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Carcinoma of Unknown Primary Site: Sequential Treatment with Paclitaxel/Carboplatin/Etoposide and Gemcitabine/Irinotecan: A Minnie Pearl Cancer Research Network Phase II Trial

Purpose. To evaluate the efficacy and toxicity of the
sequential administration of paclitaxel (Taxol®; BristolMyers Squibb; Princeton, NJ), carboplatin (Paraplatin®;
Bristol-Myers Squibb), and oral etoposide (VePesid®;
Bristol-Myers Squibb) followed by gemcitabine (Gemzar®;
Eli Lilly; Indianapolis, IN) and irinotecan (Campostar®;
Pfizer Pharmaceuticals; New York, NY) in the first-line
treatment of patients with carcinoma of unknown
primary site.
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Methods: We analyzed seven cases of primary thymic carcinoma, treated with various chemotherapy regimens in our hospital from 1990 to 1999, and carried out a literature review of case reports of thymic carcinoma successfully treated with chemotherapy.
Results: All four cases who received modified ADOC therapy obtained partial responses. Other chemotherapeutic regimens (CHOP-E, PVB) were not effective.
Conclusion: Based on the results of this study and the literature review, we feel that a positive response is obtainable with chemotherapy for thymic carcinoma. Modified ADOC therapy showed consistent efficacy in thymic carcinoma in this study.Read More →

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American Society of Clinical Oncology Technology Assessment: Chemotherapy Sensitivity and Resistance Assays

Purpose
To develop a technology assessment of chemotherapy sensitivity and resistance assays in order to
define the role of these tests in routine oncology practice.
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Thymomas and thymic carcinoma are rare neoplasms. Surgical resection is the cornerstone of effective therapy. Stage I disease is effectively treated by complete surgical resection. The role of radiation therapy in completely resected stage II disease remains controversial. Adjuvant radiation therapy is useful for local control and may improve survival in patients with incompletely resected tumours. Cisplatin-based chemotherapy regimens play an important role in the treatment of advanced stage III/IV or recurrent disease thymomas, but have proven less effective for thymic carcinoma. Phase II trials of multimodality therapy incorporating neoadjuvant chemotherapy, surgery and postoperative radiation therapy show promise for unresectable disease. This review discusses recent clinical data and the potential role for agents targeting the epidermal growth factor receptor, angiogenesis and apoptotic pathways.Read More →