HDI is an active drug in first-line therapy against adult STS. Different administration schedules should be evaluated in an attempt to improve its therapeutic index.

No abstract

The increase in life expectancy in the western world means that we are faced with patients diagnosed with breast cancer in old age with increasing frequency. The management of these cases is a challenge for the oncologist, who must take into account the conditions associated with advanced age and the lack of trials in this population. In this review, we addressed the incorporation of geriatric assessment methods that may be useful in making decisions, the particular biological characteristics of breast cancer in elderly patients and their treatment in both localized and advanced disease. Finally, we collected recommendations based on scientific evidence regarding the monitoring and life-style after finishing treatment.

12028 Background: Treatment of tumors of unknown primary site is still a challenge nowadays. D, C and G have shown high activity in solid tumors. We designed this study to evaluate activity and toxicity profile of a combination of these three drugs, according a protocol previously tested in lung cancer (Pectasides D, et al. J Clin Oncol 1999). Methods: Patients with histological diagnosis of solid tumor of unknown primary site, age ≥ 18 years old, ECOG PS ≤ 2 and adequate bone marrow, renal, hepatic and cardiac functions, were included. Treatment consisted in (d1): C AUC = 5 and G 800 mg/m2 IV; and d8): D 75 mg/m2 and G 800 mg/m2 IV, with G-CSF support. Courses were repeated every 28d for a maximum of 8 cycles, unless progression, unacceptable toxicity or consent withdrawal, whichever comes first. Results: Sixty-three patients have been included: median age was 66 years old (28–90), 89.6% of patients had ECOG PS 0–1. Tumor histology included adenocarcinoma (65.1%), undifferentiated (17.5%) and carcinoma (7.9%) or large-cell carcinoma (1.6%). Main metastatic sites were lung (49%), liver (44%), lymph nodes (41%) and bone (25%). Previous treatments included surgery (20.6%), chemotherapy (1.6%) and radiotherapy (12.7%). Treatment: 296 cycles (median 6, range 1–11) were administered. Median relative dose intensity was 96% for D, C and G. Efficacy: 8 patients achieved CR and 15 PR, resulting in an overall response rate of 36.5% (95% CI: 24.6–48.4%). Main grade III/IV toxicity per patient were asthenia (19%), diarrhea (18%), mucositis (11%), vomiting (10%), nausea (6%), thrombocytopenia (38%), neutropenia (24%), leucopenia (19%) and anemia (13%). Febrile neutropenia was observed in 2 patients (3%). Fourteen patients (22.2%) experienced severe toxicity: 9 of them were dropped out and 5 were toxic deaths (2 sepses, 2 pancytopenia and 1 pulmonary thromboembolism). Median time to treatment failure was 6.0 months (95% CI: 4.8–7.1), median TTP was 10.8 months (95% CI: 8.6–13.0) and median OS was 11.8 months (95% CI: 9.4–12.3), with a median follow up of 10.8 months. Conclusions: Despite the combination of D, C and G shows high activity in tumors of unknown primary site, its toxic death rate is > 5%. Thus, our group is working no longer with such a triplet combination. No significant financial relationships to disclose.