Adenocarcinoma is one of the most common forms of cancer. Most treatments are effective and can prevent metastases and cancer-related deaths. Adjuvant therapy with chemotherapy remains the key treatment for stage II lung adenocarcinoma.
Around 400,000 cases have been diagnosed with adenocarcinoma of the prostate. It is the second most common form of prostate cancer, with over 200,000 new cases expected to be diagnosed in the second half of this century.
Adenocarcinoma is a rare (around 1 per 10,000) but very aggressive cancer that tends to appear in and affect older smokers. The cause is unknown (although environmental carcinogens are present) but is thought to involve a defect in cell adhesion and cell division. Many adenocarcinomas have mutations of the KRAS oncogene, leading to activation of the RAS signalling pathway. Most adenocarcinomas are treated with surgery and platinum-based chemotherapy, and more than half are cured.
The main symptom of adenocarcinoma is weight loss. If a patient has persistent weight loss, and shows symptoms similar to weight loss, a biopsy should be performed. If this results in an adenocarcinoma diagnosis, then an alternative tumour should be considered, such as a primary intestinal T-cell lymphoma.
The causes of adenocarcinoma are diverse, though smoking, genetics, and environmental factors are often implicated. Some of the other causes may result in either the conversion from a less aggressive cancer such as squamous cell cancer, to a more more aggressive form, such as adenocarcinoma.
(Group a and Group b) Overall, GEM significantly increased the median DAS-28 and PGA scores at one year. Significant improvements in QOL, global health and QOL physical health parameters were noted at three months (mean: 10.02, ±7.5 for group a; 10.12, ±8.26 for group b, respectively) and three months (mean: 10.0, ±9.2 for group a; 10.0, ±9.7 for group b, respectively). Improvement was noted in Group a (p =0.003) and in Group b (p =0.0001) at three months. Significant improvements were noted in Group a (p =0.
Both cohorts had acceptable toxicity and antitumor activity. The addition of CpG ODN or Gd-DTPA to gem enhances its activity. The addition of CpG ODN is associated with enhanced toxicity. The current data, which are the first and largest of their kind, are encouraging, and warrant further studies to elucidate the effects of combination chemotherapy with gem.
Because a significant proportion of AA families with adenocarcinoma may be explained by a recessive mode of inheritance, familial adenocarcinoma should not be classed as a classic autosomal or X-linked dominant disorder.
There is insufficient evidence addressing the issues of the efficacy, safety and cost efficacy of treatment alternatives to surgery, and chemotherapy as primary therapeutic options for patients with locally advanced adenocarcinoma.
Because adenocarcinoma seems to be a less aggressive tumor than either squamous cell carcinoma or non-small cell [lung cancer](https://www.withpower.com/clinical-trials/lung-cancer), the data on response rates provided may be misleading. It will be important to look at other tumor types, such as neuroendocrine tumors, with noninvasive imaging modalities, and more data will be provided as we better understand the role of chemosensitivity in adenocarcinoma. However, even when the patient is considered in the most favorable circumstances, it appears that more than half the patients in our experience will undergo no-response evaluation, which may or may not be related to the cancer.
These clinical trial results suggest that gemcitabine should not be used as a monotherapy for patients with metastatic urothelial carcinomas of kidney but should be used in combination with other chemotherapy agents. The authors suggest further studies with high-quality design.