This subgroup of patients may therefore have a higher risk of experiencing late radiation related toxicity such as neurocognitive dysfunction, and might benefit from longer course WBRT with lower doses per fraction. Further studies of more aggressive local therapy with different dose and fractionation schedules, in a manner that could minimize late effects, could probably be more efficient AZD9291 order for this subgroup of patients supposed to have longest median survival. The combination of a tumor type that has a high potential for CNS spread and a treatment that does not penetrate the CNS but is very effective outside of the CNS creates the opportunity for CNS disease to become a major clinical problem. As an example, the introduction of trastuzumab has altered the natural history of patients with HER2 positive breast cancer, and unmasked CNS metastases as a potential sanctuary site.

It is anticipated that this HER2 paradigm is applicable Inhibitors,Modulators,Libraries across tumor types, as patients live longer with advanced cancer. In the next decade, there will be a greater need to conduct Inhibitors,Modulators,Libraries carefully designed trials of both cytotoxic chemotherapeutic agents and targeted agents, either alone, or in combination, with specific CNS end points. Conclusions In conclusion, BM patients with breast cancer are an heterogenous Inhibitors,Modulators,Libraries group of patients. BM patients with HER 2 overexpressing tumors treated by trastuzumab appears to be a clearly distinct subroup of patients who can expect a median survival time of about 20 months and a1 year survival rate of 60%.

This information may be useful to tailor the therapy for subgroups of patients, to define Inhibitors,Modulators,Libraries homogeneous cohorts for prospective randomized trials, and to identify more precisely patients with rela tive good prognosis who could be treated with innova tive approaches, Inhibitors,Modulators,Libraries in order to obtain better intra cerebral control, in a manner that could minimize late effects. Background The inherent host tumor immunosurveillance system combats the formation and growth of tumors, mainly relying on the interaction of effector immune cells with the tumor cells. Activation of tumor specific cyto toxic T lymphocytes requires presentation of tumor associated antigens primarily by dendritic cells, in addition to the helper functions of CD4 cells. For this reaction to proceed, immature DC with high endocytic activity must differentiate into mature DC with increased expression of co stimulatory molecules that prime and boost T cell and B cell func tions.

The implementation of these immune reac tions into anti tumor therapy is desirable but cannot be satisfactorily achieved in many situations through classi www.selleckchem.com/products/Tubacin.html cal systemic therapy alone. Recently, we and other groups demonstrated the induction of increasing immune reactions using oncolytic viruses in both syngeneic mouse and human ex vivo and in vivo tumor xenograft models. Parvo viruses or other viruses employed as therapeutic gene vectors are used to stimulate the immune system.