At the Salvage Therapy
meeting, researchers and community activists alike found this to be the most challenging situation.
in these patients, as well as in those with distant metastasis, can include best supportive care or chemotherapy with cisplatin, 5-FU, or taxane, or--as encouraged by the NCCN--within a clinical trial (for those with a good performance status).
Interpretation of follow-up PSA is further complicated by the well-recognized "PSA-bounce" phenomenon that occurs in up to 20% of patients.[sup.12] This intrinsic variability in PSA has complicated an early definition of biochemical failure post-radiotherapy when the institution of salvage therapy
may be at its most effective.
(2, 11) Third, STIs may be useful and beneficial in a salvage therapy
regimen whereby HIV has become multi-drug resistant and patients have limited treatment options.
* Prioritization of various available chemotherapy drugs for patients requiring salvage therapy
Although there is no simple answer when it comes to choosing a regimen for salvage therapy
, that's not necessarily a bad thing, said Dr.
My expectation is that the increasing use of magnetic resonance imaging joined to focal ablation for patients with a targetable lesion will become more widely accepted in the salvage setting.[sup.3] Focal salvage therapy
in selected patients at least fulfills the mandate of primum non nocere, and may reduce the requirement for ADT.
Patients with local recurrence, who have had prior surgery, but no prior chemoradiotherapy can undergo either salvage therapy
with radiation and concurrent 5-FU/ cisplatin or endoscopic therapy Surgery is acceptable in those whose recurrence is limited to anastomosis, the panel agreed.
She was the driving force behind the Coalition for Salvage Therapy
, pushing for faster access to new antiretroviral agents, and the Structured Treatment Interruptions Workshops, which brought together leading researchers to figure out if these stops and starts in therapy could have some benefit, or at least do no harm.
Moreover, little is known about salvage therapy
for the 13% to 15% of patients with persistent local disease after HIFU failure.[sup.15,16] A possible salvage therapy
is laparoscopic extraperitoneal RP, but the potential of salvage prostatectomy following HIFU has been demonstrated in small groups of patients and many HIFU patients are unsuitable candidates for surgery.[sup.17,18] Androgen deprivation therapy (ADT) is not curative.
RNA and CD4 cell count reponse to protease inhibitor therapy in an urban clinic: reponse to both initial and salvage therapy
Questions remain about whether the choice of first salvage therapy
should be determined by IPFSG risk group and, if so, the treatments that should be given.
* Prioritization of chemotherapy drugs for patients requiring salvage therapy