October 8, 2007, 8:51 AM CT

Race and use of breast cancer therapy

A new study finds therapy for breast cancer differs between African-American women and white women, though the differences are partly dependent on insurance type. The study appears in the November 15, 2007 issue of CANCER, a peer-evaluated journal of the American Cancer Society.

Dr. Mousumi Banerjee of the University of Michigan and co-researchers Dr. Kendra Schwartz from Wayne State University and Dr. William Hryniuk from the Cancer Advocacy Coalition of Canada evaluated and analyzed demographic, socioeconomic and medical data from 651 women diagnosed with breast cancer in the early to mid 1990s. Their objective was to evaluate the role of race in breast cancer therapy after accounting for such significant confounders as comorbidities, socioeconomic status, and health insurance status.

The study observed that, among breast cancer patients that had spread to the lymph nodes, African-Americans were less likely to have adjuvant cancer treatment than white women. In this clinical group, white women were almost five times more likely to take Tamoxifen, a widely-used cancer treatment medication, and over three times more likely to have chemotherapy. Women with early stage breast cancer who had government health insurance were less likely to have combination breast conserving cancer surgery and radiation, and more likely to have mastectomy without radiation than patients enrolled in non-governmental plans......... Posted by: Jessica      Read more         Source

October 8, 2007, 8:50 AM CT

Cancer Care Unaffected By Lower Medicare Reimbursements

Patients perceive no significant change in the quality of care for cancer since the United States government passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) as per a research studyreported in the November 15, 2007 issue of CANCER, a peer-evaluated journal of the American Cancer Society. The new study, led by Jolle Friedman from the Duke Clinical Research Institute in Durham, North Carolina, reports that, in comparison to patients treated before the MMA, there was no difference in the time to and location of therapy for patients with cancer treated after the Act was signed into law. Furthermore, patients remain highly satisfied with their cancer therapy.

In 2003 the MMA was signed into law by President Bush and was the most comprehensive restructuring of the Medicare system since its introduction in 1965. Changes included a new prescription drug benefit, managed care insurer access, and $25 billion allocated to rural hospitals. One key provision, however, was a significant reduction in Medicare reimbursement to healthcare providers that went into effect January 1, 2005. In particular, cancer therapy was targeted with reduction because it was considered by legislators to have been overly generous.

The effect of these reimbursement cuts on patient care has been unclear. On the one hand, a study commissioned by U.S. government observed that patients did not perceive any differences in care. However, other anecdotal sources report that oncologists are downsizing their practices in a number of markets by eliminating nurses and other staff and by closing satellite offices, requiring patients to travel farther for therapy, especially in rural areas Dr. Schulman and his colleagues surveyed 1,421 cancer patients treated before (n=684) and after (n=737) the MMA to compare patients perceptions of access to and satisfaction with oncologists care......... Posted by: Jessica      Read more         Source

October 2, 2007, 10:31 PM CT

Cancer researchers seek safe reduction of radiotherapy

University of Manchester researchers will discuss their research aimed at reducing the side effects of radiotherapy without decreasing its effectiveness at the National Cancer Research Institute conference in Birmingham today (Tuesday 2 October 2007).

Around half of patients receive radiotherapy as part of their cancer therapy but the dose is limited by the possibility of causing side effects (toxicity) to the normal tissues and organs that surround the tumour. Some patients are more likely to experience these side effects than others: that is, there is an individual variation in tissue response. Some patients will be very sensitive.

Dr Catharine West, of the University's Cancer Studies research group, and Dr Neil Burnet, of the University of Cambridge, are leading a large multi-centre UK study designed to identify the common genetic variations that are linked to such side effects. The study - Radiogenomics: Assessment of Polymorphisms for Predicting the Effects of Radiotherapy (RAPPER) - is funded by Cancer Research UK and aims to extract DNA from the blood samples of 2,200 patients with a variety of cancers.

Dr West explains: "This is a very exciting development in cancer research.

Genotyping studies should provide a means of identifying radiosensitive patients and lead to a greater individualisation of radiation dose prescription to optimise tumour control while reducing toxicity"......... Posted by: Jessica      Read more         Source

October 1, 2007, 5:43 AM CT

Initial reaction to nicotine can dictate addiction

Following up on studies that have indicated the speed with which adolescents can get hooked on cigarettes, scientists at the University of Massachusetts Medical School have conducted the first study to determine why some adolescents who try smoking get addicted while others do not.

We know that nicotine can have an immediate impact on the brain, and yet we also know that not every adolescent who tries a cigarette gets hooked, said the studys lead author, Joseph R. DiFranza, MD, professor of family medicine & community health at UMMS. We wanted to know what accounts for the difference in vulnerability among adolescents who pick up that first cigarette.

While personality factors often determine which young people will try smoking, it appears that it is the manner in which the brain reacts to nicotine, rather than personality, that is most important to determining whether an adolescent will become hooked on nicotine once he or she has tried it. It appears that it is an addictive physiology and not an addictive personality that determines who will become dependent, observed Dr. DiFranza.

The four-year prospective study was based on over 12,000 interviews with 1,246 sixth-graders in public schools in six Massachusetts communities. Scientists assessed 46 risk factors in categories such according tosonality, attitudes and beliefs about smoking, smoking by parents, siblings and peers, family and community involvement, and reactions to inhaling from a cigarette for the first time. When all factors were considered together, an experience of relaxation in response to the first dose of nicotine was the strongest predictor of future addiction. Other factors that predicted addiction were familiarity with the cigarette advertising character Joe Camel, a novelty-seeking personality, and a depressed mood. These findings underscore our belief that the development of dependence is triggered by the changes in brain chemistry that follow the very first dose of nicotine, said DiFranza......... Posted by: Jessica      Read more         Source

September 26, 2007, 8:55 PM CT

Drug Shows Promise In Advanced Kidney Cancer

A new drug has shown promise in patients with advanced kidney cancer whose options run out after their tumour fails to respond to the cutting edge treatment.

The study, presented today (Wednesday) at the European Cancer Conference (ECCO 14) in Barcelona, showed that the experimental drug, axitinib, shrank tumours and delayed progression of the disease in a group of patients who are among the toughest to treat.

In the study, researchers gave axitinib to 62 patients whose kidney cancer had spread and who had not benefited from a standard therapy, sorafenib, a targeted treatment designed to disrupt cell division signals in cancer cells and block the tumour's ability to form new blood vessels that help it grow. Fourteen of the patients also had been given - to no avail - another similarly targeted drug, sunitinib, after the sorafenib had failed to work. Axitinib works similarly to the other two but is thought to bemore potent.

"More than half the patients - 51 percent - experienced tumour shrinkage and in 23 percent of them the shrinkage is considered significant," said lead investigator Dr Brian I. Rini, an associate professor of medicine at the Cleveland Clinic Taussig Cancer Institute in Cleveland, Ohio, USA, and a paid member of the Pfizer scientific advisory board. "Preliminary analysis shows the progression-free survival was on average more than 7.7 months. We think these results are impressive because these patients were heavily pre-treated and with drugs believed to be similar to axitinib......... Posted by: Jessica      Read more         Source

September 25, 2007, 9:54 PM CT

ZD4054 and HRPC patients with bone metastases

New Phase II data presented today suggest that ZD4054, a novel compound in development for the therapy of men with Hormone Resistant Prostate Cancer (HRPC), could offer a promising improvement in overall survival in men with metastatic HRPC who were asymptomatic or mildly symptomatic for pain.1 Patients who received ZD4054 10mg once-daily experienced a 45 percent reduction in the risk of death in comparison to placebo (HR 0.55; 80 percent CI 0.41, 0.73).1.

To further evaluate ZD4054s potential, the Phase III trial programme ENTHUSE (ENDOTHELIN A USE), consisting of three studies, will begin this year. The first of these trials is aimed at investigating the efficacy of ZD4054 in metastatic HRPC, while the second will look at its role in non-metastatic HRPC patients. A third trial will study ZD4054 in combination with docetaxel (TaxotereTM) for the therapy of metastatic HRPC.

The results from the randomised, double-blind, placebo-controlled, Phase II EPOC (Endothelin A Proof Of Concept) Study of ZD4054 - a specific endothelin A (ETA) receptor antagonist - were delivered today at the 14th European Congress of Clinical Oncology (ECCO, 23-27 September, Barcelona).

Nick James, Professor of Clinical Oncology, Institute for Cancer Studies, Birmingham, UK, and principal investigator of the EPOC study said: Men with advanced prostate cancer are typically treated with hormonal therapies. Whilst these therapies can provide great benefits, most men will become resistant to them. Currently, the only licensed therapy option for metastatic patients shown to improve survival in men with HRPC is chemotherapy with docetaxel......... Posted by: Jessica      Read more         Source

September 18, 2007, 10:12 PM CT

Smoking can harm oral surgery procedures

A study in the recent issue of the Journal of Periodontology (JOP) observed that smokers had less desirable long term results following periodontal plastic surgery than non-smokers.

The study followed 10 smokers and 10 non-smokers for two years to evaluate the effects of cigarette smoke on the long term outcomes of a therapy to help soft tissue reattach to the root surface of the teeth. After two years, residual gum recession around the area which received the surgery was greater in smokers as in comparison to non-smokers.

Studies have shown that smoking can impair the bodys ability to heal itself immediately after surgery; but, this most recent study also showed that when a patient haccording toiodontal plastic surgery, smoking can damage the ability of that procedure to stay intact over a long period of time.

People who smoke and have had some sort of periodontal plastic surgery should be aware of the negative side effects of smoking. It can be costly to have to repeat a surgery because the desirable outcomes might have been undone by smoking, explained Preston D. Miller, Jr., DDS, President of the American Academy of Periodontology. Therefore, it is important patients and doctors agree to a smoking cessation program previous to any periodontal surgery. This will help a patients chance of achieving optimal results......... Posted by: Emily      Read more         Source

September 18, 2007, 5:16 AM CT

Initiative to increase participation in clinical trials

Before a new therapy becomes available, scientists must recruit hundreds or thousands of patients to participate in clinical research trials. But finding these patients is often difficult. A number of potential candidates are unaware of the studies or unable to participate due do logistical hurdles. As a result, patients miss out on opportunities for novel therapy approaches -- and beneficial new therapies take longer to reach the public.

In a new initiative, scientists at Weill Cornell Medical College (WCMC) and Cornell's College of Agriculture and Life Sciences (CALS) have teamed up to develop strategies to better understand and enhance patient participation in clinical trials. The project, called Improving Methods for Patient Accrual to Clinical Trials (IMPACT), is one of several recent efforts at WCMC to foster clinical research programs across the medical spectrum.

"Low patient accrual in clinical trials poses a serious problem for the advancement of medical science," said John Leonard, professor of medicine at WCMC, attending doctor at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and co-leader of the study.

The time mandatory to conduct clinical trials is widely recognized as a limiting step in moving novel therapys forward, Leonard said. For example, less than 2 percent of patients choose to participate in clinical trials for cancer therapies across the United States. Even a modest increase of 2 to 3 percentage points would make a major impact, meaning the difference between completing a study in two years instead of three years -- and potentially resulting in thousands of lives saved if the standard of care is improved more rapidly......... Posted by: Jessica      Read more         Source

September 14, 2007, 5:23 AM CT

Brain tumors need treatment with multiple 'targeted' drugs

Researchers at Dana-Farber Cancer Institute have shown that several, rather than just one, cell-growth switches are simultaneously overactive in many brain tumors and other solid tumors, explaining why treatment with just a single "targeted" switch-blocking drug often yields disappointing results.

The laboratory finding argues for quickly moving to clinical trials that combine three or more such targeted drugs for such cancers to shut down all the malfunctioning growth switches, according to the team led by Ronald DePinho, MD, director of the Center for Applied Cancer Science at the Dana-Farber. Their report is being posted online on Sept. 13 by the journal Science and will appear in a forthcoming print issue.

The switches are formed by molecules called receptor tyrosine kinases (RTKs) that often are mutated and hyperactive in cancer cells. Since a number of kinase-blocking drugs are already available -- Gleevec and Tarceva are two of the best-known -- the researchers said clinical trials of combinations of the compounds should be planned quickly.

"This is a transformative finding that will motivate clinicians and our pharmaceutical colleagues to design clinical trials with regimens using several inhibitors," said DePinho. He noted that in the laboratory study using cancer cell lines and fresh specimens of brain tumors, three or more kinase inhibitors were needed to quell the abnormal cell-growth signals......... Posted by: Jessica      Read more         Source

September 12, 2007, 8:25 PM CT

Breakthrough For Early Cancer Diagnosis

Early detection of disease is often critical to how successful therapy can be. Therefore, the development of new methods of diagnosis is a hot research field, where every small step is of great importance. In an article in the latest issue of Molecular & Cellular Proteomics, Uppsala University scientists describe a technique that the journal regards as particularly interesting.

Proteins build up the bodys cells and tissues, and our knowledge of the human genome also entails that todays researchers are aware of all of the proteins that our body can produce. It is known that a number of morbid conditions can be associated with changes in proteins, so it is important to enhance our knowledge of what proteins bind to each other, how they work together, and how processes are impacted by various disturbances.

In 2006 Ola Sderberg and colleagues at the Department of Genetics and Pathology devised a new technique, in situ PLA (in situ proximity ligation assay), that could detect communication between proteins in cells. These scientists have now refined the method and can now see how proteins undergo change inside a cell.

The method provides a better potential to truly understand how proteins function in the cell and can show what is wrong with a sick cell, as in cancer, for instance. The refined method has the potential to revolutionize cancer diagnostics, so there has been a great deal of interest in the method from the research community, says Ola Sderberg......... Posted by: Jessica      Read more         Source