John Stamos - Public Service Announcement
EVA-PCD™ Role
Is there a role for these techniques in first-line therapy?
With rare exception, all human cancers present the treating physician with therapeutic choices. Even the most curable malignancies, the acute leukemias and lymphomas are managed with varied combinations, each emphasizing specific classes of drugs. Solid tumors like lung, ovarian or breast cancer pose additional therapeutic choices.
Among the most powerful uses of assay techniques is their application to select amongst comparable options. The choice of CAF over CMF hinges upon the degree of activity of Adriamycin over that of Methotrexate. NSCLC patients face the choice of Platinum + Taxol versus Platinum + Navelbine. Ovarian cancer patients must weigh Taxol plus Platinum against the newer combinations of Topotecan or Gemcitabine. Finally, Doxorubicin may have a role in the management of small cell lung cancer, despite the current primacy of Cisplatin-VP-16-based therapy. Regrettably, equivalent response likelihoods do not automatically translate into equivalent responses.
The most effective use of cytotoxic chemotherapy is in the first-line setting. The use of ineffective drugs at the time of initial therapy may lead to treatment failure. While some patients present with inherently resistant disease, it is possible that the resistance identified against one " standard" regimen may not be obtained with all regimens. Our responsibility as clinical oncologists is to use every available resource at our disposal to select the most effective, least toxic drugs for our patients. These assay techniques can help us make the right choices for our patients whether at first-line therapy or thereafter.
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