Adjuvant Therapies of Cancer

Transplantation of syngeneic (donor is a monozygous twin) or allogeneic (donor is an HLA-identical sibling) marrow provides the opportunity for aggressive antileukemic therapy without regard to marrow toxicity. Until 1975, marrow transplantation was carried out only after failure of all other therapy. Consequently, most patients were in advanced relapse. Six of 16 recipients of syngeneic marrow and 13 of 100 recipients of allogeneic marrow are still in remission after 5. 5-10 years [3, 7]. An actuarial survival curve of the first 100 patients grafted in Seattle after conditioning with cyclophos phamide (60 mg/kg on each of 2 successive days) and total body irradiation (1,000 rad) showed three periods of interest: (1) The first 4 months showed a rapid loss of patients associated with advanced illness, graft-versus-host disease, infections (in particular interstitial pneumonias), and recurrent leukemia; (2) from 4 months to 2 years, the curve showed a much slower rate of decline attributable primarily to recurrent leukemia; and (3) from 2-10 years, the curve was almost flat with a negligible loss of patients and no recurrent leukemia. This flat portion of the curve corresponded to 13% of the patients and indicates a strong probability that the majority of these survivors are cured of their disease [8]. Attempts at reducing the incidence of leukemic relapse after transplantation were made by a number of marrow transplant groups by added chemotherapy.

Inhalt
I. General Considerations.- 1. Metastatic Potential of Metastases, Tumor Cell Heterogeneity, and Therapeutic Implications.- 2. Immune Imbalance and Immune Modulation in Solid Tumor Patients: New Insights.- 3. Markers of Minimal Residual Disease.- 4. Radiotherapy as Adjuvant Local Therapy of Local Tumors.- II. Hemopoietic and Lymphoid Neoplasias.- 5. Comparison of HLA Phenotypes in Long-Term Survivors with Acute Lymphoblastic Leukemia Treated with Immunotherapy Versus Chemotherapy.- 6. An Intensive Chemo- or Chemoimmunotherapy Regimen for Patients with Intermediate and Poor- Prognosis Acute Lymphatic Leukemia and Leukemic Lymphoblastic Lymphosarcoma: Preliminary Results with 14-Month Median Follow-Up.- 7. Poor-Prognosis Acute Lymphoblastic Leukemias.- 8. Therapeutic Effectiveness of Neuraminidase- Treated Allogeneic Myeloblasts as Immunogen in Acute Myelocytic Leukemia.- 9. Maintenance Chemoimmunotherapy of Nonlymphoblastic Acute Leukemias.- 10. Possible Mechanisms of Immunotherapy Action in Acute Nonlymphatic Leukemia: Macrophage Production of Colony-Stimulating Activity.- 11. The Finnish Leukaemia Group: Levamisole in Maintenance Therapy of Acute Myeloid Leukemia in Adults.- 12. Treatment of Acute Leukemia in Remission by Bone Marrow Transplantation.- 13. Prevention of Blastic Crisis in Ph1 -Positive Chronic Myeloid Leukemia.- 14. A Southwest Oncology Group: Chemotherapy Versus Chemotherapy Plus Radiotherapy in Treatment of Stage III Hodgkin's Disease.- 15. Maintenance Immunotherapy with BCG in Non-Hodgkin's Malignant Lymphomas: A Progress Report of a Randomized Trial.- III. Bone Tumors.- 16. Role of Lung Irradiation in the Adjuvant Treatment of Osteosarcoma.- 17. Adjuvant Interferon Treatment of Human Osteosarcoma.- 18. A Strategic Adjuvant Therapy ofOsteosarcoma.- 19. Ewing's Sarcoma: Treatment with High-Dose Radiation and Adjuvant Chemotherapy.- 20. Adjuvant Chemotherapy in Ewing's Sarcoma Patients.- 21. Early Results of Combined Modality Therapy of Patients with Ewing's Sarcoma.- 22. Ewing's Sarcoma: 5-Year Survival Under Adjuvant Chemotherapy.- IV. Breast Carcinoma.- 23. Natural History of Breast Cancer.- 24. Adjuvant Chemotherapy in Breast Cancer.- 25. Multimodal Therapy with CMF in Resectable Breast Cancer with Positive Axillary Nodes: The Milan Institute Experience.- 26. Follow-Up Results from a Randomized Trial for T3 and T4 Breast Cancer Patients: Previous BCG Immunotherapy Improves Response to Chemotherapy in the Relapse Patient.- 27. Adjuvant Treatment of Node-Positive Breast Cancer with Adriamycin-Cyclophosphamide with or Without Radiation Therapy: Interim Results of an Ongoing Clinical Trial.- 28. A Randomized Trial of Postoperative Five- Versus Three-Drug Chemotherapy After Mastectomy: A Cancer and Leukemia Group B (CALGB) Study.- 29. Adjuvant Chemoimmunotherapy with LMF Plus BCG in Node-Negative and Node-Positive Breast Cancer Intermediate Report at 4 Years.- 30. Adjuvant Intermittent Chemoimmunotherapy for Primary Breast Cancer: A Prospective Study with Immunologic Follow-Up.- 31. Short-Term and Long-Term Effects of Chemoimmunotherapy on Granulopoiesis: Adjuvant Therapy of Breast Cancer.- 32. A New Adjuvant Treatment with Polyadenylic- Polyuridylic Acid in Operable Breast Cancer.- V. Lung Carcinoma.- 33. Metastatic CNS Disease in Small Cell Carcinoma of the Bronchus: The Role of Radiotherapy and Chemotherapy.- 34. Interim Results of EORTC Protocol 08742: Comparison, After Irradiation of Locally Advanced Squamous Cell Bronchial Carcinoma, of Abstention, Immunotherapy, CombinationChemotherapy or Chemoimmunotherapy.- 35. Immunologically Defined Prognostic Subgroups as Predictors of Response to BCG Immunotherapy.- 36. Intrapleural BCG Immunotherapy of Lung Cancer Patients.- 37. Specific Active Immunotherapy in Lung Cancer: The Induction of Long-Lasting Cellular Responses to Tumour-Associated Antigens.- 38. Malnutrition in Lung Cancer: Incidence, Prognostic Implications, and Pathogenesis.- 39. Follow-Up of a Randomized Trial for Oat Cell Carcinoma Evaluating the Efficacy of Peripheral Intravenous Nutrition (PIVN) as Adjunct Treatment.- VI. Melanoma.- 40. Clinical Trials of Chemotherapy and Chemoimmunotherapy in Primary Malignant Melanoma.- 41. Trial 6: Randomized Study of Prolonged Chemotherapy, Immunotherapy, and Chemoimmunotherapy as an Adjuvant to Surgery for Stage I and II Melanoma. A Progress Report.- 42. Current Status of Melanoma Chemotherapy and Immunotherapy.- VII. Testicular Neoplasia.- 43. Adjuvant Therapy of Testicular Carcinoma.- VIII. Gastrointestinal Neoplasms.- 44. Adjuvant 5-Fluorouracil and BCNU Chemotherapy in Gastric Cancer: 3-Year Results.- 45. Adjuvant Chemotherapy in Colon and Gastric Cancer.- 46. Chemotherapy of Metastatic Gastrointestinal Cancers: Prospects for Future Adjuvant Systemic Therapies.- 47. Chemotherapy of Carcinomas of the Digestive Tract.- IX. Conclusions and Prospects.- 48. Clinical Trials on Adjuvant Therapies in Cancer: Short-Term and Long-Term Results.- 49. Long-Term Costs of Adjuvant Radiotherapy.- 50. Long-Term Cost of Combined Radiotherapy and Chemotherapy.- 51. Studies of Clonogenic Human Tumor Stem Cells.- 52. Current Status of Clinical Trials of m-AMSA, Dihydroxyanthracenedione, and Deoxycoformycin.- 53. Three New Agents for Immunotherapy Trials: Azimexon, Bestatin, and Tuftsin.- 54. Emerging Immunologic Approaches to Treatment of Neoplastic Diseases.- 55. Cellular Interactions Modulating Host Resistance to Tumours.- 56. Preliminary Clinical Results with Norgamen (Thioproline) and Revercan (S-Amino-2- Thiazoline): The First Inducers of Reverse Transformation.- 57. Biologic Response Modifiers and Adjuvant Chemotherapy: Consideration of Selected Preclinical Investigations in Relation to Clinical Potential.