Cancer

Magnetic resonance imaging (MRI) identified frequent (10%) secondary invasive or ductal carcinoma in situ cancers that would not be removed routinely by surgery or targeted in the radiation field if treated with partial breast irradiation (PBI). Data from this study suggested that MRI should be considered to assess PBI eligibility to minimize potential local failures.

Columnar cell lesions of the breast show a mild increase in breast cancer risk, a strong association with atypical hyperplasia, and do not differ in cancer risk whether or not they show columnar cell hyperplasia or atypia.

The aim of this study was to assess the prognostic value of baseline circulating tumor cells (CTCs) in a large cohort of patients with newly diagnosed metastatic breast cancer (MBC). CTCs were found to be a strong independent predictor of survival among women with either de novo or newly recurrent MBC. CTCs should be considered as a new stratification method for women with newly diagnosed MBC.

Therapy-induced hormonal changes did not contribute more than marginally at most to cognitive impairment in patients with breast cancer during their first year after diagnosis. The effects of treatment-induced menopause were more likely to be favorable, and antiestrogen treatment with tamoxifen and aromatase inhibitors did not affect cognition.

Methylation of the PTEN gene promoter was analyzed in various types of thyroid tumors and found to be associated with activating genetic alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT pathway. The findings suggest a self-enhancement mechanism for genetically activated signaling of the PI3K/AKT pathway through epigenetic silencing of its negative regulator PTEN gene.

The efficacy and feasibility of a gemcitabine (GEM) and uracil/tegafur (UFT) combination versus GEM alone was evaluated in patients with resected pancreatic cancer in a randomized phase II study. Although UFT did not show a survival benefit as adjuvant chemotherapy, adjuvant chemotherapy using GEM showed favorable results for resected pancreatic cancer.

The authors have presented long-term, single-institution data to provide a thorough understanding of the results that have been achieved until now using a consistent, aggressive approach for localized and metastatic renal cell carcinoma. These results may serve as a benchmark to compare the results of emerging medical and surgical treatments.

Individuals who have been exposed to Agent Orange have an increased incidence of prostate cancer; they develop the disease at a younger age and as a more aggressive variant than their unexposed counterparts. Consideration should be made to classify these individuals as ‘high risk’ along with men of African-American heritage and men who have a family history of prostate cancer.

Cisplatin and gemcitabine therapy for muscle-invasive bladder cancer produces definitive clinical activity in the neoadjuvant setting, with a pathological complete response rate similar to that of the standard methotrexate, vinblastine, doxorubicin, and cisplatin regimen and an excellent disease-free survival in responding patients.

Atrasentan is a potent, oral, selective endothelin-A receptor antagonist that has clinical activity in patients with hormone-refractory prostate cancer (HRPC). In this article, the authors report the results from a phase 3, randomized, double-blind, placebo-controlled trial of atrasentan in patients with nonmetastatic HRPC.

The authors used a pathway-based approach and a multifaceted approach to analyze high-order gene-gene and gene-smoking interactions. The results revealed that the alteration of risk of oral premalignant lesion by single-nucleotide polymorphisms in the cell-cycle control pathway can be attributed to smoking status. This pathway-based approach has the advantage of identifying the complex relationship between genetic polymorphisms and cancer susceptibility involving multiple factors.

The results from this study confirmed the leading role of pretransplantation positron emission tomography as prognostic factor in a homogeneous population of patients with aggressive B-cell non-Hodgkin lymphoma.

The authors hypothesized that arsenic trioxide may augment the clinical activity of low-dose cytarabine in older patients with acute myeloid leukemia (AML), and they conducted a phase 1/2 study to determine the safety and efficacy of the combination. The results indicated that arsenic trioxide combined with low-dose cytarabine appeared to improve responses in elderly patients who had AML compared with either agent alone.

Cetuximab has demonstrated evidence of activity in nonsmall cell lung cancer (NSCLC). When administered in combination with carboplatin and docetaxel, cetuximab has been reported to exhibit synergistic interaction in preclinical studies. Therefore, a phase 2 study was conducted to evaluate the efficacy of the combination of cetuximab, carboplatin, and docetaxel for the treatment of patients with advanced NSCLC.

The authors conducted a retrospective investigation of the prognostic factors in patients with recurrent small cell lung cancer receiving second-line chemotherapy, and identified performance status and sensitivity to first-line chemotherapy as significant prognostic factors. These should be used as stratification factors in future clinical trials of second-line chemotherapy.

Temozolomide, an oral methylating imidazotetrazinone, has antitumor activity against gliomas, malignant melanomas, and brain metastasis and is presently administered as a 5-day oral schedule every 4 weeks.

Chemotherapy with cisplatin and vinorelbine combined with concurrent external-beam radiotherapy was found to induce a high response rate in patients with brain metastases from breast cancer, with an acceptable toxicity profile. This combination be of interest for patients with both cerebral and extracerebral disease progression.

Brain metastases are a frequent and adverse complication in metastatic clear cell renal cancer. The aggressive treatment of patients with renal cancer brain metastases incorporating stereotactic radiosurgery (SRS) and subsequent systemic therapy resulted in prolonged survival in 16% of patients. The best outcome was obtained in ‘good-risk’ patients treated with interleukin-2-based immunotherapy after SRS.

In this study, the authors performed a retrospective review of histologic parameters and clinical outcome data in a series of 156 patients with a diagnosis of Merkel cell carcinoma. The results revealed that, in a multivariate analysis, in addition to the known prognostic value of tumor stage, 3 histologic features were independent predictors of survival: tumor thickness, the presence of lymphatic tumor emboli, and tumor growth pattern.

Black men seeking prostate cancer screening have a substantial burden of family history of prostate cancer. Targeted education and enhancing discussion in black families should increase prostate cancer screening and adherence.

In a large group of uniformly treated African–American (AA) and white patients, although the expected clinicopathologic differences were found between the 2 cohorts, race was not found to be an independent predictor of local recurrence for AA patients when other confounding variables were taken into account in the multivariate model. This suggests that breast conservation therapy is a reasonable option for appropriately selected AA patients.

Substantial increases in 5-year and 10-year childhood and adolescent cancer survival rates were noted over the 25-year period for all histologic types combined and for nearly all cancers examined. Observed trends reinforce a need for resources devoted to advancing treatment modalities, reducing disparities among racial/ethnic groups and adolescents, and providing long-term care of survivors.

The cumulative incidence of solid organ second malignant neoplasms in 1686 patients with osteosarcoma and 1156 patients with Ewing Sarcoma treated on legacy Children's Cancer Group/Pediatric Oncology Group protocols from 1980 to 2005 was 1.4% (95% confidence interval, 0.6%-2%) at 10 years. Overall, the cohort was at a 3.7-fold increased risk of second solid tumors compared with the general population.

A prospective trial was conducted randomizing patients undergoing prostate brachytherapy to a single intraoperative dose of dexamethasone versus no steroid use to determine the effect of steroids on the rate of catheterization within 48 hours. The overall rate of postimplantation catheterization in the study was 1.5%, with no statistical difference noted between treatment arms, demonstrating that dexamethasone did not decrease the rate of catheterization.

Metastases to the brain from ovarian and endometrial carcinoma are uncommon and consensus regarding their optimal management is lacking. Stereotactic radiosurgery (SRS) has proven useful for the treatment of many benign and malignant brain tumors. In the current study, the authors reviewed their experience with 27 patients who underwent gamma–knife SRS for brain metastases from endometrial or ovarian carcinoma.