Cancer

Immunohistochemical criteria for corresponding molecular classes of breast cancer predict response to neoadjuvant chemotherapy. These criteria can be reliably applied in routine practice for prognostic/predictive information.

The combination of uracil and ftorafur (UFT) and leucovorin administered orally in a 3-times-daily regimen is reported to have modest activity in patients with metastatic breast cancer who had been previously treated with anthracyclines and/or taxanes. Grade 3 toxicities were manageable.

In patients with advanced gastroesophageal cancer who were not candidates for therapy with every-3-week docetaxel, cisplatin, and 5-flurouracil (DCF), a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity. Further schedule optimization for these 3 active agents is recommended.

A negative positron emission tomography and computed axial tomography does not rule out colon cancer, colonic lymphoma, advanced adenomas, or inflammatory conditions in the colon. Standardized uptake value readings had no relation to lesion size and were not useful in distinguishing true-positive exams from false-positive exams.

Mucinous but not clear cell histology is associated with significantly worse prognosis in advanced ovarian cancer treated with combination platinum/paclitaxel. Different therapeutic strategies should be studied in this entity.

In the current study, the authors evaluated the prognostic significance of the maximum standardized uptake value (SUV) of pelvic lymph nodes in patients with cervical cancer. The SUV in pelvic lymph nodes was found to be a prognostic biomarker, predicting treatment response, risk of pelvic disease recurrence, and disease-specific survival.

Dose-intense paclitaxel, cyclophosphamide, and cisplatin with flexible filgrastim dosing yielded a high surgical response rate and encouraging overall survival in patients with advanced epithelial ovarian cancer. These data and those recently reported by the Japanese Oncology Group suggest that further study of dose-dense or dose-intense regimens may be warranted.

In this retrospective study, 74 patients with lower risk myelodysplastic syndromes received azacitidine in a named patient program. Overall, the response rate was 45.9%, and a survival benefit was observed in responding patients, indicating that azacitidine may be a feasible and effective therapeutic option for these patients.

Patients with aggressive non-Hodgkin lymphoma and human immunodeficiency virus infection benefit from the use of liposomal cytarabine (DepoCyte) as prophylaxis against meningeal disease recurrence or progression.

Approximately 66% of patients who have disappearing liver metastases have a true complete response according to assessment by resection or radiologic follow-up. Predictive factors, such as the use of hepatic arterial infusion chemotherapy, inability to observe the metastasis on magnetic resonance imaging, and normalization of the serum carcinoembryonic antigen level, help to stratify patients who are likely to harbor residual disease.

Existing staging systems for diffuse malignant pleural mesothelioma do not provide accurate survival stratification for patients undergoing primary surgery. Proposed adjustments to pathologic TNM staging criteria improve outcome stratification of patients with epithelial tumor histology who receive definitive surgical therapy by extrapleural pneumonectomy.

Despite aggressive multimodality therapy, 5-year survival in patients with advanced stage nonsmall cell lung cancer (NSCLC) was very poor and for the most part limited to small and specific pathologic subsets including resectable N2 disease, multiple primary tumors, T3N0, and single site distant metastasis. Patients with advanced stage NSCLC who did not fit into 1 of these subsets had a small chance of long-term survival.

Preclinical studies suggested that antibodies against the α_vβ₃ adhesion molecule on melanoma cells could inhibit the growth of melanoma xenografts and induce tumor cell death. The present study evaluated safety characteristics and therapeutic effects of anti-α_vβ₃ antibody given alone or with standard dacarbazine chemotherapy in patients with metastatic melanoma. The results did not show major effects on progression-free survival or overall survival with or without chemotherapy and did not warrant further evaluation in phase 3 trials.

The authors observed that there is significant diversity of biologic behavior of melanoma between 1 mm and 2 mm in thickness. Sentinel lymph node biopsy is recommended for all such patients to identify those with lymph node metastasis who are at the greatest risk of recurrence and mortality.

Data indicate that 5-aminolevulinic acid (5-ALA) is a promising marker for intraoperative visualization of anaplastic foci in diffusely infiltrating gliomas with nonsignificant contrast enhancement. The use of 5-ALA may become a novel standard for intraoperative tissue sampling in these tumors, and may therefore optimize allocation of patients to adjuvant treatments.

Radiation-related fractures of the femur occurring after surgery and radiotherapy for soft tissue sarcoma are uncommon but difficult to manage, and their nonunion rate is extremely high. The proposed model, presented as a nomogram, suggests that it is possible to predict a patient's risk of fracture with a high degree of sensitivity and specificity, which would allow for the identification of high-risk patients before fracture occurs.

For the first time, survivorship issues are reported specifically for Native American breast cancer patients (n = 266). Half of the patients had difficulties accessing treatment services, and unmanaged cancer pain was among the more prevalent problems.

Incidence rates of upper gastrointestinal tract cancers are substantially higher in men than women worldwide. Use of estrogen-progestin menopausal hormone therapy was associated with lower cancer risk, suggesting a possible role of sex hormones in the etiology of these cancers.

The authors conducted a phase 1 trial of dasatinib in patients with advanced solid tumors and determined a maximum recommended dose of 180 mg once daily based on the incidence of pleural effusion. Coadministration of dasatinib with the cytochrome P450 3A4 inhibitor ketoconazole led to a marked increase in dasatinib exposure, which was correlated with an increase in corrected QT values but not with cardiac toxicity.

Young male cancer survivors reported a marked impairment in quality of life, energy levels, and quality of sexual functioning, which was worse in those with low testosterone levels. However, psychological distress was not elevated, self-esteem was normal, and sexual relationships were not impaired. The relationship with testosterone is complex, and appears dependent on a threshold level rather than direct correlation.

We prospectively compared the proxy reporting of health-related quality of life (HRQL) by parents and nurses of children with Hodgkin disease to see how well they correlated with the children's report. There was substantial agreement among the parent's, nurse's, and children's reported HRQL scores; moreover, nurses contribute valuable additional information as proxy respondents.

We evaluated 4 different health-related quality of life measures prospectively to determine their ability to detect change over time: the Health Utilities Index Mark 2 and Mark 3, the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core and Cancer Module, the EuroQol EQ-5D visual analogue scale (EuroQol), and the Lansky Play-Performance Scale. All of the measures were able to detect change in a diverse group of children with Hodgkin disease, with the PedsQL and the EuroQol appearing to be the most sensitive to change.