Search

Background: This phase I/II study was conducted to assess the maximal tolerated dose (MTD) and the dose-limiting toxicities (DLTs) of gefitinib in combination with capecitabine in patients with advanced colorectal cancer (aCRC)., Patients and Methods: After failure of a 1st-line therapy, patients with aCRC received escalating doses of gefitinib once daily in combination with capecitabine twice daily: dose level (DL) 1: gefitinib 250 mg and capecitabine 1,000 mg/m(2), DL 2: gefitinib 250 mg and capecitabine 1,250 mg/m(2), DL 3: gefitinib 500 mg and capecitabine 850 mg/m(2). DLTs were determined after 6 weeks of treatment., Results: A total of 16 patients were enrolled. On DL1 (n = 6), 1 patient developed a DLT (hand-foot syndrome, HFS n = 1). On DL2 (n = 7), DLTs were observed in 3 patients (exanthema n = 2, HFS n = 1), and on DL3 (n = 3), DLT occurred in 1 patient (HFS n = 1) resulting in recruitment stop at DL3. No patient showed an objective tumor response. Disease stabilization was observed in 6 patients., Conclusion: The combination of gefitinib and capecitabine resulted in significant skin toxicities such as exanthema and HFS. As 2nd-line treatment of patients with aCRC, this combination showed no substantial efficacy., (Copyright 2010 S. Karger AG, Basel.)

Background: Intravascular lymphoma (IVL) is an uncommon disease characterized by atypical lymphoid cells growing inside the lumina of small vessels. The diversity of clinical presentation due to possible involvement of multiple organs often complicates its diagnosis., Case Report: Here, we report on a case of IVL with rapidly progressive dementia and Coombs-negative hemolytic anemia. Interestingly, the erythrocytes exhibited a decreased osmotic resistance. Bone marrow histopathology revealed increased erythropoiesis and, finally, a small monoclonal B lymphocyte population. Cerebral magnetic resonance imaging (MRI) demonstrated few micro-bleedings. Computed tomography (CT) showed bilateral ground-glass opacity of the lungs. Within a few days, the patient developed respiratory failure and died. On post-mortem examination, intravascular large B-cell lymphoma with almost complete infiltration of the brain and lungs was diagnosed., Conclusion: IVL should be considered early in situations of unexplained neuropsychiatric disease along with markedly elevated levels of lactic dehydrogenase, anemia, and hemolysis., (Copyright 2010 S. Karger AG, Basel.)

The anti-angiogenic, monoclonal antibody bevacizumab, in combination with chemotherapy, is proven to prolong survival in metastatic colorectal cancer. Recent data demonstrate that combining bevacizumab with widely used oxaliplatin-containing chemotherapy regimens is a promising strategy for further improving patient outcomes., (Copyright 2009 S. Karger AG, Basel.)