Cancer

This prospective clinical study confirms in vitro observations of increased apoptosis and decreased proliferation in patients with breast carcinoma who respond to chemotherapy.

Molecular genetic rather than immunohistochemical analysis of HER-2/neu and p53 was used, demonstrating that HER-2/neu amplification and p53 mutations are relatively common in ductal carcinoma in situ, occurring in 40% and 20%, respectively. The presence of HER-2/neu amplification, but not p53 mutations, correlates with histologic subtype and nuclear grade.

Relaxin-like factor (RLF) was expressed exclusively in epithelial cells of the human breast. RLF gene expression in the normal and neoplastic mammary gland was affected by transcriptional and posttranscriptional mechanisms.

This clinical trial confirms that the combination of paclitaxel and doxorubicin is an effective regimen in the treatment of advanced metastatic breast carcinoma and has an acceptable toxicity. Control of the accumulated dose of doxorubicin, use of a dose of 50 mg/m² of doxorubicin per cycle, and cardiac monitoring are recommended if cardiac complications are to be minimized. The efficacy of the combination is poorer in those patients previously treated in the adjuvant setting with anthracyclines.

Breast carcinoma results in persistent declines in multiple dimensions of functional health status. These prospective data suggest that previous studies reporting no difference in physical function among breast carcinoma cases compared with disease free women underestimated the deleterious effect of the disease on physical domains of function.

In patients who had invasive breast carcinoma, preoperative chemotherapy was associated with an unacceptably high false negative sentinel node biopsy rate. Therefore, sentinel node biopsy in these patients should be performed only in the context of a protocol that includes complete axillary node dissection.

Paclitaxel has considerable activity, with tolerable side effects, in heavily pretreated breast carcinoma patients. This activity also was observed in heavily pretreated patients with anthracycline-resistant breast carcinoma.

Patients with breast carcinoma who were uninsured or insured by Medicaid had poorer survival rates than patients who had commercial fee-for-service health insurance, primarily as a result of later stage at diagnosis. Mortality rates were higher among non-Hispanic African Americans, a finding that was not fully explained by differences in stage at diagnosis, treatment modalities used, or health insurance payer.

Gastric metastases usually present with nonspecific symptoms with diffuse infiltration of the stomach and as a late feature from lobular rather than ductal breast carcinoma. Treatment may result in fairly good palliation.

High dose conformal radiotherapy in the treatment of patients with locally advanced, unresectable pancreatic carcinoma is feasible with acceptable toxicity. In case of pain, it can offer palliation. Distant metastases remain the main problem.

In this study, the authors demonstrate that neuroendocrine-like differentiation is associated significantly with longer survival in patients with pancreatic carcinoma.

It would appear that the difference in the outcomes of gastric carcinoma patients treated in Japan compared with the West can be explained primarily by differences in tumor location, the frequency of early stage disease, and staging accuracy. The treatment of gastric carcinoma can produce results in Western centers comparable to those obtained in Japan.

Expression levels of p27^Kip1 and p53 are powerful prognostic markers in several human malignancies. The current study demonstrated that immunohistochemical detection of both proteins might provide prognostic information in patients with N0 gastric carcinoma.

The potential impact of oral epidermal growth factor (EGF) during radiation therapy involving the oral mucosa was assessed. EGF was associated with reduced severity of oral mucositis.

The recently introduced Cancer of the Liver Italian Program (CLIP) score is more effective than Okuda and TNM grouping in staging the patients with hepatocellular carcinoma, particularly in the early phases, and should be introduced in routine clinical practice.

Higher activated nuclear factor κB (NF-κB) and lower cytoplastic inhibitory IκBα protein (IκBα) levels were found in tumor tissues compared with nontumor tissues. These findings suggest that NF-κB overexpression accompanied by dysregulation of IκBα may play a role in hepatocarcinogenesis.

Increased levels of cathepsin B activity in lung tumors and in the adjacent tumor cell–infiltrated lymph nodes are of prognostic value for operated patients with lung carcinoma. These findings appear to be characteristic for the invasive tumor cell phenotype and corroborate the hypothesis that tumor cell- associated cathepsin B may play a role in the lymphogenic metastasizing process.

Both granisetron and ondansetron have similar antiemetic efficacy for prophylaxis of chemotherapy-induced nausea and vomiting, and choices between these two medications can be guided by cost considerations, convenience of administration, and/or physician preferences.

Concomitant administration of the two taxanes, paclitaxel and docetaxel, on a weekly schedule was found to increases the total taxane dose delivered modestly.

In a case–control study, significant associations were found between the occurrence of pediatric non-Hodgkin lymphoma and pesticide exposures in the home.