Cancer

Younger patients with hormone receptor-negative tumors that are highly proliferative, genomically unstable, and p53-altered are at increased relative risk for central nervous system (CNS) metastases. HER-2 expression did not increase the relative risk of CNS metastases, nor did adjuvant hormonal or chemotherapies.

The authors investigated the role of family history in association with the risk of bladder cancer. The results indicated that a positive family history of bladder cancer, smoking habits, and proband age at onset may have interacted to increase the risk of bladder cancer the study population.

The new 4-category Mayo Clinic staging system for urachal carcinoma accurately stratifies disease outcome. In this study, the authors showed that tumor grade and positive surgical margins are the most important predictors of cancer-specific death in multivariate analysis.

Urachal adenocarcinomas represent 10% of all primary adenocarcinomas of the bladder. Overall and disease-specific mortality risks are improved in patients with urachal lesions, even after controlling for numerous patient and tumor characteristics.

Based on an analysis of subjects who underwent cystectomy for bladder cancer from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, disparities were found in the utilization of continent reconstruction based on sociodemographic, clinical, and provider-based variables, disparities that may be ameliorated with the regionalization of bladder cancer care.

In hormone-refractory prostate cancer, weekly docetaxel plus oral capecitabine gave 68.2% biological response and significant pain relief, with a median overall survival of 17.7 months. Except for Grade 3–4 cutaneous toxicities (13.1%) and changes in nail (6.5%), the safety profile was good.

Survivin is highly expressed in endometrial cancer and inhibition of survivin by RNA interference reduces cell proliferation and induces apoptosis in endometrial cancer cells. Survivin is an attractive target for endometrial cancer treatment.

Hypoxia-inducible factor (HIF)-1α expression was correlated with a poor outcome in patients with squamous cell carcinoma of the head and neck, whereas HIF-2α had an additive effect on outcome. The results did not indicate that anemia influenced tumor hypoxia.

Thalidomide alone demonstrated very limited activity in unselected patients with myelodysplastic syndrome. At the schedule and dose levels used in the current study, it is not a safe and viable therapeutic option.

The delivery and toxicity of 3 fludarabine-based chemotherapy regimens in patients age 60 years and older were compared with those in younger patients. Treatments were tolerated well and could be delivered safely to older patients who had a good performance status with modestly increased myelosuppression but no increase in serious infection or treatment-related mortality.

In addition to the widely accepted prognostic factors of performance status, body mass index, and stage, pretreatment blood counts were significant prognostic factors for overall survival and time to progression in patients with advanced-stage nonsmall cell lung cancer. The authors developed a prediction equation based on the patients' own prognostic factors that may be used to evaluate the benefit of a treatment in Phase II trials by comparing the observed survival to the expected survival of a cohort in place of historic comparisons, which may have substantially different baseline patient characteristics. The usefulness of this work to clinical research and clinical practice is compelling in this population, in which advances in treatment have been slow, producing only modest improvements in survival.

The prognosis varies for patients with nonsmall cell lung cancer who have pathologic lymph node involvement (pN1). In this study, patients who had hilar lymph node involvement had a statistically worse prognosis than patients who had pulmonary lymph node involvement, and the findings indicated that this difference in survival may lead to different therapies for these patient subgroups.

The second-line irinotecan and cisplatin is a highly active and well-tolerated regimen in patients with advanced non–small-cell lung cancer who were previously treated with nonplatinum-based chemotherapy.

In this randomized trial for skin cancer risk reduction among melanoma siblings (n = 494), intervention siblings were more likely to examine all moles, including those on the back (OR 1.76; 95% CI, 1.06-2.91).

Within a population-based screening program for melanoma, men age ≥50 years significantly increased their participation in screening for melanoma and intention to screen. Within skin-screening clinics provided within the intervention program, men age ≥50 years contributed 48.5% of melanomas, and 45% of all keratinocyte carcinomas diagnosed.

Transcriptional regulation of caspase-8 may reside with interferon γ-sensitive promoters through the action of transcription factors, such as signal transducer and activator of transcription 1 (STAT-1). In this study, the authors observed a strong correlation between caspase-8 levels and STAT-1 levels in high-grade neuroblastoma samples; however, no such correlation was observed in lower stage clinical tumor samples.

Histone deacetylase inhibitors increase histone acetylation, modulating gene expression. Several agents have shown promising activity in early-phase clinical trials. Continued evaluations of these compounds based on preclinical data are ongoing.

The authors surveyed 24 comprehensive long-term follow-up (LTFU) programs for pediatric cancer survivors. This report describes the frequency, content, and setting of follow-up care delivered by the surveyed pediatric comprehensive LTFU programs.

There is limited information available regarding the reasons cancer patients decide to enter clinical trials. After analyzing data obtained from >115,000 cancer patients or their families, researchers determined that patients with the most serious cancer-related conditions expressed an increased interest in obtaining information, and there was a reduced desire for such information among the very elderly.

A subscale for assessment of health-related quality of life for esophageal cancer to be used with the Functional Assessment of Cancer Therapy has been developed and validated. The FACT-E demonstrated very good to excellent convergent and divergent validity, internal consistency, and responsiveness to change.

The authors showed a therapeutic strategy against prostate cancers involving RNA interference against human midkine (MK), a heparin-binding growth factor, which is overexpressed in human prostate cancers. Downregulation of MK with a synthetic small interfering RNA (siRNA) inhibited tumor growth in human prostate cancer (PC-3) xenografts, and antitumor activity of the siRNA in mice was augmented when combined with paclitaxel. We can reduce the dosage of a chemotherapeutic in combination with a molecular targeting therapeutic consisting of nucleic acids, especially based on RNA interference.