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Chemotherapy strategy and timing

23 articles

ACACIA trial

ACACIA (Adjuvant Chemotherapy for Adrenocortical CarcInomA), EudraCT 2018-000580-90, NCT03723941: Italian phase III trial of adjuvant cisplatin-etoposide with or without mitotane versus observation or mitotane in high-risk localized adrenocortical carcinoma; distinct from the ACACIA-HCM aficamten cardiology trial.

Adaptive therapy

Adaptive therapy is a cancer treatment strategy that modulates drug dosing in response to measured tumor burden, maintaining sensitive cells to suppress resistant ones and prolong time to progression.

ADAURA trial

ADAURA (NCT02511106) is AstraZeneca's Phase III trial of adjuvant osimertinib (Tagrisso) versus placebo after resection in EGFR exon 19 del/L858R stage IB–IIIA NSCLC; DFS HR 0.20, 5-year OS 88% vs 78%, FDA approval December 2020.

Adjuvant Chemotherapy

Adjuvant chemotherapy, also called preventative chemotherapy, is anticancer drug treatment given after surgery to kill remaining cells and prevent recurrence; contrasted with neoadjuvant chemotherapy given before surgery, with established uses in breast, colorectal, lung, and other cancers.

Adjuvant immunotherapy

Adjuvant immunotherapy gives immune checkpoint inhibitors such as pembrolizumab and nivolumab after complete tumor removal or chemoradiation, aiming to eradicate residual microscopic disease and prevent relapse.

Central nervous system prophylaxis

Central nervous system prophylaxis is preventive chemotherapy or cranial irradiation given during cancer treatment, standard in acute lymphoblastic leukemia, to stop leukemia or lymphoma reaching the brain.

Combined Modality Therapy

Combined modality therapy, also known as multimodality treatment or combination therapy, is the treatment of cancer by several therapeutic means, such as surgery, radiotherapy, and chemotherapy.

Consolidation Chemotherapy

Consolidation chemotherapy (also called intensification or postremission therapy) is treatment given after induction puts cancer into remission, to kill remaining cells. Standard in acute leukemia; in myeloma and solid tumors its survival benefit varies by disease.

Dose-dense chemotherapy

Dose-dense chemotherapy is a scheduling strategy that shortens the interval between cycles while keeping each dose unchanged, established in node-positive breast cancer with growth-factor support.

Doublet chemotherapy

Doublet chemotherapy is a cancer treatment that combines two cytotoxic drugs given together in the same treatment cycles, the standard first-line backbone for advanced colorectal cancer with regimens such as FOLFOX or FOLFIRI.

ESCCNCRTvNCT trial

ESCCNCRTvNCT trial (NCT03001596, CMISG1701): Chinese multicenter randomized phase III trial comparing neoadjuvant chemoradiotherapy versus chemotherapy followed by minimally invasive esophagectomy in 264 patients with cT3-4aN0-1M0 esophageal squamous cell carcinoma; similar safety, higher pCR, no significant survival difference.

Induction chemotherapy

Induction chemotherapy, also called first-line or primary treatment, is chemotherapy given as the first treatment for cancer, before definitive therapies such as surgery, radiotherapy, or chemoradiotherapy.

Maintenance chemotherapy

Maintenance chemotherapy is a cancer strategy of continuing lower-dose treatment after remission to prolong it, distinct from consolidation therapy; it is standard in pediatric acute lymphoblastic leukemia but unproven in ovarian cancer.

Metronomic chemotherapy

Metronomic chemotherapy is a way of giving cancer drugs continuously at low, largely non-toxic doses with no prolonged drug-free breaks, in contrast to conventional maximum-tolerated-dose cycles with rest periods.

Neoadjuvant immunotherapy

Neoadjuvant immunotherapy is the delivery of immune checkpoint inhibitors before surgical removal of a tumor, now a standard of care proven superior to adjuvant immunotherapy in several cancers.

Neoadjuvant Therapy

Neoadjuvant therapy: cancer treatment (chemotherapy, radiation, hormone therapy) given before the main treatment, usually surgery, to shrink tumors; compared with adjuvant (post-surgery) therapy across breast, esophageal, rectal, pancreatic, and gastric cancers.

Polychemotherapy

Polychemotherapy is the treatment of cancer with several chemotherapy drugs given together in a single regimen; regimens like CHOP are named by acronyms built from drug names.

Primary chemotherapy

Primary chemotherapy, also called neoadjuvant, induction, or preoperative therapy, is systemic anticancer drug treatment given as the first treatment after diagnosis, before surgery or radiotherapy, so tumors can shrink and organ-sparing surgery becomes possible.

RAPIDO trial

RAPIDO trial (NCT01558921), a phase 3 study of short-course radiotherapy plus preoperative CAPOX/FOLFOX before surgery versus chemoradiotherapy in high-risk locally advanced rectal cancer; reduced 3-year disease-related treatment failure (23.7% vs 30.4%) and doubled pCR, with no overall survival difference.

Remission induction therapy

Remission induction therapy is the first, intensive phase of acute myeloid leukemia treatment, typically the 7+3 chemotherapy regimen given in hospital to achieve complete remission.

Sequential chemotherapy

Sequential chemotherapy is a cancer treatment strategy in which drugs are given one after another rather than together, allowing higher per-cycle doses; in metastatic breast cancer it shows no survival difference from concurrent treatment.

Triplet therapy

Triplet therapy is a cancer treatment using three drugs together, shown to extend survival in metastatic colorectal and pancreatic cancer at the cost of higher toxicity.

Trofosfamide

Trofosfamide (TFF, Ixoten, A-4828) is an oral oxazaphosphorine prodrug metabolized mainly to ifosfamide; approved in Europe for lymphoma, used off-label as low-dose palliative/maintenance therapy in soft tissue sarcoma.