Cytotoxic chemotherapy for XXXX .

@entity1 @entity632 @entity8449 @entity1262 @entity5 @entity6319 @entity900 @entity1636 @entity5747
The efficacy of @entity8449 in providing objective @entity5 responses in @entity1 with @entity1636 ( @entity1636 ), has been recently questioned. Experience with non specific chemotherapy is limited. @entity5 responses have been reported with @entity900 administered as a single agent or in combination. Other reports however failed to show benefit from cytotoxic chemotherapy. The very low number of @entity1 included in each study, mostly of them previously treated with @entity8449 , may account for these controversial results. The finding that multidrug resistance mediated by @entity1262 / @entity1262 can be reverted by @entity8449 provides a rational basis for exploring the use of @entity8449 in combination with chemotherapeutic agents. In a multicenter cooperative (SWOG) phase II study, a combination of @entity8449 + @entity900 appeared active in advanced @entity1636 , with 30% response rate in 37 eligible @entity1 . These results prompted us to evaluate the activity of a combination chemotherapy of Eto-poside, @entity632 and @entity900 (EAP) in association with @entity8449 (4 g daily per os). Up to now we treated 6 @entity1 , obtaining 3 partial responses. Recently, new drugs as @entity5747 and @entity6319 have been show to have some activity in @entity1 with surgically unresectable @entity1636 , suggesting the need for further investigation. In conclusion, cytotoxic drugs+ @entity8449 and new adrenocorticolytic/cytotoxic agents, should be explored as first line treatments in @entity1 with advanced @entity1636 . However, due to the extreme rarity of the disease, coordinated multicenter investigations should be highly encouraged.
