Mayer R J
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Ann Oncol. 1995 Sep;6(7):645-9. doi: 10.1093/oxfordjournals.annonc.a059277.
R. Mayer (U.S.A.) in summarizing the data presented at the three day conference, raised several general issues. Therapeutic benefit in the past has been measured by the criterion of 'objective response'; the latter term most likely should be replaced by 'quality of life' and 'overall survival time' since they appear to be more biologically meaningful. It appears that few new cytotoxic drugs have been developed in recent years, and , as yet, none has an established role in the management of patients with gastrointestinal cancers. Of those currently under investigation, CPT-11 seems to represent the most promising, since its mode of action is something other than inhibition of thymidylate synthase. It seems that too many small, uncontrolled studies examining a give concept (e.g. neoadjuvant therapy) have been performed prior to initiating definitive, phase III trials; a greater degree of collaboration seems necessary so that new treatment principles may be objectively assessed in an efficient manner. Finally, it seems clear that economic realities are increasingly affecting choices in patient care and clinical research and this trend will undoubtedly increase in the future.
R. 梅耶（美国）在总结为期三天会议上所呈现的数据时，提出了几个一般性问题。过去治疗效果是通过“客观缓解”标准来衡量的；由于“生活质量”和“总生存时间”似乎在生物学上更具意义，后一个术语很可能应被这两个术语所取代。近年来似乎很少有新的细胞毒性药物被研发出来，并且到目前为止，还没有一种药物在胃肠道癌患者的治疗中确立其作用。在目前正在研究的药物中，CPT - 11似乎最有前景，因为其作用机制并非抑制胸苷酸合成酶。似乎在启动确定性的III期试验之前，已经进行了太多针对某个特定概念（如新辅助治疗）的小型、非对照研究；似乎需要更大程度的合作，以便能够以有效的方式客观评估新的治疗原则。最后，经济现实显然越来越影响患者护理和临床研究中的选择，而且这一趋势在未来无疑会加剧。
