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June 10, 2009, 8:44 PM CT

Tamoxifen resistance

Tamoxifen resistance
Tamoxifen is a widely used and highly successful drug in the treatment of breast cancer, though resistance to tamoxifen is still a concern in recurrent disease (affecting 25-35% of patients), since therapy resistant metastatic tumor cells are a major cause of death. In a study in this month's Molecular and Cellular Proteomics, researchers have uncovered a protein profile that may accurately predict whether a cancer will be tamoxifen resistant.

Arzu Umar and colleagues in the Netherlands and Washington examined thousands of tumor cells taken from 51 tamoxifen therapy-sensitive and therapy-resistant tumors using a combination of proteomic and mass-spectrometry approaches. Their analysis revealed a set of 100 proteins that were expressed at different abundance levels in the two tumor groups, highlighting a potential profile for tamoxifen resistance.

In addition, they analyzed the most significantly altered protein, called extracellular matrix metalloproteinase inducer, or EMMPRIN, in a separate set 156 breast tumor tissue samples. EMMPRIN levels were higher in tamoxifen-resistant tumors and significantly associated with an earlier tumor progression following first line tamoxifen treatment and poor clinical outcome, suggesting EMMPRIN may be a reliable marker for highly aggressive breast cancer.........

Posted by: Janet      Read more         Source


June 9, 2009, 5:00 AM CT

Dynamic stroma microenvironment in prostate cancer

Dynamic stroma microenvironment in prostate cancer
As stroma the supportive framework of the prostate gland react to prostate cancer, changes in the expression of genes occur that induce the formation of new structures such as blood vessels, nerves and parts of nerves, said scientists at Baylor College of Medicine in a report that appears in the current issue of the journal Clinical Cancer Research

In this study, using special techniques and gene chips that allowed them to sample the entire genome, the scientists found changes in 1,141 genes. They were either upregulated meaning that there was more of the protein with which they were associated than expected or downregulated, which meant the opposite, said Dr. Michael Ittmann, professor of pathology at BCM and a senior author of the report. These gene changes may explain why men with reactive stroma face a more aggressive disease, said Ittmann and Dr. Gustavo Ayala, professor in the departments of pathology and urology at BCM and another senior author.

"Often in prostate cancer, you don't see much change in the stromal cells," said Ittmann. "However, in this subgroup of patients (in which the stroma become visibly reactive), you see a histologically recognizable change in the appearance of the stroma. Dr. Ayala has shown previously that this correlates with a bad prognosis. We know the stroma are doing something to promote bad behavior in cancer cells".........

Posted by: Mark      Read more         Source


June 3, 2009, 5:06 AM CT

Skin Lesion Leads To More Cancer Types

Skin Lesion Leads To More Cancer Types
Actinic keratoses
The study provided up to six years of follow-up to quantify the risk of progression of actinic keratoses to cancer.
Actinic keratoses are sun-damaged rough patches or lesions on the skin - often pink and scaly - that doctors have long believed can turn into a form of skin cancer known as squamous cell carcinoma.

Now scientists at Brown University, the Veterans Administration Medical Centers in Providence and Oklahoma City, and others have determined that actinic keratoses appear responsible for a larger spectrum of skin cancers than previously thought. Their research is highlighted in the current edition of Cancer.

"We found some interesting things," said Dr. Martin Weinstock, the paper's main author. Weinstock, chief of dermatology at the VA Medical Center in Providence, is professor of dermatology and community health at The Warren Alpert Medical School of Brown University. The U.S. Department of Veterans Affairs Office of Research and Development funded the study.

Vincent Criscione, a fourth-year Alpert Medical School student, served as the paper's first author. Beyond Brown and the VA, scientists from Rhode Island Hospital and Henry Ford Hospital in Detroit also contributed.

To conduct the study, Weinstock and the other scientists looked at 169 patients from the VA Medical Center in Oklahoma City who had a high risk for skin cancers. They, in turn, were among 1,131 patients from multiple cites who took part in a chemotherapy prevention trial conducted previously. Most had at least one actinic keratosis on their body. Combined, they had about 7,784 of the lesions on their faces and ears. There were up to six years of follow-up to quantify the risk of progression of actinic keratoses to cancer.........

Posted by: George      Read more         Source


June 3, 2009, 4:58 AM CT

Oxygen plus MRI to determine cancer therapy success

Oxygen plus MRI to determine cancer therapy success
Drs. Ralph Mason (left) and Dawen Zhao, both radiologists, have demonstrated that blood oxygen level dependent MRIs might help oncologists determine the best treatment for some cancer patients.

Credit: UT Southwestern Medical Center

A simple magnetic resonance imaging (MRI) test involving breathing oxygen might help oncologists determine the best therapy for some cancer patients, report scientists at UT Southwestern Medical Center.

Previous research has shown that the amount of oxygen present in a tumor can be a predictor of how well a patient will respond to therapy. Tumors with little oxygen tend to grow stronger and resist both radiotherapy and chemotherapy. Until now, however, the only way to gauge the oxygen level in a tumor, and thus determine which therapy might be more effective, was to insert a huge needle directly into the malignant tumor.

The new technique, known as BOLD (blood oxygen level dependent) MRI, can detect oxygen levels in tumors without the need for an invasive procedure. The patient need only be able to breathe in oxygen when undergoing an MRI.

"The patient simply inhales pure oxygen, which then circulates through the bloodstream, including to the tumors," said Dr. Ralph Mason, professor of radiology, director of the UT Southwestern Cancer Imaging Center and senior author of a study appearing online and in a future edition of Magnetic Resonance in Medicine. "Using MRI, we can then go in and estimate how much oxygen a particular tumor is taking up, providing us some insight into how the tumor is behaving and what sort of therapy might be effective".........

Posted by: Janet      Read more         Source


June 1, 2009, 5:22 AM CT

Drug combination improves outcome for advanced non-small cell lung cancer

Drug combination improves outcome for advanced non-small cell lung cancer
A new, international study observed that the combination of two drugs delays disease progression for patients with advanced non-small cell lung cancer (NSCLC). Results from the Phase III "ATLAS" trial were presented today by Dr. Vincent Miller of Memorial Sloan-Kettering Cancer Center (MSKCC) at the American Society of Clinical Oncology Annual Meeting.

The goal of the study was to determine whether adding erlotinib (Tarceva), a targeted agent, to maintenance treatment with bevacizumab (Avastin), an agent usually used as a component of therapy for advanced NSCLC would delay disease progression. Maintenance treatment involves using one or more agents of a chemotherapy regimen, but not the entire regimen, to delay disease progression and possibly improve survival after patients have previously received stronger standard chemotherapy, which can have significant side effects.

"This is the first study to show the addition of erlotinib to maintenance treatment prolongs progression-free survival in patients with advanced non-small cell lung cancer," said Dr. Miller, a thoracic oncologist at MSKCC and one of the study's main authors. "Knowing which patients will get the greatest benefit from this combination, based on the identification of biomarkers, will be an important next step in this research," Dr. Miller added.........

Posted by: Scott      Read more         Source


June 1, 2009, 5:18 AM CT

Surgery for late-stage colon cancer

Surgery for late-stage colon cancer
A newly released study shows that a great majority of patients who present with advanced colorectal cancer that has spread to other organs (stage IV) don't require immediate surgery to remove the primary tumor in the colon. Scientists from Memorial Sloan-Kettering Cancer Center (MSKCC) presented their data today at the American Society of Clinical Oncology Annual Meeting.

"For this population with metastatic disease that cannot be cured by surgery, undergoing colon surgery is not always necessary," said Philip Paty, a surgical oncologist at MSKCC and one of the study's main authors. "If the colon tumor is not causing obstruction, perforation, or bleeding we've found these patients are best treated with chemotherapy. By moving straight to chemotherapy, patients can avoid the risk of surgical complications and can start therapy for all sites of disease without delay".

For this retrospective study, a multidisciplinary team looked at 233 metastatic colorectal cancer cases treated at MSKCC from 2000 to 2006. Their analysis showed that 217 of the 233 patients, or 93 percent, did not have complications that mandatory resection of the primary tumor. Only 16 patients mandatory colon surgery for symptom management.

Previously, in the conventional approach to treating stage IV disease, patients underwent colon surgery immediately following their diagnosis and would typically start chemotherapy therapys three to six weeks later. The rationale for immediate colon resection was to prevent future symptoms and complications from the primary tumor. It was assumed that the majority of colorectal cancers would have little response to chemotherapy.........

Posted by: Sue      Read more         Source


June 1, 2009, 5:05 AM CT

Genetic risk factor for testicular cancer

Genetic risk factor for testicular cancer
(PHILADELPHIA) Scientists at the University of Pennsylvania School of Medicine have uncovered variation around two genes that are linked to an increased risk of testicular cancer. Testicular cancer is the most common cancer among young men, and its incidence among non-Hispanic Caucasian men has doubled in the last 40 years -- it now affects seven out of 100,000 white men in the United States each year. The discovery, reported in the May 31, 2009 online issue of Nature Genetics, is the first step toward understanding which men are at high risk of disease.

"Despite being quite heritable, there really have not been any clear genetic risk factor that can account for most cases of testicular cancer," says Katherine L. Nathanson, MD, an assistant professor of Medicine and a specialist in medical genetics at the Abramson Cancer Center. "These variants are the first striking genetic risk factors found for this disease to date."

Nathanson and co-author Peter A. Kanetsky, PhD, MPH, an assistant professor of Epidemiology, observed that men who have two copies of the common version of the c-KIT ligand (KITLG) gene have a 4.5-fold higher risk of testicular cancer than men who have two copies of the less common or minor version of the gene. Additionally, men with two copies of the common version of variants next to another gene, sprouty 4 (SPRY4), have a 1.48-fold higher risk than men with two copies of the less common version of the gene.........

Posted by: Janet      Read more         Source


June 1, 2009, 5:04 AM CT

drug combination safe and active in kidney cancer

drug combination safe and active in kidney cancer
Fox Chase Cancer Center researchers report that a two-drug blockade of mTOR signaling appears safe in metastatic kidney cancer in a phase I trial. Early data suggests that a combination of temsirolimus and bryostatin appears to be active in patients with rare forms of renal cell cancer, which are less likely to respond to other targeted therapies.

Elizabeth Plimack, M.D., M.S., a medical oncologist and attending doctor at Fox Chase will report the trial results on Sunday, May 31 at the annual meeting of the American Society of Clinical Oncology.

"We have certainly seen sustained responses with this combination which are encouraging," Plimack says.

One of the patients with an extended response has papillary renal cell cancer, which is a rare form of the disease that does not respond well to standard therapies. "Patients with non-clear cell renal cell cancer, including papillary renal cancer, don't respond as well to tyrosine kinase inhibitors, such as sunitinib and sorafenib, as patients with clear cell renal cell. So there is an unmet need for treatment for these patients. We've seen that this combination appears to be active to some degree for them".

mTOR signaling promotes tumor cell proliferation and blood vessel development. Temsirolimus (Torisel), blocks signaling through one portion of the mTOR signaling complex, called TORC1, and slows tumor progression in patients with advanced kidney cancer. However, a second portion of the complex, called TORC2, is unaffected by temsirolimus and continues to promote cell proliferation. Therefore, Plimack and his colleagues suspect that blocking TORC2 signaling activity could improve patient outcomes. Bryostatin blocks a downstream effector of TORC2, called protein kinase C.........

Posted by: Janet      Read more         Source


May 26, 2009, 6:50 PM CT

Can we afford the cancer care of the future?

Can we afford the cancer care of the future?
When a cancer patient and his or her doctor discuss the value of a therapy option, the conversation commonly centers on a consideration of the therapy's medical benefits versus its possible side effects for the patient. Increasingly, however, as the already high costs of cancer care continue to rise, a full view of the patient's welfare must also take into account the economic impact of the therapy on the patient and his or her family.

Additionally, beyond its clear impact on patients, the increasing cost of cancer care also presents challenges to other stakeholders involved in the development and delivery of care.

"Cancer care is one of the most expensive areas of health care today, and the cost of that care is increasing steadily, for patients and for society as a whole," says Neal J. Meropol, M.D., director of the gastrointestinal cancer and gastrointestinal tumor risk evaluation programs at Fox Chase Cancer Center. Meropol, who is also a member of the American Society of Clinical Oncology (ASCO) Cost of Care Task Force and main author on the upcoming ASCO Guidance Statement on the Cost of Cancer Care, offered his analysis of the problem in a talk presented at the ASCO annual meeting in Orlando today.

"As physicians, we have a responsibility to understand the impact that the increasing cost of cancer care has on everyone involved," Meropol notes. "In particular, we need to be able to discuss with our patients the impact that high out-of-pocket expenses might have on them and their families, however difficult that conversation might be. More and more, cost considerations have an appropriate role in the evaluation of therapy options".........

Posted by: Janet      Read more         Source


May 22, 2009, 5:03 AM CT

African-American women with advanced breast cancer

African-American women with advanced breast cancer
A newly released study finds that nearly one in four African American women with late stage breast cancer refused chemotherapy and radiation treatment, potentially life saving therapies. Reported in the July 1, 2009 issue of CANCER, a peer-evaluated journal of the American Cancer Society, the study indicates that more efforts are needed to ensure that all women with breast cancer receive appropriate care.

In the United States, African American women have almost twice the rate of advanced (stage III) breast cancer than white women. To get a better sense of the tumor characteristics and medical care of these patients, scientists led by Monica Rizzo, M.D., of the Emory University School of Medicine and Emory University's Avon Comprehensive Breast Cancer Center at Grady evaluated stage III breast cancer data from 2000 to 2006 from an inner city hospital in Atlanta that serves a large African American population.

The researchers identified 107 cases of stage III breast cancers diagnosed and/or treated at this hospital over the six years of study. Approximately 87 percent of these cases were in African American women. Triple negative tumors accounted for 29 percent of the cases. These cancers do not express the estrogen receptor, the progesterone receptor or the human epidermal growth factor receptor 2 (HER2) and therefore do not respond well to therapies that target these proteins (such as trastuzumab, or Herceptin, which blocks HER2).........

Posted by: Janet      Read more         Source



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Cancer
Cancer is a very common disease, approximately one out of every two American men and one out of every three American women will have some type of cancer at some point during the course of their life. Cancer is more common in the elderly and 77 percent of cancers occur in people above age 55 or older. Cancer is also common in children. Cancer incidence is said to have two peaks once during early childhood and then during late years in life. No age period is completely exempted from development of cancers. Some cancers occur predominantly in the elderly, other types occur in children, Cancer occurs in all ethnic races, however the cancer rates and rates of specific cancer types may vary from group to group. Late stages of cancer may be incurable in most cases, but with the advancement of medicine, more and more cancers are becoming curable.

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