Our results validate the IMDC model for first-line pazopanib in mRCC and confirm the effectiveness and safety of this treatment.

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Our objective was to assess the antitumoral activity and toxicity of irinotecan (CPT-11) 60-min i.v. infusion every 2 weeks as second-line monotherapy of advanced colorectal cancer. Two doses were studied (250 and 200 mg/m) according to the risk of developing toxicity. Two groups of patients were studied: high-risk group (HR, 200 mg/m, n = 45; Karnofsky score 60-80% and/or the record of prior pelvic irradiation) and low-risk-group (LR, 250 mg/m, n = 51; Karnofsky score >80% and without prior pelvic irradiation). The mean number of cycles per patient was 7: 6.6 (HR group) and 8.3 (LR group). Median RDI was 0.96. The overall response rate was 8.9% [95% confidence interval (CI) 2.5-21.2%; HR group] and 15.7% (95% CI 7.0-28.5%; LR group), respectively. The LR group showed two complete responses and a higher percentage of stable disease (56.9 versus 33.3% in HR group). The median survival was 7.1 months (95% CI 5.2-8.9 months, HR group) and 11.7 months (95% CI 8.4-15.1 months, LR group). The median time to disease progression was 3.2 months (95% CI 1.0-5.4 months, HR group) and 5.3 months (95% CI 3.8-6.7 months, LR group). Both CPT-11 treatments were well tolerated. Grade 3/4 toxicity incidence was low, e.g. granulocytopenia (7% of patients in HR group and 9% in LR group) and delayed diarrhea (18% of patients in HR group and 14% in LR group). We conclude that the treatment of patients with the adjusted dose of CPT-11 according to prognostic factors for toxicity resulted in the improved toxicity profile, but showed poorer efficacy outcome. Therefore, the dose reduction in patients with low performance and treated with radiotherapy needs further investigation to provide some new insights on the benefit:risk ratio of such treatment.

Varón de 77 años fumador de 10 cigarrillos/día y con antecedentes de carcinoma en cuerda vocal izda que es remitido por su médico de familia para estudio al servicio de Medicina Interna por presentar desde hace seis meses astenia intensa, anorexia y dolores óseos generalizados en extremidades y parrillas costales que aumentan con el movimiento, presentando en la analítica un aumento de la velocidad de sedimentación (VSG).En la exploración física la auscultación cardiaca es normal presentando roncus difusos en la auscultación pulmonar. En el abdomen no se palpa hepatoesplenomegalia. Las arterias temporales laten simétricas y no se aprecia focalidad neurológica.En la analítica de sangre presenta una hemoglobina de 13,9 g/dl, siendo el resto del hemograma RESUMEN El mieloma múltiple es una enfermedad caracterizada por una proliferación de células neoplási -cas plasmáticas en la médula ósea y la pro d u c c i ó n de una inmunoglobulina monoclonal.Se aporta el caso de un mieloma IgA y se describe la epidemiología, clínica, diagnóstico y tratamiento del mieloma múltiple.Se resalta la importancia de la difere n c i a c i ó n con la gammapatía monoclonal de significado inc i e rto, que es la causa más común de banda monoclonal en suero u orina y que no re q u i e re tratamiento quimioterápico. El seguimiento de estos pacientes a largo plazo determina que el 16% desarrollará un mieloma múltiple. Palabras clave: Mieloma múltiple. Parapro t e inemias. Células plasmáticas. ABSTRACT The multiple myeloma is a disorder characterised by a proliferation of malignant plasma cells in the bone marrow and production of a monoclonal inmunoglobulin.We

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