Main description:

This book includes some selected presentations given at the 3rd International Congress on Neo-Adjuvant Chemotherapy which was held in Paris from February 6th to February 9th, 1991. It was attended by over 2000 physicians from around the world and by 700 nurses. Its organisation was saddened by the untimely death of Professor Claude Jacquillat on October 12th, 1990. It was further complicated in January and February 1991 by the gulf events which led some guests to cancel their participation. However with the outstanding help of the two presidents cho sen by Claude Jacquillat before his death, Pierre Banzet from Paris and James F. Holland from New York, the organizers could set up an exciting meeting confirming the impact of neo-adjuvant chemotherapy on relatively new indi cations such as non-small lung cancers, bladder cancer, esophagal cancer, cer vix cancer, etc ... It is noteworthy that a contradictory debate on primary chemotherapy in non-small lung cancer turned into a consensus conference. In breast cancer, the downstaging induced by primary chemotherapy is ack nowledged by all and the conviction that Jacquillat defended so heartily that breast preservation should be proposed to all patients with breast cancer what ever their tumour size is shared now by more and more people. A special emphasis was given to new drugs, new combination, new access (locoregional therapy) and new developments such as that of growth factors and of interleukin 2.

Contents:

The first Claude Jacquillat Memorial lecture: Chemotherapy of cancer.- Head and Neck.- Neo-Adjuvant chemotherapy for patients with oral and oro-pharyngeal T3/T4 carcinomas.- Induction chemotherapy with Cisplatin and 5-FU for squamous cell carcinoma of the head and neck. Six year experience at the Nice Cancer Center.- Neo-Adjuvant chemotherapy for organ preservation with high dose continuous infusion of Cisplatin, 5-Flurouracil and Mitoguazone for head and neck cancer: a preliminary report.- Significance of tumour site in assessing survival benefit of Neo-Adjuvant chemotherapy in advanced head and neck cancer: a lack of survival advantage in patients with oral cavity tumours despite achieving a high clinical complete remission rate after local therapy.- Preservation of the larynx following Neo-Adjuvant chemotherapy. A preliminary report.- Selection of radiocurable head and neck cancers by Neo-Adjuvant chemotherapy response.- Neo-Adjuvant chemotherapy with Cisplatin and 5-Fluorouracil, both in continuous 96 hours perfusion, in the multidisciplinary treatment of locally advanced head and neck cancer.- Organ preservation in the treatment of hypopharyngeal squamous cell carcinoma. Preliminary results of a randomized trial.- Regional control after induction chemotherapy for advanced squamous cell carcinoma of the head and neck: a retrospective analysis of 303 patients.- Exclusive chemotherapy in head and neck cancer.- Neo-Adjuvant Cisplatin, 5-Fluorouracil and high-dose Leucovorin for advanced head and neck cancer: response, toxicity, survival and comparison with historical controls.- 5-Fluorouracil modulation in head and neck cancer.- Cisplatin, 5-Fluorouracil and high dose oral Leucovorin (PFL) with Methotrexate and Piritrexim as Neo-Adjuvant chemotherapy for head and neck cancer.- Efficacy of concomitant chemoradiotherapy in poor prognosis head and neck cancer.- Radiotherapy (RT) with concomitant Cisplatin (CDDP) in the management of locally advanced or recurrent head and neck cancer (LARHNC).- Primary chemotherapy and surgery in advanced oral cavity squamous cell carcinomas: retrospective analysis.- Neo-Adjuvant intra-arterial chemotherapy by Cisplatin and 5-FU for squamous cell carcinoma of the oral cavity.- Treatment of locally advanced head and neck cancer with Neo-Adjuvant Cisplatin (CDDP) and 5-Fluorouracil (5-FU) chemotherapy (CT).- T3T4 operable cancer of oral cavity and oropharynx. Randomised trial for surgery and radiotherapy.- Neo-Adjuvant chemotherapy on T2 cancers in oropharyngeal and oral cavity.- Perioperative chemotherapy in hypopharyngeal squamous cell carcinomas.- Urology.- Chemotherapy for invasive bladder cancer: rationale and results.- Concomitant radiotherapy and Cisplatin in transitional cell bladder cancer.- Neo-Adjuvant chemotherapy for invasive transitional cell carcinoma (TCC) of the urinary bladder.- Neo-Adjuvant chemotherapy: Epirubicin in invasive bladder cancer; 4-year follow-up.- Preliminary results of a protocol of pre-operative radiation therapy with concomitant chemotherapy for invasive bladder cancer.- Induction chemotherapy with Methotrexate, Vinblastine, Epiadriamycin and Carboplatin (M-VEP) in transitional cell urothelial cancer.- Neo-Adjuvant chemotherapy aiming at bladder preservation.- Immunotherapy in metastatic renal cell cancer. The Lyon's experience on 100 patients.- Breast.- Induction chemotherapy prior to definitive treatment improves outcome in stage III carcinoma of the breast.- Multimodality treatment of stage II, III and IV breast cancer with biochemical modulation of 5-FU/Leucovorin and estrogen recruitment.- Ten years of breast preserving management in infiltrative breast cancer: results in 412 patients treated by Neo-Adjuvant chemotherapy and radiation therapy with or without hormonotherapy.- Results of Cisplatin (CPPD)/Etoposide (VP16)/5FU and alternatively Adriamycin or Mitomycin C (PEFAM) combination in primary resistant breast cancer and in heavily pre-treated metastatic breast cancer.- Primary chemotherapy for breast cancer - M.-D. Anderson experience.- Intensive and prolonged first line chemotherapy in breast cancer.- Surgical techniques for breast conserving surgery after pre-operative chemotherapy. The NSABP experience.- Neo-Adjuvant chemotherapy in 101 non inflammatory breast cancers: treatment results.- Flow cytometric DNA analysis and Samba computer assisted image analysis in the evaluation of breat carcinoma chemosensitivity.- Application of dose intensity to Neo-Adjuvant therapy.- Conservative management of breast cancer by exclusive radiation therapy following Neo-Adjuvant chemotherapy: results in 236 patients with a minimum 5 years follow-up.- Prognosis of breast cancer by state of the art laboratory techniques.- Histological and radio-clinical evaluation of locoregional response to primary chemotherapy in non inflammatory breast cancers.- Breast cancer cell kinetic as prognostic parameter in perioperative adjuvant chemotherapy.- Cytotoxic or endocrine primary systemic therapy (PST) for operable large primary breast cancer.- Early results of the British Columbia breast cancer preoperative (Neo-Adjuvant) chemotherapy trial.- Combined modality approach in treatment of inflammatory carcinoma of the breast - M.D. Anderson Cancer Center Experience.- Induction chemotherapy in locally advanced breast cancer: prognostic variables affecting results.- Dose response relationship with epirubicin in Neo-Adjuvant combination chemotherapy for advanced breast cancer. End results of a prospective randomized trial.- Continuous prolonged intra-arterial (IA) chemotherapy for extensive locally recurrent breast cancer.- Locoregional advanced breast cancer. Clinical response to Neo-Adjuvant chemotherapy and survival.- Gastro-Intestinal Tumors.- Clinical outcome of intraperitoneal hyperthermo-chemotherapy for patients with refractory gastric cancer.- Neo-Adjuvant therapy for gastric cancer.- The effects of Verapamil in potentiating the action of Doxorubicin in recently derived pancreatic carcinoma cell lines.- Preoperative 5-Fluorouracil in resectable colorectal cancer. Preliminary results of a prospective randomized trial.- Double 5-FU modulation with folinic acid and recombinant alfa 2b-Interferon: a phase I-II study in metastatic colorectal cancer patients.- Loco-Regional.- Neo-Adjuvant locoregional chemotherapy in pelvis osteosarcoma.- Treatment of advanced intra-abdominal or thoracic malignancies using high-dose intra-arterial chemotherapy with concomitant hemofiltration.- Technical aspects of adjuvant intraperitoneal chemotherapy.- Combined intravenous and intra-arterial chemotherapy using Cisplatin, Fluorouracil, Mitomycin C and Etoposide in the treatment of hepatic metastasis.- Drug sensitivity testing for regional chemotherapy.- Preoperative intra-arterial chemotherapy of advanced breast cancer. Response rate as prognostic factor for overall survival.- High dose of Rtnf? with interferon-g and melphalan in isolation perfusion (ILP) for in transit melanoma metastases and recurrent soft tissue sarcoma.- Testicular circulatory isolation prevents testicular exposure to doxorubicin in a rat model.- Early postoperative intraperitoneal Adriamycin. Pharmacologic studies and a preliminary clinical report.- Surgical treatment of pseudomyxoma peritonei.- Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer.- Esophagus.- Neo-Adjuvant therapy for esophagus cancer: a coming of age.- Symptomatic improvement and esophagoscopic response after Neo-Adjuvant chemotherapy with Cisplatin, Vindesine and Bleomycin in patients with esophageal cancer (EC).- Non surgical multimodality treatment of squamous cell cancer of the esophagus.- Role of pathologic response after primary chemoradiotherapy and esophagectomy for predicted T3-4 NO-1 MO squamous carcinoma of the thoracic esophagus.- Gynecology.- Neo-Adjuvant chemotherapy in cervical cancer stage IIb; PEC + RT vs RT. Preliminary results.- Follow-up of treated gynecologic cancer: CT and MRI contribution.- Intra-arterial chemotherapy in uterine cancer.- Concomitant chemotherapy and radiotherapy in the treatment of advanced cervix carcinomas.- High-Dose Chemotherapy.- High-dose chemotherapy with hematologic rescue for high-risk nonseminomatous germ cell tumors.- High-dose chemotherapy and autologous bone marrow transplantation.- High-dose therapy in breast cancer.- Radio-Chemotherapy.- Differential expression of P-glycoprotein and certain other multidrug resistance characteristics in tumour cells pre-exposed in vitro either to anti-tumour drugs or to fractionated radiation.- Simultaneous chemo-radiotherapy in advanced head and neck cancer.- Pediatric Tumors.- Two different regimens with ifosfamide as preoperative chemotherapy in children with unresectable rhabdomyosarcoma. A report from the German soft tissue sarcoma study CWS-86 and the Italian rhabdomyosarcoma study ICG-88.- Limb sparing treatment in osteosarcoma with Neo-Adjuvant chemotherapy and intraoperative radiotherapy in pediatric patients. Analysis of local control.- Bone and Soft Tissue Sarcomas.- The combination of Etoposide and Cyclophosphamide as Neo-Adjuvant chemotherapy for osteosarcoma.- Dose response relationship in adult osteosarcoma patients treated with Neo-Adjuvant high dose Methotrexate, surgery and adjuvant chemotherapy.- Chemotherapy of soft tissue sarcomas with Cyclophosphamid or Ifosfamid, Adriamycin and DTIC (CAD or IAD) preoperatively and in patients with metastatic disease: a non randomized pilot study.- Phase II study of THP-adriamycin (Pirarubicin) and DTIC in advanced soft tissue sarcomas.- Combined approach to malignant small round blue cell neoplasms in the adult.- Neo-Adjuvant chemotherapy in the management of appendicular soft tissue sarcomas.- Hematosarcomas.- Neo-Adjuvant treatment in locally advanced thymoma.- Neo-Adjuvant chemotherapy in locally advanced invasive thymomas.- Neo-Adjuvant chemotherapy for invasive thymoma: an interim analysis.- Involvement of the Interleukin 2/Interleukin 2-receptor system in the proliferation of human immature leukemic T cells.- Pharmacokinetic.- Issues in multidrug resistance.- Pharmacokinetic study of Neo-Adjuvant chemotherapy combining Carboplatin, Cisplatin and 5-Fluorouracil in head and neck squamous cell carcinoma.- The influence of tumour stage on in vitro sensitivity of renal carcinoma cells to Mitozantrone.- Circadian chemotherapy against stage IIIB-IV non-small-cell lung cancer (NSCLC) with 5-Fluorouracil (5-FU), folinic acid (FOL) and cisplatin (CDDP) via a multichannel programmable pump. Preliminary results.- New Drugs.- Morpholinyl anthracyclines: option for reversal of anthracycline resistance ?.- Diarysulfonylureas: new anticancer agents with novel activities, toxicities and mechanism of action.- Current development of fotemustine: perspectives.- CPT-11: An analog of Camptothecin in early clinical development.- Modulation of glutathione and associated enzymes as a therapeutic strategy.- Lung.- Neo-Adjuvant chemotherapy (N-CT) followed by concomitant chemotherapy and radiotherapy (CC-CT) for locally advanced non-small cell lung cancer (NSCLC).- Multimodality therapy of non-small cell lung cancer (NSCLC).- Combined modality therapy for stage III non-small cell lung cancer: the University of Chicago experience.- High incidence of CNS metastases in long-term survivors (LTS) stage III (T4/N2) non-small Cell Lung Cancer (NSCLC). Patients treated with Neo-Adjuvant chemotherapy.- Combined modality therapy for stage IIIA (clinical N2) non-small cell carcinoma of the lung (NSCLC).- Phase II pilot study of Ifosfamide-Cisplatin-Etoposide association as Neo-Adjuvant chemotherapy in locally advanced non-small cell lung cancers.- Initial intensive drug chemotherapy (CT) followed by extensive irradiation for limited small cell lung cancer (LSCLC). Improved response rate and survival. A pilot study.- Cisplatinum, 5-Fluorouracil + Leucovorin and Vindesine, in non-small cell lung cancer: a phase II study.- Faster response and survival advantage with Neo-Adjuvant Cisplatin and 5-Fluorouracil infusion versus Cisplatin and Bleomycin in advanced non-small cell lung cancer.- Multimodality treatment for small cell bronchial carcinoma (SCLC).- Special Lectures.- Neo-Adjuvant chemotherapy: new approaches involving alkylating agent modulation.- The impact of molecular genetics on the detection of residual malignant disease.- Hairy cell leukemia: current treatment strategies.- Dose intensification and autologous stem cell support in breast cancer.- The current status of therapy for aggressive non-Hodgkin lymphoma.