Salvage chemotherapy for XXXX .

@entity43 @entity1 @entity2600 @entity5 @entity13627 @entity9986 @entity902 @entity1945
@entity43 is a highly chemosensitive solid @entity5 with response rates of 70-80% to first-line chemotherapy, including a high proportion of complete responses. The majority of @entity1 , however, eventually relapse and ultimately die of chemoresistant disease. Response rates to salvage agents are modest, and duration of response is relatively short. Important new agents have been identified in the salvage setting, however, and all @entity1 with @entity43 recurring or persisting after front-line therapy should be encouraged to enroll in clinical trials. Phase II trials should include multiple adequately sized cohorts, for @entity1 with @entity902 -sensitive disease and those with @entity902 -refractory disease. In addition, @entity1 should be stratified by treatment-free interval. An effort should be made to report standard response endpoints, such as median duration of response, median time to progression, and median survival. Retreatment with a @entity902 -containing compound is appropriate in @entity1 with @entity902 -sensitive disease. Trials of high-dose chemotherapy with hematologic support may be most appropriate for @entity1 with minimal disease following first-line therapy, but are unlikely to benefit @entity1 with @entity902 -resistant or bulky disease. Paclitaxel should figure prominently in consideration of salvage therapy for @entity1 with @entity902 -resistant disease. Responses to other single agents or combination chemotherapy have been modest and generally of short duration. Efforts at hormonal therapy have been disappointing. Promising new agents include topoisomerase I inhibitors, such as @entity1945 , @entity13627 , @entity2600 ( @entity2600 ), and @entity9986 . Therapies focusing on novel molecular targets include antiangiogenesis agents, antimetastatic agents, and signal transduction inhibitors. Immunotherapy, including radioimmunotherapy, immunotoxins, and direct antitumor effects of monoclonal antibodies, may be useful. Greater understanding of the molecular pathology of @entity43 may help us develop more rational and effective treatment.
