Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Screening in Milan
- Francesco Carelli (19 July 2004)
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Correction of factual errors
- Anthony J PICKUP, S Peter Eggleton (International Director of R+D - Oncology), Denise Richard (Head of Oncology) (21 July 2004)
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New Treatment Options for Colorectal Cancer--NEJM 22 July 2004
- Jay Ilangaratne (22 July 2004)
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The role of Boron Neutron Capture Therapy in the management of advanced colon cancer
- Francesco Trotta, Ubaldo Prati (Experimental Surgery), Carlo Filice (Infectious&Tropical Diseases) (12 September 2004)
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Francesco Carelli, EURACT Council Nat. Rep. - GP/Gastroenterologist 20123 - Milan - Italy
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To confirm we believe in colon rectal screening campaign, all GPs in Milan will be involved in it. This is a campaign managed to begin in Autumn and will involve the population of the second city in Italy. This will help also the Local Health Authority to " clean " the names of inhabitants concerning problems on this topic. The campaign will last two years and research on data collecting is on agenda. GPs' involvement, voluntary, could be at full time ( from sending letters to study on results ). Competing interests: None declared |
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Anthony J PICKUP, Medical Director Harrier House, High Street, West Drayton UB7 7QG, S Peter Eggleton (International Director of R+D - Oncology), Denise Richard (Head of Oncology)
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Sir: We write to correct errors of fact in the recent editorial "New treatments for colon cancer "BMJ 2004;329:124-126 (17 July). On a number of occasions the anticancer agent Erbitux (cetuximab) is mis-spelt cituximab. In addition, a statement is made that the drug is approved in the USA and Switzerland and has been recommended for licensing in the EU. This information is out of date. Erbitux is licensed in many countries, including the USA, Switzerland, Argentina, Mexico,and marketing authorisation was granted in the European Union on 29th June 2004. We would be grateful if you would consider an appropriate correction Yours faithfully, A J Pickup Competing interests: All authors are employees of Merck KGaA or subsidiaries. Merck KGaA holds the EU Marketing Authorisation for Erbitux (cetuximab) |
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Jay Ilangaratne, Founder Medical-Journals.com
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In today's NEJM(22 July 2004)the same subject matter is addressed in an editorial.However,the full-text article is not free,but the currently free extract is pasted below. **Epidermal growth factor receptor (EGFR) is a member of the HER family of tyrosine kinase cell-surface receptors that are dysregulated in many types of tumor; its expression has been associated with a poor prognosis in colon cancer.1 There are at least two opportunities to interfere with EGFR signaling that are being exploited clinically.2 In one approach, the extracellular receptor domain is bound by antibodies, such as cetuximab, that block ligand-mediated dimerization and subsequent activation of the receptor. In the second, the tyrosine kinase domain is bound by drugs that inhibit phosphorylation, such as gefitinib and erlotinib.** Competing interests: None declared |
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Francesco Trotta, resident in surgery Hepato-Pacreatic Surgery, San Matteo Hospital, 27100 Pavia - Italy, Ubaldo Prati (Experimental Surgery), Carlo Filice (Infectious&Tropical Diseases)
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In this editorial (BMJ 2004;329:124–6) the authors summarized interesting results of recently published clinical trials in the field of management of early and advanced colon cancer. We propose to add the Boron Neutron Capture Therapy (BNCT) of isolated liver to the list of experimental available therapy for advanced colon cancer (i.e. diffuse and unresectable (and unresponsive-to-chemotherapy) liver metastases from colon cancer). The BNCT is based on the effects of neutron irradiation of neoplastic cells previously loaded with 10Boron (10B). The interaction between 10B and neutrons produces an a particle which damages the cellular structures and determines cell death. Clinical applications of BNCT were until now mainly in the field of cerebral neoplasms or cutaneous melanoma with collimated neutron beams directed against the tumour. In our case the whole liver was put in an isotropic neutron field (1, 2). Thus, detected and undetectable (occult) metastases can be treated. The BNCT procedure in our case is made of three distinct phases: (A) hepatectomy; (B) isolated liver neutron irradiation; (C) liver autotransplantation. After extensive experimental trials and approval of local Ethics Committee and Health Authorities, we carried out the first in the world procedure of BNCT of isolated liver on December 2001. The patient suffered form colon cancer syncronous diffuse unresectable liver metastases, unresponsive to standard chemotherapy. The operation lasted 21 hours on the whole. The cost of entire procedure was about 140,000 dollars. A peritoneal recurrence nearby the III hepatic segment was detected during the follow-up (20 months), but no hepatic recurrence was present: the patient has been re-operated and is disease free up to last control (30 months). A second patient underwent BNCT, but died on 30th post-operative day due to ARDS. The whole liver was examined and a tumour necrosis rate of 99% was found; no signs of hepatic sufference was found in the non neoplastic liver. The high selection of patients (advanced liver metastases in absence of other site of metastases, good performance status) limited the number of enrolled patients in this clinical study up to date (two patients underwent the procedure; 3 patients are in the waiting list). Also the complexity of the BNCT and its high costs represent the limits of BNCT. However this procedure demonstrated good and selective anti-neoplastic activity in absence of toxicity to non neoplastic tissue. Thus, we think that the BNCT can be considered an innovative approach to advanced liver metastases and should be mentioned in the list of available therapies for such malignancies. REFERENCES 1. Altieri S, Braghieri A, Fossati F, et al. Evaluation of a selective boron absorption in liver tumours. Strahlenter Onkol 1989; 165:170-172. 2. Pinelli T, Altieri S, Fossati F, et al. Development of a method to use Boron Neutron Capture Therapy for diffused tumours of liver (Taormina Project). Proceedings of the Sixth International Symposium on Neutron Capture Therapy for Cancer. Kobe, Japan: New York Plenum Press, 1996:783- 794. Competing interests: None declared |
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