Cancer

The authors evaluated the predictive value of quantitative hormone receptor expression in patients with HER2-positive advanced breast cancer receiving trastuzumab and chemotherapy. Whereas high hormone receptor expression predicted reduced response rate, hormone receptor positivity was associated with a large progression-free survival benefit when endocrine therapy was added to trastuzumab after chemotherapy.

Data from a nationally representative survey of primary care physicians from 2006 and 2007 were used to examine breast cancer screening recommendations for hypothetical patients ages 50 years, 65 years, and 80 years who were healthy, had a moderate comorbidity, or had a terminal comorbidity. The results suggest that over-recommendation of screening mammography is likely for terminally ill women and varies by physician and practice characteristics, including specialty.

In selected patients with early stage breast cancer who received accelerated partial breast irradiation therapy, the risk of axillary failure was 0.2% at 5 years, and the regional failure rate was 0.4%. The rates of regional and axillary failure were comparable to the rates observed with traditional whole-breast irradiation.

The authors analyzed the timing between the termination of neoadjuvant chemotherapy and cystectomy and assessed its impact on the survival of patients with muscle-invasive bladder cancer. By using a multidisciplinary approach, the authors determined that the median time to cystectomy was 6.9 weeks. The results indicated that undergoing cystectomy within 10 weeks after the completion of neoadjuvant chemotherapy did not compromise cancer-specific or overall survival.

Over the past decade, there has been widespread adoption of robotic-assisted prostatectomy and increasing centralization of prostate cancer surgery at high-volume centers. These changes have had a major impact on patterns of care and geographic access to care for patients with prostate cancer.

In a study of 46 men with castration-resistant prostate cancer, treatment with dasatinib plus docetaxel was well tolerated, and encouraging rates of tumor and bone responses were observed.

Neoadjuvant gemcitabine and cisplatin chemotherapy was found to be capable of down-staging urothelial cancer in the bladder; however, no effect on disease in nodes was seen in this study.

The results from this study indicted that total serum cell-free DNA levels and CpG island methylation represent novel diagnostic serum biomarkers for patients with renal cell carcinoma. In addition, total serum cell-free DNA may be a useful prognostic biomarker that may assist in tailoring postoperative surveillance and therapy.

In a study that investigated prediagnostically collected sera from a group of 118 women with invasive ovarian cancer and a control group of 951 healthy women who participated in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, analytical models that included cancer antigen 125 (CA 125) and 7 biomarkers failed to improve on the sensitivity of CA 125 alone. This was in contrast to observations in previous studies using postdiagnostically collected serum samples, in which improved sensitivity was observed with the addition of proteomic biomarkers to CA 125 alone.

The presence of occult neck metastases was the main predictor of outcome in patients with early stage tongue cancer. The results from this study indicated that, with the exception of small superficial (<2 mm thick) T1 tumors, all patients should undergo elective neck dissection to stage the neck, and, if occult metastases are identified, then adjuvant postoperative radiation should be considered.

The objective of this study was to assess patients who had acute myeloid leukemia with and without central nervous system (CNS) disease to determine whether cytogenetic findings correlated with or predicted CNS involvement.

ENACT is the largest clinical study of patients with chronic myeloid leukemia in the chronic phase (N = 1422) who failed prior imatinib therapy because of resistance or intolerance. This study confirms the clinical efficacy and safety of nilotinib for the treatment of these patients, which was observed in the phase 2 registration study.

Abnormalities involving chromosome 7 are frequent in myelodysplastic syndrome (MDS) and suggest a poor prognosis. In this study, the authors observed that isolated patients who had MDS with deletion of part of the long arm of chromosome (7q) had distinct clinicopathologic characteristics and better survival than patients who had MDS with isolated monosomy 7 (complete loss of chromosome 7). Therefore, the current results indicate that isolated 7q deletion no longer should be considered in the same prognostic category as monosomy 7.

In this study, the authors originally investigated the expression levels, clinical relevance, and biologic function of the so-called factor that binds to inducer of short transcripts-1 (FBI-1) in patients with hepatocellular carcinoma (HCC). The findings revealed that FBI-1 was highly elevated in HCC tissues, and overexpression of FBI-1 was correlated with a poor prognosis in patients with HCC after hepatic resection; furthermore, FBI-1 was capable of promoting cell proliferation and enhancing chemotherapy resistance of HCC in vitro and in vivo, suggesting that FBI-1 may serve as a novel prognostic marker and therapeutic target for HCC.

The results from this study provided data on the usefulness of assessing tumor vascularization in hepatocellular carcinoma with the use of modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. mRECIST characterized a population of 23% of responders who had a significantly better prognosis compared with nonresponding patients.

Tumor cell expression of estrogen receptor-α, progesterone receptor (PR), and androgen receptor (AR) was evaluated in patients who received radiotherapy for stage II/III non-small cell lung cancer with respect to locoregional control, metastases-free survival, and overall survival. Expression of PR and AR was not found to be associated with outcomes.

Lung cancer has emerged as the most common cause of death from non-acquired immunodeficiency syndrome-defining malignancies. For this report, the authors reviewed the outcome of patients with lung cancer at their institution who had human immunodeficiency virus (HIV) disease and noted a shorter latency from the diagnosis of HIV to lung cancer in women. A higher CD4 count was associated with improved lung cancer-related survival.

In this study, the authors comprehensively summarize the existing literature on pineoblastoma and identify variables and treatments that had an impact on patient outcomes. Patient age >5 years and gross total resection were associated with improved patient survival.

Sixteen patients with radiation-associated sarcoma from the authors' institutions and 19 patients from the literature who received reirradiation with or without hyperthermia were analyzed. In contrast to the common assumption, the high response rate and the possibility of durable local control suggest that this treatment is promising.

The authors found that disclosure policies and the definition of conflict of interest varied considerably among oncology journals. Many oncology journals did not publish disclosure statements, with deficiencies particularly among editorials and commentaries.

The current analysis shows that only black patients have poorer overall and disease-specific survival relative to whites, even when stratified by type of surgery and use of radiation. Therefore, this survival disparity is unlikely to be because of lack of radiation use.

In this large cancer association study, the authors identified several novel genetic predisposition variants in nucleotide excision repair pathway genes for bladder cancer and observed potential gene-gene and gene-environment interactions. The results reinforce the importance of a comprehensive, pathway-focused, and tagging single nucleotide polymorphism-based candidate gene approach to identify low-penetrance cancer-susceptibility loci.

Incidence rates of papillary thyroid cancer vary by nativity and age among Hispanic women residing in California. These patterns can provide insight for future etiologic investigations of modifiable risk factors for this increasingly common and understudied cancer.

Human leukocyte antigen alleles DRB1*0403 and DRB1*0405 are, respectively, associated with the high viral load and persistent infection of human papillomavirus type 18 (HPV18). The DRB1*0403 allele is associated with an increased risk of developing high-grade squamous intraepithelial lesions or cervical cancer after adjustment for viral load and persistent infection of HPV18.

Representing one of the first attempts to systematically integrate various levels of alterations associated with the often complex cancer genomes and phenotypes, this study provided a holistic view and a mechanistic explanation over the functional connections of multiple 9p21.3-related events in glioblastoma multiforme, as well as clinically useful biomarker information for predicting the disease outcomes.

The authors designed an exploratory, open-label, randomized phase 2 study to investigate the activity and tolerability of exemestane and anastrozole as first-line hormone therapy and to explore the optimal aromatase inhibitor sequence in postmenopausal women with hormone-responsive, advanced breast cancer. A sequential strategy of anastrozole followed by exemestane appeared to be the more appropriate endocrine therapy option for these patients.

In this population-based study, the authors did not detect a survival benefit from the administration of adjuvant chemoradiation therapy for resected gastric cancer in patients aged 65 years and older.

In this decision analysis of primary radiotherapy versus surgery for high-risk prostate cancer, primary radiotherapy was associated with a higher quality-adjusted life expectancy than surgery and adjuvant radiotherapy. However, a hypothetical trimodality paradigm of prostatectomy, adjuvant radiotherapy, and hormone therapy led to the highest quality-adjusted life expectancy, suggesting that a more aggressive treatment paradigm may benefit a meaningful population of men with high-risk disease.

The authors demonstrated that post-therapy pathologic American Joint Committee on Cancer stage and the number of positive lymph nodes were independent prognostic factors for both disease-free and overall survival in a consecutive cohort of 240 patients with pancreatic ductal adenocarcinoma (PDAC) who received neoadjuvant chemoradiation followed by pancreaticoduodenectomy (PD). Pathologic evaluation of PD specimen and post-therapy pathologic tumor staging remained the key factors in predicting clinical outcome in patients with PDAC who received neoadjuvant chemoradiation and subsequent PD.

Preliminary results did not decrease local control of limited-stage small cell lung cancer. Mediastinal N3 disease was the only risk factor to predict outfield recurrence.