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Our results also suggest that sunitinib combined with gemcitabine may be a more active regimen than gemcitabine-based chemotherapy, which has also shown limited activity in sarcomatoid RCC (Stadler et al, 2003; Nanus et al, 2004).
With respect to this hypothesis, we considered the cisplatin plus vinorelbine regimen (CCDP/VNR) as the more active regimen compared with the non-cisplatin-containing regimen of ifosfamide plus high-dose epirubicin (IFO/EPI).
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More active regimens are needed to further evaluate the utility of this clinical trial design in patients with prostate cancer.
However, many medical oncologists feel that this regimen is now outdated and that there are more active regimens available for gastric cancer.
Second, since about half of patients with a poor-prognosis according to the IGCCCG are cured with the BEP regimen, we need to improve the selection of patients for potentially more active regimens so that patients who can be cured with BEP are spared the added toxicity of these regimens.
Nevertheless, data from a small randomised trial that compared the use of FAMTX as preoperative therapy before surgery vs surgery alone in operable gastric cancer could not demonstrate that the FAMTX regimen was suitable as neoadjuvant chemotherapy, and the authors concluded that more active regimens should be tested in further randomised studies (Songun et al, 1999).
Capecitabine and oxaliplatin are being tested in advanced oesophagogastric cancer and would certainly provide a more convenient and hopefully more active systemic regimen.
Subsequently, one randomized trial investigating the role of peri-operative chemotherapy using a more active chemotherapy regimen and a larger number of accrued patients has been conducted [ 15].
Although results of tumour response are exploratory, with this dose (130 mg m−2), irinotecan was poorly effective and a more active chemotherapeutic regimen should be considered for this group of patients.
Finally, we suggest that as the MTD in patients with a high-risk UGT1A1 *28/*28 genotype (130 mg m−2) is ineffective, other more active chemotherapeutic regimen should be considered for these patients.
Although the emphasis in LBP management has shifted towards more active treatment regimen in Finland, this explanation is not presumable, because no changes in the incidence of unspecified LBP were seen.
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