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2011 RFA Links and Provocative Questions  

PQ - 19
Why are some disseminated cancers cured by chemotherapy alone?

Background: Although chemotherapy is often effective, it is only rarely curative. However, It is well established that certain disseminated cancers can be completely cured with chemotherapy, even with drugs that are often of much less value in other settings. The tumors that can be cured include solid tumors (testicular carcinoma, choriocarcinoma, and Wilms’ tumor) and hematological malignancies (ALL, Burkitt’s lymphoma, and some diffuse large B-cell lymphoma). However, there is little understanding of the underlying mechanisms that might explain why these cancers can be completely cured with chemotherapy.

Feasibility: This question has largely been ignored since it was recognized, often decades ago, that such tumors could be cured by standard chemotherapeutic strategies. New methods are available for studying the biology of these “curable” cancers and for exploring the mechanisms by which the effective drugs work.

Implications of success: If we could identify the properties of cancers that render them susceptible to eradication by chemotherapy, we might better understand how certain therapies work, contemplate converting relatively insensitive tumors to highly sensitive ones, or develop new approaches to the treatment of intransigent malignancies.

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