Aims: Gastric cancer in the elderly represents a distinct entity with specific clinicopathological characteristics and the majority of affected patients belong to this age group. Subtotal or total gastrectomy with radical lymph node dissection, adjuvant chemo-radiotherapy or perioperative chemotherapy represent the only potentially curative treatment options and seem to be performed with acceptable morbidity and mortality rates in selected elderly patients. Published research is very limited due to the strict selection and under-representation of elderly patients in clinical trials. A review of current recommendations and practice was performed.Methods: A comprehensive literature review was performed searching Medline for articles published since 1974, using "gastric cancer", "elderly" and "treatment" as key words.Observations: The data suggest that elderly patients that fulfill the inclusion criteria of clinical trials experience the same advantages and toxicities from chemotherapy as younger patients. Fit elderly patients with operable gastric cancer should be canndidates for the standard surgical resection provided that pre-operative comorbidities are taken into account. Peri-operative chemotherapy or post-operative chemoradiotherapy should be added in case of locally advanced disease. Palliative systemic chemotherapy seems to prolong survival in recurrent and metastatic disease.Conclusions: Chronological age alone is not sufficient reason to withhold curative or palliative treatment from an elderly gastric cancer patient. Performance status does not suffice in order to estimate the general condition of elderly patients and cofactors regarding their functional, social and mental status have to be considered.Word count (abstract): 234

Oesophageal cancer (OC), is an aggressive cancer constituting a major cause of cancer-related deaths worldwide. Recent advances in surgical techniques, incorporation of new therapeutic approaches -- adjuvant/neoadjuvant chemoradiotherapy -- and integration of new cytotoxic drugs into the management of oesophageal cancer have increased the response rate percentages to 40-50%, with minor impact on the overall survival. The need for an efficacious therapy with minimal toxicity along with a better understanding of molecular pathways of oesophageal carcinogenesis has led to the development of novel anticancer agents. These agents have targeted mechanisms of action such as: (1) inhibitors of the ErbB receptor family, (2) vascular endothelial growth factor (VEGF) inhibitors, (3) selective inhibitors of cycloxygenase-2, (4) matrix metalloproteinase inhibitors, (5) cell-cycle regulators, and (6) promoters of apoptosis. The incorporation of these agents into combined modality treatment schedules for advanced and early stage tumors together with the identification of patients who will most likely benefit will provide novel opportunities in the treatment of oesophageal cancer.

Autoimmunity can be associated with cancer and one of the forms of its expression is the development of antibodies to autologous cellular antigens. The types of cellular proteins which induce autoantibody responses in gastrointestinal malignancies are quite varied and include cellular proteins encoded by mutated normal genes (p53), cellular proteins that are overexpressed and/or aberrantly expressed in malignant tissues (carcinoembryonic antigen), inhibitors of apoptosis (survivin and livin), major components of mucus (mucins), surface receptors of apoptosis (Fas) and nuclear-restricted proteins (double-stranded DNA, single-stranded DNA and Sm family proteins). In the past few years, due to the great clinical interest and the advancement in detection techniques, the above list has grown significantly and a large number of cancer-related antigens, which trigger a specific humoral immune response to the host, have also been identified. The authors review the autoantibodies associated with gastrointestinal malignancies and their clinical implications.

Background:The most satisfactory treatment for patients with locally advanced NSCLC is combination chemotherapy-radiotherapy (CT-RT). The optimal treatment modalities remain to be determined. Methods: 60 patients (pts) with inoperable locally advanced NSCLC, stage IIIAN2/IIIB (no pleural T4), were included in a phase II study with induction chemotherapy consisting of three cycles of Docetaxel 75 mg/m 2 on D1 and Cisplatin 40 mg/m 2 D1-2 every 3 weeks and, if no surgery, then received concurrent CT-RT with Docetaxel 30 mg/m 2 every 2 weeks for four courses, during thoracic conformal radiotherapy (60-66 Gys, 180 cGy/day). The primary objective: overall survival; secondary: progression free survival, response rate (RR) and toxicity. Median follow-up: 9.1 mo. Results:The pts characteristics were: mean age 62.9 yrs (43-74); male/ female: 56/4; ECOG 0/1 in 17/43 pts; stage IIIAN2: 17 pts (28.3%) and stage IIIB 43 pts (71.7%). 56 pts were evaluables for response and 58 pts for toxicity. Induction chemotherapy response: 1 CR and 34 PR (RR 62.5%; CI95%:50-75), 16 SD (28.6%) and 5 PD (8.9%). 6 pts went to surgery: 3 pPR, 1 pSD, 1 pPD and 1 unresectable. 34 pts completed concurrent CT-RT treatment with 6 CR, 21 PR, 4 SD and 3 PD (RR 79.3%; CI95%:66-93). The median time to progression was 13 mo and median overall survival was 14 mo. The progression-free survival and overall survival at 1 year was 52% and 62% respectively. A total of 163 cycles of induction chemotherapy were administered (2.8 per pts), with the main toxicity (NCI-CTC) per pts Grade (g) 1-2/3-4 (%) was as follows: neutropenia 20.