Cancer

Patients with advanced Hodgkin disease and large mediastinal involvement can be treated with eight cycles of chemotherapy alone without radiotherapy when a major response has been obtained after six cycles. A study of 82 patients with large mediastinal involvement among 533 included in the H89 Groupes d'Etudes des Lymphomes de l'Adulte clinical trial.

Receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) are key regulators of osteoclast functions, including differentiation, survival, fusion, activation, and apoptosis. These compounds play important roles in the regulation of bone resorption and calcium homeostasis. Abnormalities of the RANKL/OPG system have been implicated in the pathogenesis of various primary and secondary bone malignancies. Moreover, systemic administration of OPG appears to emerge as a potent novel therapeutic modality for these disorders.

Magnetic resonance breast imaging has been increasingly accepted as an alternative imaging modality in radiologically difficult cases but has been limited because of its low specificity. A simple method of magnetic breast imaging with increased specificity (94% specificity and sensitivity) was found to discriminate malignant from benign mammographic abnormalities.

Mutations in the ATM gene, specifically those predicted to result in amino acid substitutions, were significantly increased in breast carcinoma cases selected for positive family history.

In this study, the authors investigated the mechanism underlying the regulation of vascular endothelial growth factor (VEGF) expression and evaluated VEGF gene expression and K-ras gene status in specimens from 48 patients with pancreatic carcinoma. The results suggest that K-ras oncogene mutation may be associated with VEGF gene expression and that patients with pancreatic carcinoma who have high levels of VEGF gene expression were associated with a poor prognosis.

2-Methoxyestradiol-induced gastric carcinoma cell apoptosis occurs through caspase-3 and caspase-8 activation. Reactive oxygen species formation maybe responsible for G₂/M-phase arrest induced by 2-methoxyestradiol. Calcium modulators (A23187 and thapsigargin) partially reversed G₂/M arrest, resulting in differential caspase-3 activation, suggesting that G₂/M arrest is not a prerequisite for caspase-3 activation. This endogenous estrogen metabolite may hold potential use in the treatment of patients with gastric carcinoma by the direct activation of caspases in tumor cells.

The level of thymidylate synthase activity correlated with both the progression of the stage and the increase of the grade of bladder carcinoma. In addition, the elevated thymidylate synthase activity was associated with early recurrence in Ta and T1 bladder carcinoma.

This study is a report of a Phase II clinical trial of paclitaxel, α-interferon, and cis-retinoic acid in advanced renal cell carcinoma. This was a well tolerated regimen with minimal clinical efficacy.

Data from a population-based, randomized clinical trial in which participants were screened for prostate carcinoma according to well standardized protocols clarified that men with isolated, high-grade prostatic intraepithelial neoplasia on initial biopsy are at no greater risk of being diagnosed with prostate carcinoma on repeated biopsy than if their initial biopsies were assessed as benign only. However, men with a prostate biopsy suspicious for malignancy are at considerable risk of having malignant disease on repeated biopsy, and the tumor characteristics of the malignancies detected indicate that these may resemble the cancers/carcinomas found on initial biopsy.

Carbon dye was used with isosulfan blue dye and radiocolloid for lymphatic mapping of the sentinel lymph nodes (SNs) in patients with cutaneous melanoma. Carbon particles were visualized in SNs from 96 of 100 patients and in all tumor-positive SNs. Carbon dye provides a histopathologic marker to help the pathologist confirm that the SN has been identified correctly.

Each reduced expression of MRP1/CD9 and integrin α3 was strikingly correlated with histologic grade and metastasis in endometrial cancer. The expression of MRP1/CD9 was regarded as a significant prognostic factor in disease-free survival.

This study compares the rise in the incidence of adenocarcinoma of the esophagus both for the United States and for Europe and Australia. The relatively short period of 2 decades for the increase provides hard evidence for an influence of environmental factors.

The expression of vascular endothelial growth factor family members has appeared to be a common feature in both experimental and clinical models of head and neck squamous cell carcinoma (HNSCC). The differential expression patterns of these angiogenic factors were found to have importance in the promotion of HNSCC growth and progression by way of lymphatic spread.

The combination of 2′-deoxy-2′,2′-difluorocytidine (gemcitabine) and cisplatin appears to have greater antitumor activity and more prolonged survival than single-agent gemcitabine in the treatment of patients with locally advanced and metastatic carcinoma of the pancreas with a manageable but not insignificant level of hematologic toxicity.

Indication for resection of liver metastases in patients with germ cell tumors is dependent on the size of the postchemotherapy residual liver mass, the histologic type of the primary tumor, and patient's gender.

A case–control study was conducted to evaluate the efficacy of a mass screening program for lung cancer in Miyagi Prefecture, Japan. The results revealed that annual screening could reduce by 46% the risk of death from carcinoma of the lung.

The combination of pemetrexed disodium and cisplatin resulted in a response rate of 45% in 29 evaluable patients with nonsmall cell lung carcinoma. The median survival rate was 8.9 months with 49% 1-year survival rate, and the regimen was well tolerated in both patients with Stage IV disease and those with performance status of 2 with a median of 6 cycles of treatment delivered.

Single-agent carboplatin is well tolerated in patients with poor prognosis small cell lung carcinoma and has efficacy similar to that of combination chemotherapy with cyclophosphamide, doxorubicin, and vincristine.

In the current study, the addition of high-dose tamoxifen to a regimen of concurrent biochemotherapy for patients with metastatic melanoma did not appear to improve treatment response or overall survival, despite the attainment of in vivo plasma concentrations known to elicit tumor cell chemosensitization in vitro.

The expression of the carcinoma-associated antigen epithelial cell adhesion molecule is regulated negatively by tumor necrosis factor α (TNFα) and 12-O-tetradecanoylphorbol-13-acetate through the activation of nuclear factor κB (NF-κB). The repression may rely on the competition of NF-κB for p300/CREB binding protein histone acetyl transferase activity, because the overexpression of p300 reverts TNFα effects.

Neuropeptide Y, leptin, and cholecystokinin 8 have been implicated in cancer-associated anorexia. To date, however, no assessment of circulating concentrations of these hormones has been undertaken in cancer patients with advanced disease and anorexia. In this trial, the authors explored potential correlations between these three hormones and cancer-associated anorexia.

In human gastric carcinoma, the expression of glucose transporter-1 (Glut1) was associated closely with histologic subtype (high in well differentiated, low in mucin-producing type), depth of invasion, lymphatic permeation, venous invasion, lymph node metastasis, hepatic metastasis, and carcinoma stage. Patient survival was significantly high in Glut1-negative cases.

The combination of paclitaxel, carboplatin, and long-term infusional 5-fluorouracil is feasible, well tolerated, and highly efficacious in patients with advanced squamous carcinomas of various primary sites.

Combined regimen of cisplatin, doxorubicin, and α-2b interferon is active in malignant pleural mesothelioma, but toxicity may limit its application.

C-kit germline mutation in the juxtamembrane domain leads to a syndrome characterized by multiple gastrointestinal stromal tumors and urticaria pigmentosa.

Vascular endothelial growth factor (VEGF) has been reported to be a potent inducer of angiogenesis in malignant tumors. Increased serum VEGF concentration (S-VEGF) has been found in patients with various solid tumors and appears to be correlated with tumor burden. In the current study, high S-VEGF was found to be associated with tumor progression, poor patient response to treatment, and poor survival in patients with esophageal squamous cell carcinoma.

Surgery results in excellent rates of cure in patients with unicentric Castleman disease; radiotherapy also can achieve clinical response and cure in selected patients. Multicentric Castleman disease is a more aggressive clinical entity and is treated most effectively with combination chemotherapy, whereas the role of radiotherapy in its treatment remains unclear.

Amplification of the HER-2/neu oncogene, as assessed by fluorescent in situ hybridization on archival tissue, was shown to be uncommon in high-grade pediatric osteosarcomas.

A randomized, placebo-controlled, double-blind clinical trial was conducted in 32 patients ages 3–25 years who had undergone allogeneic or autologous stem cell transplantation. This study indicates that the homeopathic medication TRAUMEEL S® may significantly reduce the severity and duration of chemotherapy-induced stomatitis in children undergoing bone marrow transplantation.

Clinician perspectives on informed consent for pediatric research were obtained from five major medical centers that routinely enroll patients in Children's Cancer Group studies. Clinicians report a range of approaches, opinions, concerns, and suggestions for improving the informed consent process.

Preoperative embolization of meningiomas increases the likelihood of necrosis, reactive/reparative atypia, and proliferative activity on histopathologic examination, thereby leading to potential overgrading as atypical meningioma. Recently proposed grading criteria minimize this possibility and correlate well with biologic behavior in embolized meningiomas. Only a rough association was found between the extent of necrosis and either postembolization angiographic findings or particle size utilized.