Cancer

Clinical data were collected from 87 institutions on clinical use of the MammoSite™ breast brachytherapy catheter for delivering accelerated partial breast irradiation. Acceptable technical reproducibility and acute toxicity was demonstrated between multiple institutions and use in appropriate groups of patients.

Over the past 30 years, the distribution of incident breast carcinoma cases in the U.S. has shifted toward smaller tumors, even within conventional stage categories. A substantial proportion of the improvement noted in breast carcinoma survival can be attributed to this within-stage migration of tumor size. Standardizing survival estimates on the basis of tumor size improves the understanding of secular trends in breast carcinoma outcomes.

Patients with an isolated recurrence of breast carcinoma that has been treated locally with surgical resection and/or irradiation with curative intent, such that there is no evidence of clinically measurable disease are classified as Stage IV—no evidence of disease (Stage IV-NED). Compared with historic controls, these patients demonstrated improved outcomes in Phase II studies if they received systemic chemotherapy after local treatment for their isolated recurrence. A proportion of these patients with Stage IV-NED breast carcinoma had prolonged disease-free and overall survival after chemotherapy, and the only significant independent prognostic factor was the number of involved axillary lymph nodes at initial diagnosis.

A clinical evaluation program among Sardinian patients with breast carcinoma was useful in defining indicators (breast carcinoma diagnosis before age 50 yrs, familial recurrence of ovarian carcinoma or male breast carcinoma, or 3 affected generations) of the presence of BRCA1 and BRCA2 germline mutations. The majority of breast carcinoma families remained negative for BRCA1 and BRCA1/BRCA2 mutations, confirming that additional breast carcinoma susceptibility genes must be identified.

A total of 156 reported cases of pancreatic carcinoids contained in the Niigata Registry, 144 typical and 12 atypical, were statistically evaluated and, where necessary, were compared with carcinoids of other representative sites. The pancreatic carcinoid series was characterized by a high metastatic rate (66.7%), a large average tumor-size (68.6 mm), a high incidence of the carcinoid syndrome (23.3%), a high rate of immunohistochemical detection for serotonin (92.9%), and a low five-year survival rate (28.9% ± 16.7%).

Independent of factors known to influence survival in patients with bladder carcinoma, including race/ethnicity, disease stage, and lymph node status, married patients appear to have better survival after radical cystectomy than nonmarried patients. Psychosocial and immunologic mechanisms may explain the differential survival.

Our molecular data suggest that both clear cell and sarcomatoid components of renal cell carcinomas are derived from the same progenitor cell. Different patterns of allelic loss in multiple chromosomal regions were observed in clear cell and sarcomatoid components from the same patient. This genetic heterogeneity indicates genetic divergence during the clonal evolution of renal cell carcinoma.

Irinotecan at a dose of 60 mg/m² on Days 1, 8, and 15 with carboplatin 5 mg · mL/minute on Day 1 every 4 weeks was recommended for patients with advanced ovarian carcinoma who previously received platinum-containing chemotherapy.

Cytomegalovirus (CMV) infection has emerged as an important cause of life-threatening pneumonia among patients with lymphoma. Its incidence is increasing. In the current study, a high Acute Physiology and Chronic Health Evaluation (APACHE) II score and development of antiviral toxicity were associated with fatal CMV pneumonia.

In this study, the authors demonstrated that radiotherapy (RT) may be curative for patients with Ann Arbor Stage I–II lymphocyte-predominant Hodgkin lymphoma and that limited-field RT potentially demonstrate equivalent treatment efficacy with a reduction in toxicity compared with wide-field RT.

AMN107 is highly effective in inhibiting the activation of p190 Bcr-Abl and the in vitro proliferation of p190 Bcr-Abl–expressing acute lymphoblastic leukemia cells. With a similar mechanism of action, the antiproliferative potency of AMN107 was 30–40-fold higher than that of imatinib.

Gemcitabine infused at a fixed dose rate (10 mg/m² per minute) appears to be active and well tolerated in patients with advanced-stage pancreatic and biliary tree carcinoma. The survival and clinical benefit results noted with this regimen were encouraging and prompted further evaluation of this schedule.

In the current study, the authors investigated the antitumoral activity of melanoma-infiltrating immune system cells and found a statistically significant, favorable correlation between survival and the density of primary tumor-infiltrating CD8 T lymphocytes or human leukocyte antigen-D-related cells. These results may be important for identifying additional prognostic factors with which to evaluate disease progression and develop immune therapies for patients with primary cutaneous melanoma.

Accumulation of cell cycle alterations led to increased MIB-1 labeling index and nuclear pleomorphism, a previously described prognostic indicator in chordoma. The authors believe that p53 overexpression, in particular, is associated with an unfavorable prognosis in patients with chordoma.

Intraabdominal desmoplastic small round cell tumors are uncommon neoplasms. Despite the current multimodality approach of surgery, chemotherapy, and radiation, the prognosis for patients with this disease remains poor.

The lymphocyte-to-neutrophil ratio in percutaneous fine-needle aspiration biopsy cytologic specimens offered significant independent prognostic information for patients with advanced-stage nonsmall cell lung carcinoma. This ratio may have similar significance as the histologic assessment of tumor-infiltrating lymphocytes in surgically resected carcinomas.

The results of the current study confirmed the feasibility of giving RMP-7 and carboplatin daily during radiotherapy.

The authors investigated the association between vital exhaustion and cancer risk in a prospective cohort design. The results provided no evidence that vital exhaustion is a risk factor for the development of cancer.

The use of intensity-modulated radiation therapy, a technological development that enables conformal delivery of photon-beam radiation therapy, has increased dramatically in the U.S. since 2002. Prospective data evaluating its risks and benefits and guidelines for its use in the general community are limited yet increasingly are needed.

The 5-year actuarial rate of late rectal complication (LRC) ≥ Grade 2 was 5.4% in patients who received a total biologically effective dose (BED) at rectal point (BED_RP) < 125 Gy₃ and 36.1% in patients who received a BED_RP ≥ 125 Gy₃ (P < 0.001). The BED_RP was a useful dosimetric parameter for predicting the risk of LRC ≥ Grade 2 and should be limited to < 125 Gy₃ whenever possible to minimize the risk of LRC ≥ Grade 2 in patients with uterine cervical carcinoma who are treated with a combination of external beam radiotherapy and high-dose-rate intracavitary irradiation.

The cytotoxic somatostatin analog, AN-238, consists of a superactive derivative of doxorubicin linked to a somatostatin analog carrier. It was targeted to somatostatin receptors in experimental endometrial carcinomas and powerfully inhibited tumor growth.

Curcumin (diferuloylmethane) is a phytochemical with potent nuclear factor-κB (NF-κB)-inhibitory activity. It is pharmacologically safe, but its bioavailability is poor after oral administration. The authors encapsulated curcumin in a liposomal delivery system that would allow intravenous administration. Liposomal curcumin down-regulated the NF-κB machinery, suppressed growth, and induced apoptosis of human pancreatic cells in vitro. Antitumor and antiangiogenesis effects were observed in vivo.