Cancer

In a case-control study of 2005 women with benign breast disease, breast cancer risk was greater for premenopausal women with atypical lobular hyperplasia than for women with atypical ductal hyperplasia. Approximately 60% of the cancers developed in the ipsilateral breast.

The results from this study suggested that an activated β-catenin/T-cell factor pathway may be used as a promising novel gene therapy modality in gastric cancer and that a recombinant adenovirus that carries a lethal gene (p53 up-regulated modulator of apoptosis) under the control of a β-catenin/T-cell factor-responsive promoter can selectively and efficiently kill gastric cancer cells.

Progression of prostate cancer can occur in the context of a low to undetectable serum prostate-specific antigen level. Complete physical evaluation and imaging studies are indicated as part of the follow-up of patients with high-grade, locally advanced tumors, especially when atypical histologic variants are present.

An inflammation-based prognostic score (the Glasgow Prognostic Score) predicted survival, independent of established scoring systems, in patients with metastatic renal cancer.

The American Joint Committee on Cancer (AJCC) staging system for prostate cancer is based primarily on clinical tumor (T) classification. Men with localized prostate cancer who received treatment with external beam radiation alone were analyzed according to the 1997 AJCC system compared with a system that included prostate-specific antigen (PSA) level and Gleason score (GS). Multivariate analyses using a Cox proportional-hazards model were carried out to evaluate T classification, GS, and pretreatment PSA (pPSA) as predictors of overall survival (OS), disease-specific survival (DSS), and freedom from PSA failure (FFPF). The results indicated the independent statistical significance of T classification, GS, and pPSA in predicting OS, DSS, and FFPF (model chi-square value, P < .0001 for each). Current practice patterns support the argument that AJCC staging should be changed to incorporate pPSA and GS and to incorporate risk stratification.

A symptom index that incorporated 6 symptoms along with symptom frequency and duration was successful in identifying women with ovarian cancer. This symptom index may be useful in a primary care setting for identifying women who are at risk of having ovarian cancer.

The apoptosis inhibitors XIAP and Survivin, but not Livin, are frequently expressed in ovarian carcinoma. XIAP and cytoplasmic Survivin are up-regulated in effusions and solid metastases, respectively. Nuclear Survivin expression correlates with improved survival for patients with prechemotherapy effusions.

Based on the results of this study, the authors concluded that the current follow-up schedule has limited influence on life expectancy in elderly patients with laryngeal cancer. Follow-up should not be abolished: Rather, it should be reduced in length and intensity.

Subcutaneous homoharringtonine was administered to patients with chronic myelogenous leukemia who had failed prior therapy in a Phase I/II trial. The maximal tolerated dose was established at 1.25 mg/m² twice daily. Five of the 6 patients treated in the Phase II portion of the study achieved a complete hematologic response and 3 had a cytogenetic response, including 2 with ABL kinase domain mutations.

Analyzing data on 955 patients with Hodgkin lymphoma (HL) treated between 1981 and 1996, 4 variables (age, visceral disease, constitutional symptoms, and number of involved lymphoid areas) were identified that remained significantly associated with 10-year overall survival. Based on these variables, a 3-stage prognostic scoring system (PSS) was constructed that was shown to have better prediction and discrimination properties than all presently existing staging systems.

The authors update their experience with decitabine in patients with myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML) and analyze the cytogenetic response patterns and the prognostic factors associated with decitabine therapy. The results indicate that longer term experience with decitabine in MDS and CMML is favorable and that pretreatment prognostic factors may predict the outcome of decitabine therapy in patients with MDS and CMML.

The results from this study indicated that patients with advanced nonsmall cell lung cancer who present with brain metastases represents a therapeutic challenge for both medical and radiation oncologists. Up-front therapy with new platinum-based chemotherapy regimens may be meaningful treatment options for selected subsets of these patients.

The authors analyzed the current series of 225 patients with leiomyosarcoma to investigate the relation between clinical characteristics and outcome. Higher malignancy grade, larger tumor size, and deeper tumor location were correlated significantly with decreased metastasis-free survival, inadequate local treatment was correlated with local recurrence, and high malignancy grade was correlated with decreased overall survival.

For this study, the authors conducted a comprehensive review of the efficacy of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography (FDG-PET) in the detection of primary tumors in patients with disseminated carcinoma of unknown primary site. FDG-PET appeared to be an efficient method with which to detect primary tumors that were not detected by other modalities, it was sensitive for the detection of previously unrecognized metastases, and it may changes clinical management significantly in approximately one-third of patients.

Venous thromboembolism occurs in fewer than 5% of meningioma patients who receive combined-modality prophylaxis. Venous thromboembolism prophylaxis, including low-dose subcutaneous heparin, is well tolerated in this population.

Fifty-two patients with metastatic melanoma, including small brain metastasis, received treatment with temozolomide with or without immunotherapy. Among 13 patients who achieved disease stabilization or had a response of systemic disease, 11 patients also had a cerebral response. Cranial radiotherapy for cerebral recurrence was required in only 2 patients.

Intensity-modulated or conformal radiotherapy improved the quality of life of patients with nasopharyngeal carcinoma.

A randomized, double-blind, placebo-controlled trial evaluated the safety and efficacy of Saforis (glutamine) powder in UpTec for oral suspension for the prevention and treatment of oral mucositis in 326 patients receiving mucotoxic cancer therapy for breast cancer. Treatment with Saforis significantly reduced the incidence of World Health Organization grade ≥2 oral mucositis with a safety profile comparable to that of placebo.

EphA2 is associated with angiogenesis and markers of invasion. EphA2 is also an important predictor of poor clinical outcome in ovarian cancer and represents an important therapeutic target.