Open Access Medical Books

TEXTBOOK : NEOADJUVANT CHEMOTHERAPY - INCREASING RELEVANCE IN CANCER MANAGEMENT

CHEMOTHERAPY

Edited by Maurie M. Markman .

Open Access .
112 pages .

Neoadjuvant chemotherapy is not a new concept in cancer management. It has long been recognized that a subgroup of patients with advanced local (e.g., breast cancer) or regional (e.g., ovarian cancer) malignant disease would not be able to undergo definitive treatment to control the primary lesion. By delivering chemotherapy first it was hoped local control would subsequently be able to be accomplished.
A second category of patients felt to be candidates for a neoadjuvant treatment approach included individuals with significant co-morbid medical conditions (e.g., cardiac history) where it was believed to not be possible to undertake the extensive surgery required to control the local disease process due to the severity of the underlying non-malignant illness.
For example, there is a relatively a long history of the primary administration of chemotherapy to patients with extensive ovarian cancer where the surgeon felt the extent of the surgery would be problematic in view of an individual patient’s baseline cardiac status.
However, assuming an excellent response to chemotherapy, with an accompanying reduction in ascites and pleural effusions, surgery was felt to be able to be successfully and safely undertaken in many such patients.
However, over the past decade there has been increasing evidence that not only is neoadjuvant chemotherapy an option in some patients with extensive local or regional disease, or where an individual patient’s medical status prevents a primary surgical approach, but in some settings it has become the preferred option based on the results of solid evidence-based phase 3 randomized trials.
The general justification for employing a primary neoadjuvant chemotherapeutic approach in several malignancies include: (a) the availability of highly biologically and clinically active anti-neoplastic agents; (b) the presence of significant volume local or regional disease making definitive local control difficult if not impossible in the absence of a substantial reduction in the tumor volume; (c) and the desire to minimize the extent of surgery while not reducing the opportunity for the most favorable survival outcome for the individual patient.
In the chapters of this excellent text, the authors have described advances in the neoadjuvant chemotherapeutic management of a number of tumor types. Based on the extensive experience with this management concept in breast cancer, several chapters are devoted to this important topic (Section 1). Section 2 deals with the administration of neoadjuvant chemotherapy in non-breast malignancies.
Those who read and study the content of the chapters that follow will come away with a far greater understanding of the rationale supporting neoadjuvant chemotherapy, the existing evidence-based data regarding its use, limitations of the approach, and required future investigative efforts to learn how to optimize the benefits of this innovative management concept.

Maurie Markman, M.D.
Senior Vice President for Clinical Affairs, 
Cancer Treatment Centers of America
Clinical Professor of Medicine, 
Drexel University College of Medicine, 
USA
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CONTENTS : 

Section 1 of the Textbook : Neoadjuvant Chemotherapy of Breast Cancer .


1 Neoadjuvant (Preoperative) Therapy in Breast Cancer 3 Vladimir F. Semiglazov and Vladislav V. Semiglazov

 2 Monitoring the Response to Neoadjuvant Chemotherapy in Breast Cancer 25 Katia Hiromoto Koga, Sonia Marta Moriguchi, Gilberto Uemura, José Ricardo Rodrigues, Eduardo Carvalho Pessoa, Angelo Gustavo Zucca Matthes and Dilma Mariko Morita

 3 Neoadjuvant Chemotherapy for Breast Cancer 49 Suthinee Ithimakin and Suebwong Chuthapisith

 4 Neoadjuvant Chemotherapy: Role in Breast Cancer 63 Jasmeet Chadha Singh and Amy Tiersten

Section 2 of the Textbook : Neoadjuvant Chemotherapy of Other Malignancies .


 5 Rationale for Neoadjuvant Chemotherapy in the Management of Malignant Disease 83 Maurie Markman

 6 Neoadjuvant Chemotherapy for Cervical Cancer: Rationale and Evolving Data 87 Sung-Jong Lee, Jin-Hwi Kim, Joo-Hee Yoon, Keun-Ho Lee, Dong- Choon Park, Chan-Joo Kim, Soo-Young Hur, Tae-Chul Park, Seog- Nyeon Bae and Jong-Sup Park

 7 Neoadjuvant Chemotherapy in the Management of Advanced Ovarian Cancer and Primary Cancer of the Peritoneum: Rationale and Results 99 Maurie Markman



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