New chemotherapeutic agents: update of major chemoradiation trials in solid tumors.
The institution of combined modality therapy for unresected solid tumors has resulted in significant improvements in tumor control and survival benefit compared with radiotherapy (RT) alone. A number of chemotherapy agents that can enhance the effectiveness of RT, such as cisplatin and 5-fluorouracil, are now considered standard treatment for patients with a number of cancer types. There is growing interest in a number of additional agents that have also been found to have radiosensitizing ability. These include paclitaxel, docetaxel, irinotecan, gemcitabine, and vinorelbine, as well as biologic agents. Other agents may be of value because they act to counter dose-limiting toxicities associated with RT. This article provides an update of some important, recently completed and ongoing clinical trials evaluating novel chemoradiation protocols, with examples taken primarily from studies conducted by the Radiation Therapy Oncology Group (RTOG). Theoretical approaches to the development of new agents and combined modality regimens are also discussed.
Curran
Walter J
WJ
Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pa. 19107-5097, USA. walter.curran@mail.tju.edu
D019883:Alkyl and Aryl Transferases / Q000037:antagonists & inhibitors; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D043168:Angiostatins; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D015507:Drugs, Investigational / Q000627:therapeutic use*; D016228:Endothelial Growth Factors / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D051231:Farnesyltranstransferase; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D008222:Lymphokines / Q000627:therapeutic use; D008297:Male; D008565:Membrane Proteins; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D010446:Peptide Fragments / Q000627:therapeutic use; D010958:Plasminogen / Q000627:therapeutic use; D011451:Prostaglandin-Endoperoxide Synthases; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D011758:Pyrroles / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D015507:Drugs, Investigational; D016228:Endothelial Growth Factors; D004791:Enzyme Inhibitors; D007211:Indoles; D036341:Intercellular Signaling Peptides and Proteins; D007527:Isoenzymes; D008222:Lymphokines; D008565:Membrane Proteins; D010446:Peptide Fragments; D011758:Pyrroles; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; C116890:Semaxinib; D043168:Angiostatins; D010958:Plasminogen; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D019883:Alkyl and Aryl Transferases; D051231:Farnesyltranstransferase