilemma that oncologists frequently encounter. Only 15% to 20% of patients are diagnosed when cancer of the pancreas is still surgically resectable. However, pancreaticoduodenectomy is the only curative option for this disease and should be offered to all patients who meet resection criteria and do not have significant comorbidities. For inoperable pancreatic cancer, the goals of treatment are to palliate symptoms and prolong life. Improved survival in locally advanced disease has been demonstrated with chemoradiation plus fluorouracil or with gemcitabine (Gemzar) alone. In metastatic disease, single-agent gemcitabine has been associated with improvement in symptoms and survival. Trials combining various chemotherapeutic agents with gemcitabine have not had a significant impact on overall survival, although meta-analyses suggest a small benefit. The targeted agent erlotinib (Tarceva) has shown a modest improvement in overall survival in combination with gemcitabine. This combination is another option for first-line therapy in patients with locally advanced or metastatic disease. Despite these recent advances, survival for patients with inoperable pancreatic cancer continues to be poor. Future investigations need to focus on understanding the molecular nature of this malignancy, with the goal of developing interventions based on this knowledge.
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PMID:Inoperable pancreatic cancer: standard of care. 1817 46

Eribulin mesylate (Halaven-Eisai) has been approved by the FDA for treatment of patients with metastatic breast cancer who have previously received at least 2 chemotherapy regimens for metastatic cancer. Prior therapy should have included an anthracycline and a taxane in either an adjuvant or metastatic setting. Other drugs used to treat anthracycline- and taxane-refractory metastatic breast cancer include capecitabine (Xeloda), gemcitabine (Gemzar, and others) and vinorelbine (Navelbine, and others).
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PMID:Eribulin mesylate (Halaven) for breast cancer. 2150 35


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