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Capecitabine is known to be active in advanced gastric cancer, with a single agent response rate in chemonaive pts of 24% (Koizumi et al, 2003).
It was approved for the treatment of canine mast cell tumors (MCTs) based on a single agent response rate of approximately 43% in dogs with recurrent or non-resectable grade 2 or 3 MCTs [ 2].
To date, single agent response rates in heavily pretreated patients with solid tumour malignancies have been low; however, combination strategies with conventional chemotherapy and molecularly targeted agents have activity and are tolerable (Fanucchi et al, 2006; Dees et al, 2008; Dudek et al, 2009).
The intravenously administered alkylating agent dacarbazine (DTIC) is a standard treatment for metastatic melanoma with single agent response rates reported in the range of 5 15% (Falkson et al, 1998; Chapman et al, 1999; Middleton et al, 2000; Avril et al, 2004).
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As a single agent responses are seen in about 10% of patients [ 12] and response rates are higher when concurrent irinotecan is administered [ 12].
The movement away from the anticipated combination effects can be partly attributed to the fact that the single agent responses seen concurrently with the mixture study were slightly higher than previously recorded, particularly in the high-effect range.
While monotherapy with these drugs has had success in cancers with historically poor outcomes (e.g., gastrointestinal stromal tumours and renal cell carcinoma), single agent responses in other solid tumour malignancies have been limited (Barrios et al, 2010; Gallagher et al, 2010).
Used as single agents response rates of cisplatin and gemcitabine in malignant mesothelioma have been reported of 13 14% and 7 24% respectively (Mintzer et al, 1985; Zidar et al, 1988; Van Meerbeeck et al, 1999; Kindler et al, 2001).
Phase II studies have demonstrated single-agent response rates of approximately 20% for a number of chemotherapeutic agents.
Drugs such as fotemustine and temozolomide have reported single-agent response rates of 25% (Douglas and Margolin, 2002).
Moreover, gemcitabine has shown single-agent response rates of 28 36% in previously untreated metastatic bladder patients, with mild myelosuppression (Chester et al, 2004).
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