U.S. Pharmacist



Cancer News



US Pharm. 2007;1:30-31.

Breast Cancer Patients May Benefit from Second Opinion
A study from the University of Michigan (U-M) Comprehensive Cancer Center revealed that more than half of breast cancer patients who sought a second opinion from a multidisciplinary tumor board received a change in their recommended treatment plan.

According to the study, a multidisciplinary tumor board includes a network of specialists from different disciplines devoted to treating breast cancer. These disciplines include surgeons, radiation oncologists, medical oncologists, radiologists, and pathologists. The researchers at the U-M Cancer Center studied records of 149 consecutive patients who had already been diagnosed with breast cancer after having undergone initial evaluation, breast imaging, and biopsy and who had already received treatment recommendations from another hospital or health care provider.

In general, 52% of the patients had one or more changes in their recommendations for surgery. This was a result of their mammograms being read differently and/or breast pathologists interpreting biopsy results differently. In some cases, different treatment recommendations were suggested after a case was reviewed by medical oncologists and radiation oncologists prior to surgery. It is estimated that approximately 213,000 women will be diagnosed with cancer this year.

Treatment of Early-Stage Prostate Cancer in Older Patients Increases Life Span
A study published in the JAMA supports that treating early-stage prostate cancer with surgery or radiation therapy in men between the ages of 65 and 80 is associated with longer survival rates.

The notion of treating early-stage prostate cancer has been rebuffed by many physicians, since low- and intermediate-grade prostate cancers generally grow slowly and many patients may never suffer complications or a spreading of the disease. However, according to Yu-Ning Wong, MD, a medical oncologist at Fox Chase Cancer Center in Philadelphia and lead author of the JAMA study, the data show that such "watch and wait" treatments may not be the proper course of action.

"In our study, we looked back at existing data that tracked long-term outcomes of elderly men whose cancer was at low and intermediate risk of spreading. After accounting for all of the observed differences between the groups, we found that men who had either a radical prostatectomy or radiation therapy within six months of their prostate cancer diagnosis were 30% less likely to die than were those who did not undergo treatment during this time period," said Dr. Wong.

Allergy Drug Shows Signs of Slowing Pancreatic Tumor Growth
Researchers at the University of Texas M. D. Anderson Cancer Center may have found a link between the use of cromolyn, an antiallergy drug that has been used for more than 40 years, and a reduction in tumor growth in animal models of human pancreatic cancer, the most lethal form of cancer.

The research, which was published in the Journal of the National Cancer Institute, revealed that when the investigators combined the drug with chemotherapy in the treatment of pancreatic tumors in mice, it retarded the tumor growth nearly three times better than with the chemotherapy agent gemcitabine alone. Craig Logsdon, PhD, lead author of the study and a Professor in the Department of Cancer Biology at M. D. Anderson, said he will be working with physicians at the cancer center to prepare for a cromolyn-gemcitabine clinical trial. It is estimated that more than 95% of patients diagnosed with pancreatic cancer die from the disease; half those deaths occur in the first six months after diagnosis.

Breast Cancer Vaccine in Development
According to research presented at the 29th Annual San Antonio Breast Cancer Symposium, a vaccine to prevent breast cancer may be a step closer to reality.

George Peoples, MD, of the Cancer Vaccine Development Laboratory in Bethesda, Maryland, presented results of a vaccine trial targeting HER2, a protein that is related to cell growth and is commonly overexpressed in breast cancer cells. Dr. Peoples reported that he and his colleagues have isolated and purified a piece of that protein (known as E75) that is normally exposed on the surface of cancer cells. The purified protein is injected into patients once each month, along with factors that stimulate the immune response.

According to Dr. Peoples, all vaccinated patients showed a rapid increase in immunologic response up until month 4, after which the response leveled off. Months after receiving the vaccination series, patients demonstrated a 50% reduction in breast cancer recurrence, compared with similar breast cancer patients who had not been vaccinated. Minimal side effects and no serious systemic effects were reported.

Estrogen Link May Lead to New Colon Cancer Drugs
Researchers at Dana-Farber Cancer Institute, Boston, are investigating the effect of estrogen use on the survival of older women already diagnosed with colon cancer, based on previous research demonstrating that postmenopausal women with colon cancer lived longer and had less likelihood of dying of the disease if they had been taking estrogen supplements within five years of their diagnosis.

The investigators caution that while studies have shown a link between the use of estrogen and a reduction in colorectal cancer risk, it is too early to view estrogen as a treatment or preventive therapy for colon cancer. Instead, it offers a solid baseline to further study the basic mechanism by which estrogen influences the development and treatment of the disease.

"By understanding how estrogen offers potentially beneficial effects in some types of cells yet deleterious effects in others, it may be possible to design therapies that are effective against colon cancer without posing a significant risk of other problems," said Jennifer Chan, MD, MPH, of Dana-Farber.

Characteristics of Fast-Growing Melanomas Identified

A report that appeared in Archives of Dermatology showed that melanomas are more likely to grow rapidly if they are thicker, symmetrical, elevated, have regular borders, or present with symptoms. They are also more likely to occur in elderly men and individuals with fewer moles and freckles, and their cells tend to divide more quickly and to have fewer pigments than the cells of slower-growing cancers.

The report is based on a work by Wendy Liu, MBChB, PhD, and colleagues at the Peter MacCallum Cancer Center in East Melbourne, Australia. According to Dr. Liu, the study "provides descriptive data on the spectrum of melanoma rates of growth and insights into subgroups of patients with melanomas that are associated with rapid growth." It is believed that awareness of the clinical features of faster-growing melanomas could help ensure that aggressive cancers are diagnosed and treated quickly.

Study Shows that Prostate Cancer May Be Inherited
Data released from the Cancer Genetic Markets of Susceptibility (CGEMS) study on prostate cancer may prove helpful in identifying genetic factors that influence prostate cancer. This could likely lead to the discovery and development of new therapies that better target the disease.

CGEMS is the largest comprehensive initiative to identify genetic risk factors for breast and prostate cancers. According to the National Cancer Institute (NCI), the organization that released the study, by finding genetic variations that differ in frequence between patient and control groups, researchers can identify the location of multiple inherited genes that increase or decrease the risk of prostate cancer.

"The immediate sharing of this data with scientists in the cancer research community will allow individual researchers to compare existing and developing information with CGEMS data to identify new genes associated with increased prostate cancer risk," said NCI Deputy Director for Advanced Technologies and Strategic Partnerships Anna D. Barker, PhD. "The CGEMS database will provide information we need to develop new strategies for the early detection and prevention of  [prostate] cancer."

Prostate cancer is the third-leading cause of cancer-related death in men. According to NCI, in 2006, there will be an estimated 234,460 new prostate cancer cases in the United States.

Cancer Deaths in the U.S. Continue to Drop

A report from the nation's leading cancer organizations finds that Americans' risk of new cancers remains stable. The report, titled "Annual Report to the Nation on the Status of Cancer was published in the journal Cancer.

The report includes comprehensive data on trends over the past several decades for all major cancers for all races and both sexes combined. Death rates decreased for 11 of the 15 most common cancers in men and for 10 of the 15 most common cancers in women. The authors attributed the decrease in death rates in part to successful efforts to reduce exposure to tobacco, earlier detection through screening, and more effective treatments.

Among women, incidence rates decreased for colon and rectal, cancers of the uterus, ovarian cancers, oral cancers and, stomach and cervical cancers. There were increases in breast and lung cancers. For men, there were decreases in colon and rectal cancers, stomach cancers, oral cancers, and lung cancer. There were increases in cancers of the prostate, kidney, esophagus and in myeloma and leukemia.

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U.S. Pharmacist is a monthly journal dedicated to providing the nation's pharmacists with up-to-date, authoritative, peer-reviewed clinical articles relevant to contemporary pharmacy practice in a variety of settings, including community pharmacy, hospitals, managed care systems, ambulatory care clinics, home care organizations, long-term care facilities, industry and academia. The publication is also useful to pharmacy technicians, students, other health professionals and individuals interested in health management. Pharmacists licensed in the U.S. can earn Continuing Education credits through Postgraduate Healthcare Education, LLC, accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.

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