Five studies presented at the 1992 ASCO meeting are analysed. Kligerman's study was designed to determine if pre-treatment with WR-2721 could protect normal tissues from the toxicities induced by radiation therapy (in 100 patients with advanced rectal cancer). This pre-treatment resulted in a 13 % reduction of moderate and severe acute toxicity. No WR-2721 patient experienced moderate or severe late toxicities compared to five in the group without pre-treatment. The complete response rate was higher in the WR-2721 group and there was no major WR-2721 related toxicity. Minski studied the acute toxicity (during treatment and two weeks after) of combined pelvic radiation therapy, 5-FU and leucovorin when delivered pre-operatively (16 patients) versus post-operatively (25 patients) in patients with rectal cancer. The toxicity criteria were fatigue, diarrhea, tenesmus, bowel movements, dysuria and erythema. Grade 3+ toxicity was more important in the post-operative therapy group (48 % versus 13 %). Given this high incidence of grade 3+ toxicity future randomized trials should explore the pre-operative approach. The final report of the inter group study of 5-FU plus levamisole as adjuvant therapy for stage C colon cancer was made by Moertel. With a median follow-up time of 5.5 years, the 5-FU plus levamisole treatment has reduced the recurrence rate by 39 %, the cancer related death rate by 32 % and the overall death rate by 31 %. Most of the recurrences occurred during the first two years. There was a decrease in the liver, great omentum, peritoneum and lung metastases, but there was no modification in loco-regional recurrence rate. Welt presented a phase I/II study of radio-immunotherapy with I-131-monoclonal antibody A33 in patients with advanced colorectal carcinoma. Results were characterised by major hematologic toxicity and minor tumor response rate. This study (from a leading research team working with one of the best monoclonal antibody) outline the extreme difficulty of cancer therapy with radio-labeled monoclonal antibody. Humanization of A33 is planned to improve these results. Heiss undertook a prospective study to evaluate the influence of homologous blood transfusion on recurrence rate after colorectal cancer surgery. Fifty-eight patients receiving autologous blood transfusion were compared with sixty-two patients receiving homologous transfusion. With a median follow-up of 21 months a higher recurrence rate was found in the homologous group (29.4 % versus 16.7 %). This study methodology is rather criticizable, but its main interest is to focus on the immunosupressive effect of blood transfusion during surgery in cancer patients.
