Summary of the Second International Conference on Biology, Prevention and Treatment of Gastrointestinal Malignancies.
R. Mayer (U.S.A.) in summarizing the data presented at the three day conference, raised several general issues. Therapeutic benefit in the past has been measured by the criterion of 'objective response'; the latter term most likely should be replaced by 'quality of life' and 'overall survival time' since they appear to be more biologically meaningful. It appears that few new cytotoxic drugs have been developed in recent years, and , as yet, none has an established role in the management of patients with gastrointestinal cancers. Of those currently under investigation, CPT-11 seems to represent the most promising, since its mode of action is something other than inhibition of thymidylate synthase. It seems that too many small, uncontrolled studies examining a give concept (e.g. neoadjuvant therapy) have been performed prior to initiating definitive, phase III trials; a greater degree of collaboration seems necessary so that new treatment principles may be objectively assessed in an efficient manner. Finally, it seems clear that economic realities are increasingly affecting choices in patient care and clinical research and this trend will undoubtedly increase in the future.
Mayer
R J
RJ
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
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