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In an adjuvant breast cancer trial conducted more than 20 years ago, older patients were randomized to treatment with tamoxifen and prednisone or no adjuvant therapy. Now, at 21 years of follow-up, it is clear that disease-free and overall survival remain better for those who received treatment.
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In this largest reported series of surgical Stage I UPSC patients, recurrence rates were lower than those published in previous studies, suggesting a potential benefit of comprehensive surgical staging in these patients. The risk of recurrence and the mean overall survival were similar between surgical Stage I UPSC patients who were managed conservatively and those treated with adjuvant radiation therapy.
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Patients with elevated bilirubin treated with irinotecan have an increased risk of toxicity, and a dose reduction is recommended. Patients with elevated AST, creatinine or prior pelvic radiation do not appear to have increased sensitivity to irinotecan, but the data are not adequate to support a specific dosing recommendation.
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Hepatocellular carcinoma is one of the most common malignancies worldwide, and, for those with advanced disease, treatment responses have been dismal. The current report of a trial of gemcitabine and oxaliplatin offers some hope. Using 2 different schedules of these agents, this study found an approximate 20% objective response rate with stable disease occurring in an additional 50%.
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Merkel cell carcinoma is a tumor of the skin that is well known for its metastatic potential. Because of its scarcity, no trials have been reported. Poulsen and colleagues from Australia conducted a unique multi-institutional Phase II prospective trial of concomitant chemoradiation for patients with high-risk disease and concluded that their regimen resulted in disease control and survival rates that are better than those reported in the literature.
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A debate that has become more heated in the 21st century is whether all embryonic research should be subject to human subject research protection and IRB review.
