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NTHRACYCLINES ARE AMONG the most widely used agents for breast cancer treatment, followed by taxanes, which were gradually introduced during the last decade. Combinations of these drug classes have proven superior to anthracyclines alone in advanced or metastatic breast cancer, 1,2 while taxanes are still under evaluation in early breast cancer. 3 Uncertainties regarding the optimal schedule of administration in combination with anthracyclines, as well as safety and cost issues, are fueling a debate on whether the use of taxanes is justified outside of clinical trials. 4 Febrile neutropenia is a common adverse effect of chemotherapy, the severity of which depends both on the types and doses of drugs administered and on individual risk factors. 5 Several groups have tested combinations of docetaxel with anthracy-clines in adjuvant and neoadjuvant settings, and the data were recently reviewed. 3 Higher rates of febrile neutro-penia are reported with these combinations, including various docetaxel schedules, than with more traditional

BackgroundMetastatic colorectal cancer frequently occurs in elderly patients. Bevacizumab in combination with front line chemotherapy (CT) is a standard treatment but some concern raised about tolerance of bevacizumab for these patients. The purpose of PRODIGE 20 was to evaluate tolerance and efficacy of bevacizumab according to specific end points in this population.Patients and methodsPatients aged 75 years and over were randomly assigned to bevacizumab + CT (BEV) versus CT. LV5FU2, FOLFOX and FOLFIRI regimen were prescribed according to investigator’s choice. The composite co-primary end point, assessed 4 months after randomization, was based on efficacy (tumor control and absence of decrease of the Spitzer QoL index) and safety (absence of severe cardiovascular toxicities and unexpected hospitalization). For each arm, the treatment will be consider as inefficient if 20% or less of the patients met the efficacy criteria and not safe if 40% or less met the safety criteria.ResultsAbout 102 patients were randomized (51 BEV and 51 CT), median age was 80 years (range 75–91). Primary end point was met for efficacy in 50% and 58% and for safety in 61% and 71% of patients in BEV and CT, respectively. Median progression-free survival was 9.7 months in BEV and 7.8 months in CT. Median overall survival was 21.7 months in BEV and 19.8 months in CT. The 36-month overall survival rate was 27% in BEV and 10.1% in CT. Severe toxicities grade 3/4 were mainly non-hematologic toxicities (80.4% in BEV, 63.3% in CT).ConclusionBevacizumab combined with CT was safe and efficient. Both arms met the primary safety and efficacy criteria.

PSA values are of major prognostic significance in assessing the 4-year results of radical radiation therapy for localized prostate cancer. The rate of decline of PSA values is the strongest predictor of outcome and might help to identify a subset of patients with poorer prognosis who may benefit from early hormonal therapy.

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