Speciality
Spotlight

 




 


Oncology


 

 





Cancer
Biology, Markers, and Diagnosis

    

  • Billingslay KG, Lewis JJ, Leung DHY, et al [ Mem Sloan -Kettering Cancer Ctr, New York]

    Multifactorial Analysis of the Survival of Patients with Distant Metastasis From Primary Extremity Sarcoma

    Cancer 85:389-395, 1999

          

    Distant metastasis from extremity sarcoma occurs in approximately 25% of patients despite excellent local control and lungs are the commonest site of distant spread. The 994 patients with primary extremity soft tissue sarcoma were followed up for mean of 33 months. The first metastatic site was lung
    73%. The predictors of postmetastasis survival are resection of the metastatic disease, length of disease free survival. The local site and patients’ age older than 50 years, postmetastasis survival was not related to factors that defined the primary tumor such as histologic grade, depth and microscopic margin. The editor believes in surgical resection of metastasis from soft tissue sarcoma if clinical situation warrants. Multiagent chemotherapy has had improved response in the last decade but without improving the survival.

         

  • Rubio IT, Korourian S, Cowan C, et al [Univ of Arkansas, Little Rock, Univ of Vermont, Burlington]

    Use of Touch Preps for Intraoperative Diagnosis of Sentinel Lymph Node Metastases in Breast Cancer

    Ann Surg 5: 689-694, 1998

       

    The status of sentinel lymph node [SLN] during surgery for breast cancer is important for planning axillary lymphadenectomy. The touch prep[ TP] diagnoses correctly in 99.2% of the nodes. The false positive rate are 0 and false negative 0.8 and hence TP is fast, accurate, simple technique for identifying metastasis SLN. The editor comments that this [TP] results in improvement in both cost and time. The obvious drawbacks are immunohistochemistry and polymerase chain reaction evaluations are not possible.

      

  • Dorudi
    S, Kinrade E, Marshall NC, et al [ Royal London Hosp]

    Genetic Detection of Lymph Node Micrometastases in Patients with Colorectal Cancer

    Br J Surg 85: 98-100, 1998

          

    Undetected micrometastases are the most important cause
    of treatment failure in patients with putatively
    curative colorectal cancer surgery. The detection in the
    regional lymph node of mRNA expressed from cytokeratin
    [CK] 20 gene upstaged 4 of 15 patients, following a
    resection for colorectal cancer. The CK 20 gene product
    being a cytokeratin is restricted to intestinal
    epithelium and is not likely to be expressed in the
    lymph node. The editor comments that these so called
    negative nodes by hematoxylin eosin may be placed into
    trials for adjuvant therapy once these molecular biology
    techniques are standardized and gained experience in
    clinical practice.

        

  • Delbeke D, Martin WH, Sandler MP, et al [ Vanderbilt Unit, Nashville, Tenn]

    Evaluation of Benign vs Malignant Hepatic Lesions with Positron Emission Tomography

    Arch Surg 133: 510-516, 1998

        

    The relatively low levels of glucose-6-phosphatase is most malignant cells results in accumulation and trapping of [18F] flurodeoxyglucose [FDG] intracellularly, & then visualizing the increased uptake. This technique of FDG PET has been used in 110 consecutive patients with hepatic tumors of 1 cm or greater to differentiate between benign vs. Malignant lesions. All liver metastasis from adenocarcinoma or sarcoma and all cholangiocarcinomas showed increased uptake. Whereas hepatocellular carcinoma [HCC] had an increased FDG uptake in 16 of 23 patients and poor uptake in 7 of 23 with the exception of one abscess which had increased uptake. Rest all benign lesions revealed a poor uptake. The limitation of this technique is false positive in a minority of abscess and false negative in minority of HCC. FDG PET would also be useful in future for staging, detecting recurrences and monitoring response.

      

  • Eary JF, Conrad EU, Bruckner JD, et al [ Univ of Washington, Seattle]

    Quantitative [F-18] Fluorodeoxyglucose Positron Emission Tomography in Pretreatment and Grading of Sarcoma

    Clin Cancer Res 4: 1215-1220, 1998

        

    Positron emission tomography imaging with [F18] fluorodeoxyglucose [FDG] of sarcoma was used to monitor tumor metabolism and this correlated with tumor grade and thereby overcome some of the limitation of traditional pathologic assessment. The overlap of MRFDGPET values with tumor grade offer an alternative way to assess tumor biological potential. The neo adjuvant therapy in bone and soft tissue sarcoma is dependent on tumor grade.

      

  • Rose PG, Adler LP, Rodriguez M, et al [ Ireland Cancer Ctr, Cleveland, Ohio, Univ Hosps of Cleveland, Ohio; Case Western Reserve Univ, Cleveland, Ohio]

    Positron Emission Tomography for Evaluating Para-aortic Nodal Metastasis in Locally Advanced Cervical Cancer Before Surgical Staging: A Surgicopathologic Study

    J Clin Oncol 17: 41-45, 1999

       

    Locally advanced cancer of the cervix at presentation have para -aortic lymph node involvement in 25%, which becomes the most important indicator of recurrence.

      

    20mCi of 2-[18F] fluoro-2-deoxy -D-glucose [FDG] uptake in para-aortic LN by PET is seen in 91% of cervical tumors. Yielding a positive predictor value of 75% and negative predictor value of 92% and a relative risk of 9.0 for metastatic disease. The editor comments that identifying the para-aortic LN would allow modification of radiation therapy field to include such site of disease.

       

  • Chan TA, Morin PJ, Vogelstein B, et al [ Johns Hopkins Univ, Baltimore, Md]

    Mechanisms Underlying Nonsteroidal Anti-inflammatory Drug-Mediated Apoptosis

    Proc Natl Acad Sci : U.S.A. 95: 681-686, 1998

      

    Nonsteroidal anti-inflammatory drug [NSAIDs] have been reported to have limited efficacy as
    chemopreventive agent. The NSAIDs resulted in increase in prostaglandin precursor arachidonic acid [ AA] which in turn stimulated the conversion of sphingomyelin to ceramide, a substance known to mediate apoptosis. The editor comments that by manipulation of lipids ceramide and AA by dietary or pharmaceutical agent, may be the key to prevention of colorectal tumors.

       

  • Sorensen HT, Mellemkjaer L, Steffensen FH, et al [ Univ of Aarhus, Denmark; Inst of Cancer Epidemiology, Copenhagen; Aalborg Hosp, Denmark]

    The Risk of a Diagnosis of Cancer After Primary Deep Venous Thrombosis or Pulmonary Embolism

    N Engl J Med 338: 1169-1173, 1998

       

    The relation between pulmonary embolism [PE], deep venous thrombosis [DVT] and cancer has been debated. This large study of 15,348 patients with DVT and 11,305 with PE revealed an increased risk of 1.3 for development of cancer. Although the risk was significantly elevated only during the first 6 months of follow-up. Pancreas, ovary, liver, and brain were most common sites of cancer in patients with thromboembolism. Exhaustive search for cancer in such patient was not of clinical benefit.

      

  • Schiffenbauer
    YS, Abramovitch R, Meir G, et al [ Weizmann Inst of Science,
    Rehovet, Israel; Meir Hosp, Kfar Saba, Israel; Hebrew
    Univ-Hadassah Med School, Jerusalem]

    Loss of Ovarian Function Promotes Angiogenesis in Human Ovarian Carcinoma

    Proc Natl Acad Sci U S A 94: 13203-13208, 1997

         

    Menopause or ovariectomy increase the levels of gonadotropins i.e.
    leuteinizing hormone and follicle -stimulating hormone which further lead to increase secretion of vascular endothelial
    growth factor thereby enhancing
    angiogenesis. This study demonstrates that this angiogenesis is a possible mechanism for progression of ovarian cancer after menopause and the possible role of hormonal therapy administered at the time when patients with ovarian cancer are in complete remission with induction chemotherapy to suppress the
    gonadotrophins.

         

  • Paulli M, Berti E, Boveri E, et al [ Univ of Pavia, Italy; Univ of Milano, Italy: IRCCS Policlinico, Milano, Italy; et al]

    Cutaneous CD30+ Lymphoproliferative Disorders : Expression of bcl-2 and Proteins of the Tumor Necrosis Factor Receptor Superfamily

    Hum Pathol 29: 1223-1230, 1998

           

    This study included 25 patients who had CD30+ cutaneous lymphoma and analyzed expression of CD95 and other proteins associated with apoptosis nerve growth factor receptor [NGF-R], the anti-apoptotic protein bcl-2. Analysis revealed consistent expression of CD95 but rare or absent expression of CD27, CD40, and NGF-R on tumor cells from regressing lymphomatoid papulosis [LyP] and nonregressing CD30+ lymphomas. Levels of bcl-2 were low in LyP and high in pleomorphic CD30+ lymphomas. The increased expression of bcl-2 by tumor cells that did not regress suggests the possibility that this oncoprotein may actually protect tumor cells from apoptosis with
    CD30+ cutaneous lymphomas.

        

  • Levesque PE, Nieh PT, Zinman LN, et al [ Lahey Clinic Ctr, Burlington, Mass]

    Radiolabeled Monoclonal Antibody Indium 111-Labeled CYT-356 Localizes Extraprostatic Recurrent Carcinoma After Prostatectomy

    Urology 51: 978-984, 1998

      

    Elevated prostate-specific antigen [PSA] can detect recurrence but not the locations of the disease. Murine monoclonal antibody, 7E11-C5. 3-glycyl-tyrosyl-[N, e-diethylenetriamine pentaacetic acid] – lysine [CYT-356], linked to 111In was used to localize primary and metastatic prostate cancer. A large majority with elevated PSA, the CYT-356 was taken up outside the prostate fossa. Approximately, two third have activity in pelvic lymph nodes. Even when the lymph node dissections were negative at the time of prostatectomy.

        

    Scan failed to localize the disease in 21% of the patients with elevated PSA possibly because the antibody fail to bind to all the tumors or is unable to find small foci.

       

  • Djavan B, Kadesky K, Klopukh B, et al [Univ of Vienna; Presbyterian Hosp of Dallas; Univ of Texas, Dollas]

    Gleason Scores From Prostate Biopsies Obtained with 18-Gauge Biopsy Needles Poorly Predict Gleason Scores of Radical Prostatectomy Specimens

    Eur Erol 33 : 261-270, 1998

      

    The Gleason grading system is a well accepted prognostic factor for prostate cancer. This study has correlated with Gleason score from needle biopsy with that from radical prostatectomy. For needle biopsy 37.2% of patients had no scoring change, 12.7% were overgraded, and 50.1% undergraded. To conclude 50% of all gleason score when obtained from needle biopsy specimen had to be revised in the direction of a worse. The clinician have to keep this in mind when advising patients when gleason grading system is taken into consideration for planning the therapy.

       

  • Choe DH, Lee JH, Lee BH, et al [ Korea Cancer Ctr Hosp, Seoul]

    Obliteration of the Pulmonary Vein in Lung Cancer : Significance in Assessing Local Extent with CT

    J Comput Assist Tomogr 22: 587-591, 1998

       

    The lung tumor growth through the pulmonary veins intra pericardially or in the [L] atrium is uncommon. The obliteration of the superior pulmonary vein on CT in patients with lung tumor strongly suggests intrapericardial tumor extension through the pulmonary vein. Identifying this type of growth preoperatively is essential in planning surgical treatment as it may result in systemic tumor embolization with fatal consequences with manipulation or ligation of the involved pulmonary vein. Inferior pulmonary vein obliteration is a less reliable indicator of intrapericardial extension.

        

  • Moog F, Bangerter M, Diederichs CG, et al [Univ of Ulm, Germany]

    Extranodal Malignant Lymphoma: Detection With FDG PET Versus CT

    Radiology 206: 475-481, 1998

       

    The exact staging technique for lymphoma by noninvasive methods to detect disease in spleen, liver and bone marrow are not clear. This study compares PET versus CT scan. 42 lesions were detected by both PET & CT & were confirmed with biopsy results . Another 24 results were seen on PET, 15 of which were verified by biopsy, MRI scintigraphic, or follow up results. Seven lesions not detected by FDG PET were identified on CT. 6 of which were confirmed by biopsy or follow-up. Findings on PET resulted in changes in tumor staging in 13 patients. Functional imaging with FDG PET can provide important information for diagnosis of untreated lymphoma and can assess liver, spleen and bone marrow involvement however further clinical studies would be required.

        

  • Yahata N, Ohyashiki K, Ohyashiki JH, et al [Tokyo Med College; Univ of Texas, Dallas]

    Telomerase Activity in Lung Cancer Cells Obtained from bronchial Washings

    J Natl Cancer Inst 90: 684-690, 1998

      

    Telomerase which are components of the chromosomal ends containing nucleotide protects them from sticking to each other. Shortening of the length of telomere is activated by telomerase which is an intracellular reverse transcriptase with an RNA component. Experimental studies indicate that failure of telomerase to shorten progressively with each cell division lead to cellular immortalization a critical step in cancer progression.

        

    In this Japanese study telomerase activity from the bronchial washing were assayed. Telomerase activity was detected in bronchial washings from the majority of lung cancer patients. The editor comments that utility of such a concept for early
    detection, essentially at a premalignant level would be
    useful.

        

  • O’Regan RM, Cisneros A, England GM, et al [Northwestern Univ, Chicago; Univ of Wisconsin, Madison]

    Effects of the Antiestrogens Tamoxifen, Toremifene, and ICI 182, 780 on Endometrial Cancer Growth

    J Natl Cancer Inst 90: 1552-1558, 1998

        

    Tamoxifen plays an important role in adjuvant therapy of breast cancer patients. Chronic use of tamoxifen has shown an increase in endometrial cancer. This is due to its estrogen and antiestrogen action. 

       

    This study on athymic mice demonstrated the toremifene a chlorinated derivative of tamoxifen has identical effects to tamoxifen for the development of endometrial cancer whereas ICI 182,780 pure antiestrogen. seems to be superior and may not adversely affect the
    endometrium.

       

  • Elmore JG, Barton MB, Moceri VM, et al [ Univ of Washington, Seattle; Harvard Med School, Boston]

    Ten-year Risk of False Positive Screening Mammograms and Clinical Breast Examinations

    N Engl J Med 338: 1089-1096, 1998

         

    The current recommendation for breast cancer screening by a yearly mammography and clinical breast examination leads to ample opportunities for false positive tests. This 10-year retrospective study analyzed the cumulative risk of a false positive breast cancer screening result. After 10 tests
    [mammography], the cumulative risks of a false positive mammograms was estimated to be 49% [ 95% confidence interval [CI], 40% to 64%]. For clinical breast examination the cumulative risk was 22%. Women in their 40’s were more likely to have false positive than those in their 50’s and 70’s. Each 100$ spent on screening carried an additional $ 33 for evaluation of false positive results. This study does not undermine the importance of breast screening but it would encourage dissemination of knowledge regarding the risks of false positive tests to minimize the patient’s anxiety.

       

  • Felnyk O, Zimmerman M, Kim KJ, et al [ Univ of California at San Francisco, Genentech Inc, South San Francisco, Calif

    Neutralizing Anti-Vascular Endothelial Growth Factor Antibody Inhibits Further Growth of Established Prostate Cancer and Metastases in a Pre-clinical Model

    J Urol 161: 960-963, 1999

         

    Angiogenesis i.e. deriving blood supply from the existing vasculature promotes tumor growth metastasis. Vascular endothelial growth factor [ VEGF], a potent angiogenic factor and vascular permeability mediator, promotes tumor growth through neovascularisation. Inhibitors of VEGF would reverse this process has been well-studied
    previously. This study also gives an insight that inhibitors of VEGF through monoclonal anti VEGF neutralizing antibody suppressed the primary tumor growth in mice and also inhibited metastatic dissemination to the lung in human prostate cancer cell line study.

        

  • Baselga J, Norton L, Albanell J, et al [Mem Sloan-Kettering Cancer Ctr, New York 

    Vall d’Hebron Univ Hosp, Barcelona]

    Recombinant Humanized Anti-HER2 Antibody [Herceptin] Enhances the Antitumor Activity of Paclitaxel and Doxorubicin Against HER2/neu Overexpressing Human Breast Cancer Xenografts

    Cancer Res 58: 2825-2831, 1998

      

    HER2 gene, a new biological prognostic marker in breast cancer has revealed 25-30% overexpression and is associated with worse prognosis.

      

    In this study on human breast cancer cell lines in nude mice have revealed that a recombinant humanized anti HER2 antibody [ rhuMAb HER2 [Herceptin] enhanced the anti tumor activity of paclitaxel and doxorubicin, greater enhancement was seen with paclitaxel. This study obviously provides the rationale for clinical trials to evaluate rhuMAb in combination with these and other drugs in breast tumors and other erb-B2 positive tumors.

         

  • Rohan TE, Hartwick W, Miller AB, et al [Univ of Toronto; Mt. Sinai Hosp, Toronto]

    Immunohistochemical Detectio of c-erB-2 and p53 in Benign Breast Disease and Breast Cancer Risk

    J Natl Cancer Inst 90: 1262-1269, 1998

      

    The prognostic marker in breast cancer, c-erbB-2 and p53 protein expression are also relevant to the progression of breast cancer. This study reveals an association of p53 accumulation but not c-erbB-2 overexpression with increased risk of
    progression of benign breast disease to breast cancer and hence a close follow up and earlier intervention may be warranted in women with benign breast disease and p53 accumulation.

          


 

 



 

 

Speciality Spotlight

 

 

Cancer Biology, Markers, and Diagnosis
    

  • Billingslay KG, Lewis JJ, Leung DHY, et al [ Mem Sloan -Kettering Cancer Ctr, New York]
    Multifactorial Analysis of the Survival of Patients with Distant Metastasis From Primary Extremity Sarcoma
    Cancer 85:389-395, 1999
          
    Distant metastasis from extremity sarcoma occurs in approximately 25% of patients despite excellent local control and lungs are the commonest site of distant spread. The 994 patients with primary extremity soft tissue sarcoma were followed up for mean of 33 months. The first metastatic site was lung 73%. The predictors of postmetastasis survival are resection of the metastatic disease, length of disease free survival. The local site and patients’ age older than 50 years, postmetastasis survival was not related to factors that defined the primary tumor such as histologic grade, depth and microscopic margin. The editor believes in surgical resection of metastasis from soft tissue sarcoma if clinical situation warrants. Multiagent chemotherapy has had improved response in the last decade but without improving the survival.
         

  • Rubio IT, Korourian S, Cowan C, et al [Univ of Arkansas, Little Rock, Univ of Vermont, Burlington]
    Use of Touch Preps for Intraoperative Diagnosis of Sentinel Lymph Node Metastases in Breast Cancer
    Ann Surg 5: 689-694, 1998
       
    The status of sentinel lymph node [SLN] during surgery for breast cancer is important for planning axillary lymphadenectomy. The touch prep[ TP] diagnoses correctly in 99.2% of the nodes. The false positive rate are 0 and false negative 0.8 and hence TP is fast, accurate, simple technique for identifying metastasis SLN. The editor comments that this [TP] results in improvement in both cost and time. The obvious drawbacks are immunohistochemistry and polymerase chain reaction evaluations are not possible.
      

  • Dorudi S, Kinrade E, Marshall NC, et al [ Royal London Hosp]
    Genetic Detection of Lymph Node Micrometastases in Patients with Colorectal Cancer
    Br J Surg 85: 98-100, 1998
          
    Undetected micrometastases are the most important cause of treatment failure in patients with putatively curative colorectal cancer surgery. The detection in the regional lymph node of mRNA expressed from cytokeratin [CK] 20 gene upstaged 4 of 15 patients, following a resection for colorectal cancer. The CK 20 gene product being a cytokeratin is restricted to intestinal epithelium and is not likely to be expressed in the lymph node. The editor comments that these so called negative nodes by hematoxylin eosin may be placed into trials for adjuvant therapy once these molecular biology techniques are standardized and gained experience in clinical practice.
        

  • Delbeke D, Martin WH, Sandler MP, et al [ Vanderbilt Unit, Nashville, Tenn]
    Evaluation of Benign vs Malignant Hepatic Lesions with Positron Emission Tomography
    Arch Surg 133: 510-516, 1998
        
    The relatively low levels of glucose-6-phosphatase is most malignant cells results in accumulation and trapping of [18F] flurodeoxyglucose [FDG] intracellularly, & then visualizing the increased uptake. This technique of FDG PET has been used in 110 consecutive patients with hepatic tumors of 1 cm or greater to differentiate between benign vs. Malignant lesions. All liver metastasis from adenocarcinoma or sarcoma and all cholangiocarcinomas showed increased uptake. Whereas hepatocellular carcinoma [HCC] had an increased FDG uptake in 16 of 23 patients and poor uptake in 7 of 23 with the exception of one abscess which had increased uptake. Rest all benign lesions revealed a poor uptake. The limitation of this technique is false positive in a minority of abscess and false negative in minority of HCC. FDG PET would also be useful in future for staging, detecting recurrences and monitoring response.
      

  • Eary JF, Conrad EU, Bruckner JD, et al [ Univ of Washington, Seattle]
    Quantitative [F-18] Fluorodeoxyglucose Positron Emission Tomography in Pretreatment and Grading of Sarcoma
    Clin Cancer Res 4: 1215-1220, 1998
        
    Positron emission tomography imaging with [F18] fluorodeoxyglucose [FDG] of sarcoma was used to monitor tumor metabolism and this correlated with tumor grade and thereby overcome some of the limitation of traditional pathologic assessment. The overlap of MRFDGPET values with tumor grade offer an alternative way to assess tumor biological potential. The neo adjuvant therapy in bone and soft tissue sarcoma is dependent on tumor grade.
      

  • Rose PG, Adler LP, Rodriguez M, et al [ Ireland Cancer Ctr, Cleveland, Ohio, Univ Hosps of Cleveland, Ohio; Case Western Reserve Univ, Cleveland, Ohio]
    Positron Emission Tomography for Evaluating Para-aortic Nodal Metastasis in Locally Advanced Cervical Cancer Before Surgical Staging: A Surgicopathologic Study
    J Clin Oncol 17: 41-45, 1999
       
    Locally advanced cancer of the cervix at presentation have para -aortic lymph node involvement in 25%, which becomes the most important indicator of recurrence.
      
    20mCi of 2-[18F] fluoro-2-deoxy -D-glucose [FDG] uptake in para-aortic LN by PET is seen in 91% of cervical tumors. Yielding a positive predictor value of 75% and negative predictor value of 92% and a relative risk of 9.0 for metastatic disease. The editor comments that identifying the para-aortic LN would allow modification of radiation therapy field to include such site of disease.
       

  • Chan TA, Morin PJ, Vogelstein B, et al [ Johns Hopkins Univ, Baltimore, Md]
    Mechanisms Underlying Nonsteroidal Anti-inflammatory Drug-Mediated Apoptosis
    Proc Natl Acad Sci : U.S.A. 95: 681-686, 1998
      
    Nonsteroidal anti-inflammatory drug [NSAIDs] have been reported to have limited efficacy as chemopreventive agent. The NSAIDs resulted in increase in prostaglandin precursor arachidonic acid [ AA] which in turn stimulated the conversion of sphingomyelin to ceramide, a substance known to mediate apoptosis. The editor comments that by manipulation of lipids ceramide and AA by dietary or pharmaceutical agent, may be the key to prevention of colorectal tumors.
       

  • Sorensen HT, Mellemkjaer L, Steffensen FH, et al [ Univ of Aarhus, Denmark; Inst of Cancer Epidemiology, Copenhagen; Aalborg Hosp, Denmark]
    The Risk of a Diagnosis of Cancer After Primary Deep Venous Thrombosis or Pulmonary Embolism
    N Engl J Med 338: 1169-1173, 1998
       
    The relation between pulmonary embolism [PE], deep venous thrombosis [DVT] and cancer has been debated. This large study of 15,348 patients with DVT and 11,305 with PE revealed an increased risk of 1.3 for development of cancer. Although the risk was significantly elevated only during the first 6 months of follow-up. Pancreas, ovary, liver, and brain were most common sites of cancer in patients with thromboembolism. Exhaustive search for cancer in such patient was not of clinical benefit.
      

  • Schiffenbauer YS, Abramovitch R, Meir G, et al [ Weizmann Inst of Science, Rehovet, Israel; Meir Hosp, Kfar Saba, Israel; Hebrew Univ-Hadassah Med School, Jerusalem]
    Loss of Ovarian Function Promotes Angiogenesis in Human Ovarian Carcinoma
    Proc Natl Acad Sci U S A 94: 13203-13208, 1997
         
    Menopause or ovariectomy increase the levels of gonadotropins i.e. leuteinizing hormone and follicle -stimulating hormone which further lead to increase secretion of vascular endothelial growth factor thereby enhancing angiogenesis. This study demonstrates that this angiogenesis is a possible mechanism for progression of ovarian cancer after menopause and the possible role of hormonal therapy administered at the time when patients with ovarian cancer are in complete remission with induction chemotherapy to suppress the gonadotrophins.
         

  • Paulli M, Berti E, Boveri E, et al [ Univ of Pavia, Italy; Univ of Milano, Italy: IRCCS Policlinico, Milano, Italy; et al]
    Cutaneous CD30+ Lymphoproliferative Disorders : Expression of bcl-2 and Proteins of the Tumor Necrosis Factor Receptor Superfamily
    Hum Pathol 29: 1223-1230, 1998
           
    This study included 25 patients who had CD30+ cutaneous lymphoma and analyzed expression of CD95 and other proteins associated with apoptosis nerve growth factor receptor [NGF-R], the anti-apoptotic protein bcl-2. Analysis revealed consistent expression of CD95 but rare or absent expression of CD27, CD40, and NGF-R on tumor cells from regressing lymphomatoid papulosis [LyP] and nonregressing CD30+ lymphomas. Levels of bcl-2 were low in LyP and high in pleomorphic CD30+ lymphomas. The increased expression of bcl-2 by tumor cells that did not regress suggests the possibility that this oncoprotein may actually protect tumor cells from apoptosis with CD30+ cutaneous lymphomas.
        

  • Levesque PE, Nieh PT, Zinman LN, et al [ Lahey Clinic Ctr, Burlington, Mass]
    Radiolabeled Monoclonal Antibody Indium 111-Labeled CYT-356 Localizes Extraprostatic Recurrent Carcinoma After Prostatectomy
    Urology 51: 978-984, 1998
      
    Elevated prostate-specific antigen [PSA] can detect recurrence but not the locations of the disease. Murine monoclonal antibody, 7E11-C5. 3-glycyl-tyrosyl-[N, e-diethylenetriamine pentaacetic acid] – lysine [CYT-356], linked to 111In was used to localize primary and metastatic prostate cancer. A large majority with elevated PSA, the CYT-356 was taken up outside the prostate fossa. Approximately, two third have activity in pelvic lymph nodes. Even when the lymph node dissections were negative at the time of prostatectomy.
        
    Scan failed to localize the disease in 21% of the patients with elevated PSA possibly because the antibody fail to bind to all the tumors or is unable to find small foci.
       

  • Djavan B, Kadesky K, Klopukh B, et al [Univ of Vienna; Presbyterian Hosp of Dallas; Univ of Texas, Dollas]
    Gleason Scores From Prostate Biopsies Obtained with 18-Gauge Biopsy Needles Poorly Predict Gleason Scores of Radical Prostatectomy Specimens
    Eur Erol 33 : 261-270, 1998
      
    The Gleason grading system is a well accepted prognostic factor for prostate cancer. This study has correlated with Gleason score from needle biopsy with that from radical prostatectomy. For needle biopsy 37.2% of patients had no scoring change, 12.7% were overgraded, and 50.1% undergraded. To conclude 50% of all gleason score when obtained from needle biopsy specimen had to be revised in the direction of a worse. The clinician have to keep this in mind when advising patients when gleason grading system is taken into consideration for planning the therapy.
       

  • Choe DH, Lee JH, Lee BH, et al [ Korea Cancer Ctr Hosp, Seoul]
    Obliteration of the Pulmonary Vein in Lung Cancer : Significance in Assessing Local Extent with CT
    J Comput Assist Tomogr 22: 587-591, 1998
       
    The lung tumor growth through the pulmonary veins intra pericardially or in the [L] atrium is uncommon. The obliteration of the superior pulmonary vein on CT in patients with lung tumor strongly suggests intrapericardial tumor extension through the pulmonary vein. Identifying this type of growth preoperatively is essential in planning surgical treatment as it may result in systemic tumor embolization with fatal consequences with manipulation or ligation of the involved pulmonary vein. Inferior pulmonary vein obliteration is a less reliable indicator of intrapericardial extension.
        

  • Moog F, Bangerter M, Diederichs CG, et al [Univ of Ulm, Germany]
    Extranodal Malignant Lymphoma: Detection With FDG PET Versus CT
    Radiology 206: 475-481, 1998
       
    The exact staging technique for lymphoma by noninvasive methods to detect disease in spleen, liver and bone marrow are not clear. This study compares PET versus CT scan. 42 lesions were detected by both PET & CT & were confirmed with biopsy results . Another 24 results were seen on PET, 15 of which were verified by biopsy, MRI scintigraphic, or follow up results. Seven lesions not detected by FDG PET were identified on CT. 6 of which were confirmed by biopsy or follow-up. Findings on PET resulted in changes in tumor staging in 13 patients. Functional imaging with FDG PET can provide important information for diagnosis of untreated lymphoma and can assess liver, spleen and bone marrow involvement however further clinical studies would be required.
        

  • Yahata N, Ohyashiki K, Ohyashiki JH, et al [Tokyo Med College; Univ of Texas, Dallas]
    Telomerase Activity in Lung Cancer Cells Obtained from bronchial Washings
    J Natl Cancer Inst 90: 684-690, 1998
      
    Telomerase which are components of the chromosomal ends containing nucleotide protects them from sticking to each other. Shortening of the length of telomere is activated by telomerase which is an intracellular reverse transcriptase with an RNA component. Experimental studies indicate that failure of telomerase to shorten progressively with each cell division lead to cellular immortalization a critical step in cancer progression.
        
    In this Japanese study telomerase activity from the bronchial washing were assayed. Telomerase activity was detected in bronchial washings from the majority of lung cancer patients. The editor comments that utility of such a concept for early detection, essentially at a premalignant level would be useful.
        

  • O’Regan RM, Cisneros A, England GM, et al [Northwestern Univ, Chicago; Univ of Wisconsin, Madison]
    Effects of the Antiestrogens Tamoxifen, Toremifene, and ICI 182, 780 on Endometrial Cancer Growth
    J Natl Cancer Inst 90: 1552-1558, 1998
        
    Tamoxifen plays an important role in adjuvant therapy of breast cancer patients. Chronic use of tamoxifen has shown an increase in endometrial cancer. This is due to its estrogen and antiestrogen action. 
       
    This study on athymic mice demonstrated the toremifene a chlorinated derivative of tamoxifen has identical effects to tamoxifen for the development of endometrial cancer whereas ICI 182,780 pure antiestrogen. seems to be superior and may not adversely affect the endometrium.
       

  • Elmore JG, Barton MB, Moceri VM, et al [ Univ of Washington, Seattle; Harvard Med School, Boston]
    Ten-year Risk of False Positive Screening Mammograms and Clinical Breast Examinations
    N Engl J Med 338: 1089-1096, 1998
         
    The current recommendation for breast cancer screening by a yearly mammography and clinical breast examination leads to ample opportunities for false positive tests. This 10-year retrospective study analyzed the cumulative risk of a false positive breast cancer screening result. After 10 tests [mammography], the cumulative risks of a false positive mammograms was estimated to be 49% [ 95% confidence interval [CI], 40% to 64%]. For clinical breast examination the cumulative risk was 22%. Women in their 40’s were more likely to have false positive than those in their 50’s and 70’s. Each 100$ spent on screening carried an additional $ 33 for evaluation of false positive results. This study does not undermine the importance of breast screening but it would encourage dissemination of knowledge regarding the risks of false positive tests to minimize the patient’s anxiety.
       

  • Felnyk O, Zimmerman M, Kim KJ, et al [ Univ of California at San Francisco, Genentech Inc, South San Francisco, Calif
    Neutralizing Anti-Vascular Endothelial Growth Factor Antibody Inhibits Further Growth of Established Prostate Cancer and Metastases in a Pre-clinical Model
    J Urol 161: 960-963, 1999
         
    Angiogenesis i.e. deriving blood supply from the existing vasculature promotes tumor growth metastasis. Vascular endothelial growth factor [ VEGF], a potent angiogenic factor and vascular permeability mediator, promotes tumor growth through neovascularisation. Inhibitors of VEGF would reverse this process has been well-studied previously. This study also gives an insight that inhibitors of VEGF through monoclonal anti VEGF neutralizing antibody suppressed the primary tumor growth in mice and also inhibited metastatic dissemination to the lung in human prostate cancer cell line study.
        

  • Baselga J, Norton L, Albanell J, et al [Mem Sloan-Kettering Cancer Ctr, New York 
    Vall d’Hebron Univ Hosp, Barcelona]
    Recombinant Humanized Anti-HER2 Antibody [Herceptin] Enhances the Antitumor Activity of Paclitaxel and Doxorubicin Against HER2/neu Overexpressing Human Breast Cancer Xenografts
    Cancer Res 58: 2825-2831, 1998
      
    HER2 gene, a new biological prognostic marker in breast cancer has revealed 25-30% overexpression and is associated with worse prognosis.
      
    In this study on human breast cancer cell lines in nude mice have revealed that a recombinant humanized anti HER2 antibody [ rhuMAb HER2 [Herceptin] enhanced the anti tumor activity of paclitaxel and doxorubicin, greater enhancement was seen with paclitaxel. This study obviously provides the rationale for clinical trials to evaluate rhuMAb in combination with these and other drugs in breast tumors and other erb-B2 positive tumors.
         

  • Rohan TE, Hartwick W, Miller AB, et al [Univ of Toronto; Mt. Sinai Hosp, Toronto]
    Immunohistochemical Detectio of c-erB-2 and p53 in Benign Breast Disease and Breast Cancer Risk
    J Natl Cancer Inst 90: 1262-1269, 1998
      
    The prognostic marker in breast cancer, c-erbB-2 and p53 protein expression are also relevant to the progression of breast cancer. This study reveals an association of p53 accumulation but not c-erbB-2 overexpression with increased risk of progression of benign breast disease to breast cancer and hence a close follow up and earlier intervention may be warranted in women with benign breast disease and p53 accumulation.
          

 

 

 

By |2022-07-20T16:44:02+00:00July 20, 2022|Uncategorized|Comments Off on Cancer Biology, Markers, and Diagnosis

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