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October 22, 2008, 10:42 PM CT

Gene expression for advanced bowel cancer

Gene expression for advanced bowel cancer
Research by researchers in France has demonstrated for the first time that identifying patterns of gene expression can be used to predict response to therapy in patients with advanced metastatic colorectal cancer.

Dr Maguy Del Rio, a scientist at the Institut de Recherche en Cancrologie de Montpellier (Montpellier, France), presented a study to the 20th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics in Geneva today (Wednesday) [1] in which she and her team had identified an 11-gene signature that could be used to separate those patients who would respond to a particular chemotherapy (FOLFIRI leucovorin, fluorouracil and irinotecan) from those who would not. FOLFIRI is one of the most usually used, first-line therapys for metastatic colorectal cancer.

Dr Del Rio said: "Gene expression signatures are a new class of molecular diagnostic tests for cancer. For cancer prognosis, three tests are commercially available, all for breast cancer. It is more difficult to predict responses to anticancer drugs than it is to predict prognosis. Few studies have been made in this field. This and our prior study [2] are the first that demonstrate the utility of gene expression profiling for the prediction of response in colorectal patients".

About half of patients with colorectal cancer develop liver metastases during the course of their disease. Dr Del Rio said: "When this happens, it is critical for the success of overall therapy to chose a chemotherapy regime that is most likely to induce a maximal response during the first course of therapy. It is a major clinical challenge to identify a subset of patients who could benefit from a particular chemotherapy, and to identify those who will not and therefore need to be treated using an alternative therapy".........

Posted by: Sue      Read more         Source


October 6, 2008, 10:14 PM CT

Stool DNA testing for colorectal cancer

Stool DNA testing for colorectal cancer
The first generation of a stool DNA test to identify early colorectal cancer has limitations, as per a Mayo Clinic-led study reported in the Oct. 7, 2008, issue of Annals of Internal Medicine Results did not corroborate findings of an earlier multicenter study that showed stool DNA testing was more accurate than fecal blood testing for colorectal cancer detection. *.

"But the concerns we identified with stool DNA testing are all solvable," says David Ahlquist, M.D., lead researcher in the study that included 4,482 participants and 22 academic medical centers. Scientists have hoped that stool DNA testing could be the user-friendly and accurate screening tool that would increase screening numbers.

More than half of adults in the United States have never been screened for colorectal cancer, the second-leading cause of cancer deaths. While available screening tools work, the most effective tests involve time, effort and costs. For example, colonoscopy requires fasting, bowel cleansing, a doctor visit, sedation, an invasive procedure and lost work time -- factors that contribute to low screening participation.

This blinded study, conducted from 2001 to 2007, compared screening effectiveness of two widely used fecal blood tests (Hemoccult and HemoccultSensa) with a stool DNA test in average-risk patients, ages 50 to 80. The DNA test used was the prototype for PreGenPlus, the first commercially-used stool DNA test, and waccording toformed on samples sent to EXACT Sciences in Marlborough, Mass. All participants underwent a colonoscopy, the gold standard in current screening. Scientists used colonoscopy as the benchmark to detect cancer or premalignant polyps.........

Posted by: Sue      Read more         Source


October 3, 2008, 5:09 AM CT

Colonoscopy reduces colorectal cancer

Colonoscopy reduces colorectal cancer
Patients who undergo a complete negative colonoscopy have a reduced occurence rate of colorectal cancer, confirms a study published in Clinical Gastroenterology and Hepatology However, in the proximal colon, the incidence reduction of colorectal cancer following complete negative colonoscopy differs in magnitude and timing. The reduction of colorectal cancer is observed in about half of the 14 follow-up years and for the most part occurs after just seven years of follow-up. Clinical Gastroenterology and Hepatology is the official journal of the American Gastroenterological Association (AGA) Institute.

"Our study raises a question about the effectiveness of colonoscopy in usual clinical practice," said Linda Rabeneck, MD, MPH, of the University of Toronto and Institute for Clinical Evaluative Sciences in Toronto and lead author of the study. "Our findings suggest that the effectiveness of colonoscopy is reduced for cancers arising in the proximal colon. Whether this is due to colonoscopy quality, or whether it is due to tumor biology is the key issue that we need to address."



Findings


The relative rate of colorectal cancer overall and the relative rate of distal (left-sided) colorectal cancer in the study group remained significantly lower than the control population. The relative rate of proximal (right-sided) colorectal cancer was significantly lower than the control population in half of the follow-up years, mainly after seven years of follow-up.........

Posted by: Sue      Read more         Source


October 1, 2008, 8:25 PM CT

Breakthrough optical technology to assess colon cancer risk

Breakthrough optical technology to assess colon cancer risk
Scientists at NorthShore University HealthSystem (NorthShore) and Northwestern University have discovered that fiber optic technology can for the very first time effectively measure blood levels in the colonic lining (mucosa) in humans, thus having potential applications for analyzing risk of colon cancer.

The study appears in the October 2008 issue of Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.

The study used fiber optic technology to map microvascular blood content in patients during colonoscopy. The results provide the first indication that the early increase in blood supply (EIBS) is detectable in humans and that a high blood level mirrors proximity to neoplasia (process of tumor formation). The findings also suggest that this technology could be a valuable screening tool for enhancing polyp detection and could lead to improvements in colon cancer prevention.

"Our premise is that since the lining of the large intestine -- rectum and colon -- is contiguous, if you see an abnormality in one part of the colon, then somewhere else in the colon you have a higher likelihood of harboring an adenoma [non-malignant tumor] or carcinoma [cancerous tumor]," said Hemant K. Roy, M.D., director of gastroenterology research at NorthShore University HealthSystem and the study's principal clinical researcher. "EIBS strengthens our premise thanks largely to the unique and accurate ability of Four Dimensional Elastic Light Scattering Fingerprinting (4D-ELF)".........

Posted by: Sue      Read more         Source


September 14, 2008, 10:09 PM CT

Cancer-causing gene in many colon cancers

Cancer-causing gene in many colon cancers
Demonstrating that despite the large number of cancer-causing genes already identified, a number of more remain to be found, researchers at Dana-Farber Cancer Institute have linked a previously unsuspected gene, CDK8, to colon cancer.

The discovery of CDK8's role in cancer was made possible by new tools for assessing the activity of specific genes, say the authors of the new study. As these tools are further improved, the stream of newly discovered cancer genes is expected to increase, providing new avenues for treatment, the authors suggest. The findings are being published as an advanced online publication by the journal Nature on Sept. 14.

"This study provides confirmation that a number of of the genes involved in cancer have yet to be identified," remarked the study's senior author, William Hahn, MD, PhD, of Dana-Farber and the Broad Institute of Harvard and M.I.T. "When it comes to identifying gene targets for treatment, we've really only scratched the surface".

The study is noteworthy in another respect, as well, the authors indicated. A number of of the abnormal proteins associated with cancer are known as "transcription factors" because they're able to "read" cell DNA and use that information for producing other cell proteins. Eventhough transcription factors are important regulators, this class of proteins has proven to be impossible to target with drugs. Genes that influence such transcription factors, however, make attractive targets for drugs, since they can potentially disrupt the cancer process and disable tumor cells. CDK8 is such a gene.........

Posted by: Sue      Read more         Source


September 9, 2008, 9:29 PM CT

Early stage colon cancer and gatekeeper gene

Early stage colon cancer  and gatekeeper gene
The absence or inactivation of the RUNX3 gatekeeper gene paves the way for the growth and development of colon cancer, Singapore researchers report in the Sept. issue of the journal Cancer Cell Prior studies have shown that RUNX3 plays a role in gastric, breast, lung and bladder cancers.

The inactivation of RUNX3 occurs at a very early stage of colon cancer, as per the Singapore scientists' studies with human tissue samples and animal models.

Because the inactivation of RUNX3 is relatively easy to detect, and it is possible that inactivated RUNX3 can be reactivated, this new research may prove to be a crucial step in the development of an early diagnostic test as well as a therapeutic target for colon cancer.

Previous to these new findings, researchers knew that a tumor suppressor gene called APC is disrupted in most cases of human colon cancer. APC disruption activates bete-catenin and TCF4, a protein complex that plays an important role in cancer development. For decades, this has been considered the molecular basis for colon cancer.

These latest findings are the first to show that the activity of beta- catenin/TCF4 also is inhibited by RUNX3.

The Singapore researchers are based at the National University of Singapore's (NUS) Yong Loo Lin School of Medicine and the Institute of Molecular and Cell Biology (IMCB), one of the 14 research institutes under the country's Agency for Science, Technology and Research (A*STAR).........

Posted by: Sue      Read more         Source


September 2, 2008, 8:04 PM CT

Colorectal cancer screening should start at age 50

Colorectal cancer screening should start at age 50
Colorectal adenomas, the precursor polyps in virtually all colorectal cancers, occur infrequently in younger adults, but the rate sharply increases after age 50. Additionally, African Americans have a higher rate of proximal, or right-sided, polyps, and may have a worse prognosis for survival if the polyps become malignant. Therefore, the results of this study further emphasize the importance of colonoscopies, which view the entire colon, for the prevention of colorectal cancer beginning at age 50. The results of this study, which represents the largest investigation, by several-fold, of this kind, were published in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

"While colorectal polyps are rare in adults aged 30 to 50, our study reveals an increase in polyp prevalence with age and a dramatic increase in colorectal adenoma incidence occurring in adults over the age of 50," said Francis M. Giardiello, MD, of The John Hopkins University and lead author of the study. "Understanding the natural occurrence of colorectal polyps, particularly in younger adults, is important to the development of colorectal cancer prevention strategies".



Findings


Scientists found the prevalence of colorectal polyps in younger adults increased from 1.72 percent to 3.59 percent from age 30 to 50. This rate sharply increased after age 50 with the prevalence of polyps ranging from 10.1 to 12.06 percent in the sixth and ninth decade, respectively. The study results quantified the number of adenomas typically found in people under the age of 50. It is important to note that those with two or more adenomas under 50 years of age represent unusual individuals who might merit closer colonoscopic surveillance for subsequent adenoma development.........

Posted by: Sue      Read more         Source


July 14, 2008, 9:48 PM CT

Colorectal cancer screening rates still too low

Colorectal cancer screening rates still too low
Eventhough colorectal cancer screening tests are proven to reduce colorectal cancer mortality, only about half of U.S. men and women 50 and older receive the recommended tests, as per a report in the July 2008 issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

The Centers for Disease Control and Prevention conducted a National Health Interview Survey and found only 50 percent of men and women 50 and older had received screening in 2005. Eventhough this was an improvement over the 43 percent of screened individuals reported in 2000, it is still far from optimal, researchers say.

"Colorectal cancer is one of the leading cancer killers in the United States, behind only lung cancer. Screening has been shown to significantly reduce mortality from colorectal cancer, but a lot of people are not yet getting screened," said Jean A. Shapiro, Ph.D., an epidemiologist at the Centers for Disease Control and Prevention (CDC).

Shapiro says a major problem appears to be insurance coverage. Among people without health insurance, scientists found the rate of colorectal cancer screening was 24.1 percent in comparison to over 50 percent of insured Americans, depending on the type of insurance. Among patients without a usual source of health care, the screening rate was 24.7 percent in comparison to 51.9 percent of patients with a usual source of health care.........

Posted by: Sue      Read more         Source


May 21, 2008, 9:53 PM CT

Virtual biopsy for colon polyp

Virtual biopsy for colon polyp
Colon polyp
A probe so sensitive that it can tell whether or not a cell living within the human body is veering towards cancer development may revolutionize how future colonoscopies are done, say scientists from the Mayo Clinic in Jacksonville, Fla.

Investigators have observed that technology known as a high resolution confocal endomicroscopy probe system can determine whether a colon polyp is non-malignant (not premalignant) - without having to remove it for examination by a pathologist.

Their study, to be presented at the Digestive Disease Week, a scientific meeting of gastrointestinal specialists and scientists held in San Diego, shows that using the probe system was 89 percent accurate in identifying whether polyps were either premalignant or benign. But more importantly, it was correct 98 percent of the time in flagging polyps that were benign, which would then not need to be removed for biopsy. The Mayo researchers, who are the first in the U.S. to comprehensively test the system in the colon, believe they can push accuracy close to 100 percent with more research.

What this means is that the probe system can be used to during a colonoscopy to rule out removal of polyps that are not harmful, says the study's senior author, Michael Wallace, M.D., M.P.H., Professor of Medicine at Mayo Clinic.........

Posted by: Sue      Read more         Source


May 18, 2008, 9:48 PM CT

Which patients should get treatment for colorectal cancer

Which patients should get treatment for colorectal cancer
A new study being presented at the American Society of Clinical Oncology meeting in Chicago (Abstract #4020), may change therapy practice in about 25 percent of colon cancer patients and is the basis for proposed changes to the way colorectal cancers will be staged.

This new study, using National Cancer Institute (NCI) SEER population-based statistic registries from 1992 to 2004, and phase III clinical trial data, shows that outcomes of patients with positive nodes (Stage III) in colorectal cancer interact, to a greater extent than previously thought, with how deeply the cancer penetrates the bowel wall.

Survival outcomes depend on the thickness of the primary cancer within or beyond the bowel wall in addition to whether nodes are positive or negative. A patient with a node positive thin lesion (i.e., confined to the bowel wall) has a stage III cancer with better survival outcomes than a patient with a Stage II node negative thick cancer that penetrates beyond the bowel wall. The current standard of practice for patients with colon cancer is that all or most Stage III patients receive chemotherapy after surgical removal of their cancer, but Stage II patients do not routinely receive chemotherapy. In a separate National Cancer Data Base (NCDB) analysis, patients with Stage III colon cancers confined to the bowel wall who did not receive chemotherapy still had better survival than Stage II patients.........

Posted by: Sue      Read more         Source



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Colorectal cancer
Colorectal cancer is a malignant tumor that arises from the inner wall of the large intestine or rectum. Colorectal cancer is the third commonest cancer diagnosed in the United States. Each year over 100,000 people are diagnosed with colorectal cancer in the United States. Most, of these cancers develop from growths in the colon called polyps. Removal of these polyps can prevent colon cancer.

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