Cancer

The results from this study indicated that differential tumor response to neoadjuvant therapy among patients with similar stage of breast cancer may aid in developing tailored therapy and identifying new targets for drug-resistant tumors.

Systemic therapy, sequenced by whole-brain radiotherapy (WBRT), was found to improve survival in patients with breast cancer of luminal A, luminal B, and human epidermal growth factor receptor 2 (HER2) subtypes with brain metastases. Targeted therapy appears to have an additional positive impact on survival. In triple-negative breast cancer subsets, the role of systematic treatment after WBRT appears to be less clear; therefore, this issue required further investigation.

A genetic association between SERPINE1 (serpin peptidase inhibitor, clade E, member 1) (a gene that encodes plasminogen activator inhibitor 1) and diffuse-type gastric cancer was discovered. The association was observed with 4 correlated variations in intron 7 that affected SERPINE1 expression rather than with the promoter 4G/5G polymorphism.

Final results and prognostic factor analysis of a phase 3 trial assessing everolimus in patients with metastatic renal cell cancer who progressed on sorafenib and/or sunitinib are reported. Median progression-free survival was 4.9 months with everolimus versus 1.9 months with placebo by independent central review. Survival was 1.9-fold longer with everolimus compared with placebo after correcting for 80% of patients in the placebo arm who crossed over to everolimus, using a rank-preserving structural failure time model. Independent prognostic factors for shorter overall survival included low performance status, high corrected calcium, low hemoglobin, and prior sunitinib.

Quantitative methylation analysis of 4 genes in a full spectrum of cervical lesions was able to detect cervical intraepithelial neoplasia type 3 or worse with high accuracy. The results validated the clinical potential of quantitative methylation analysis, and the authors believe that the application of these new biomarkers will be clinically important in the next generation of cervical cancer screening.

Relative telomere length was not associated with endometrial cancer risk in this prospective population-based study. Elevated endometrial cancer risk associated with polymorphisms at telomere maintenance gene loci suggests that other aspects of telomere dynamics may be involved in endometrial carcinogenesis.

Central nervous system (CNS) disease recurrence in patients with diffuse large B-cell lymphoma is a rare but devastating event. This article reports that intravenous methotrexate can be safely administered concurrently with cyclophosphamide, doxorubicin, vincristine, and prednisone with rituximab (R-CHOP) and is associated with decreased risk of CNS recurrence in high-risk patients.

Patients with extranodal and nodal marginal zone lymphoma (MZL) have a similar prognosis, whereas patients with splenic MZL have a comparatively better prognosis. Three factors, B symptoms, β₂-microglobulin, and gender, appear to be prognostic factors in patients with MZL.

To the authors' knowledge, this is the first report of efficacy and safety findings from the combination of rituximab, fludarabine, and mitoxantrone (R-FM) in patients with recurrent/refractory follicular lymphoma who were selected on the basis of high tumor burden criteria at study entry. The results indicated that a 4-course R-FM induction was safe and yielded high overall and complete response rates.

Epidermal growth factor receptor (EGFR) mutation testing using denaturing high-performance liquid chromatography can be incorporated into the routine care of lung cancer patients. Clinical differences might exist between exon 19 deletions and L858R EGFR mutations in nonsmall cell lung cancer.

There is a close interplay between angiogenesis and the immune system. The authors of this report investigated for the first time the combination of angiogenic markers with in situ immunity markers and observed that this coexpression had an independent prognostic impact on nonsmall cell lung cancer.

In this prospective analysis, which was performed to evaluate whether human leukocyte antigen (HLA) phenotype influences the likelihood of a favorable outcome or response, the presence of HLA-Cw*06 allele was associated with better relapse-free and overall survival and the appearance of autoimmunity. The Cw*06 allele has been correlated with psoriasis. These results, if validated in trials of adjuvant interferon conducted in separate US and European cooperative groups, could be used to identify patients who would benefit from adjuvant interferon.

In this retrospective, observational study, the authors investigated the prognostic significance of clinical and pathologic findings from 137 children with melanoma. The results indicated that Breslow thickness predicted an increased risk of metastases, whereas age and metastases at diagnosis predicted an increased risk of death.

In this prospective investigation of meat, nitrate, nitrite, and meat mutagens and bladder cancer in the NIH-AARP Diet and Health Study, the authors found modest support for involvement of total dietary nitrite and nitrate plus nitrite from processed meat in this malignancy. Findings also suggested a positive association between both red meat and 1 hetrocyclic amine and bladder carcinogenesis.

Rectal and rectosigmoid cancer are increasing in the United States among young patients. This has been observed across races and in both sexes, but is in contrast to stable rates of colon cancer in the young population.

Clinically relevant musculoskeletal symptoms develop in women treated with adjuvant aromatase inhibitors, leading to treatment discontinuation in a substantial percentage. The upper extremities are frequently affected, especially the wrists, hands, and fingers. In this pilot study, no statistically significant association was found between patient-reported musculoskeletal symptoms and abnormalities detected with wrist ultrasonography.

Severe neutropenia on the day of port-a-catheter insertion did not increase the risk of catheter-associated infections in children with newly diagnosed acute lymphoblastic leukemia (ALL). High-risk precursor B-cell and T-cell ALL were identified as risk factors for late catheter-associated infections.

The authors investigated the prognostic significance of the initial response to salvage therapy in pediatric patients with relapsed Hodgkin lymphoma (HL). The results indicated that pediatric patients with relapsed HL who have an inadequate response after initial primary salvage chemotherapy have a very poor prognosis and should be considered for novel therapies directed at biologic or immunologic targets.

The Surveillance, Epidemiology, and End Result-9 registry was analyzed for incidence, histological subtypes, risk factors, outcomes, and changing risk trends of secondary malignancies in 111 survivors of childhood cancer. Survivors of childhood cancer are at increased risk of developing secondary hematological malignancies, particularly secondary acute myeloid leukemia; close long-term monitoring in these patients is warranted.

The authors estimate that 18% of newly diagnosed survivors and 14% of all US cancer survivors reside with 1 or more of their children younger than 18 years of age. This represents a population of 1.58 million survivors and 2.85 million children for whom cancer may pose special challenges and who may require additional resources.

In this retrospective cohort study, the authors found that phase 1 outpatients referred to palliative care had a better performance status but similar symptom burden compared with non-phase 1 patients. Phase 1 involvement did not appear to delay palliative care referral compared with patients not in phase 1, supporting the development of a simultaneous care model.

Dysregulations in diurnal cortisol levels were observed in ovarian cancer patients and were associated with greater functional disability and fatigue but not with life stress or depressed affect.

The authors constructed an adenovirus (Ad) vector that expressed the truncated form of the E2F-1 gene (E2Ftr) under regulation of the tetracycline (Tet)-off system (AdTet-E2Ftr3). The results demonstrated that this vector is a novel anticancer agent with significant therapeutic activity in vitro and in vivo. AdTet-E2Ftr3 induced apoptosis in cancer cells independent of p53 status with low cytotoxicity in normal cells.