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June 21, 2006, 9:26 PM CT

ASCO Releases Updated Antiemetics Guideline

ASCO Releases Updated Antiemetics Guideline
ASCO's most recent Clinical Practice Guideline, "Antiemetics in Oncology: Update 2006," is now available online. The revised guideline incorporates the Update Committee's recommendations based on review and analysis of antiemetic-specific data published from 1997 through February 2006. The literature included results from randomized controlled trials, systematic reviews, and meta-analyses of published phase II and phase III randomized controlled trials. The Committee also considered the guidelines and consensus statements from the International Antiemetic Consensus Conference, hosted by the Multinational Association of Supportive Care in Cancer (MASCC) in March 2004, at which representatives from nine international oncology organizations-including ASCO-established a guideline generation process.

The Update Committee concluded that clinicians who administer antiemetics should consider patients' emetic risk categories and other characteristics. Among the key topics addressed in the updated guideline are:
  1. Emesis Caused by Intravenously Administered Antineoplastic Agents
  2. Radiation-Induced Emesis


ASCO first published a guideline for the use of antiemetics in 1999. The Society's Health Services Committee and Board of Directors reviewed and approved the final draft of the 2006 guideline February 28, 2006. The Society considers adherence to these guidelines voluntary and expects that the administration of these therapies be applied appropriately in the clinical practice, but not within the context of clinical trials.........

Posted by: Janet      Permalink         Source


June 21, 2006, 9:10 PM CT

FDA Approves Avastin For Second Line Treatment Of Colon Cancer

FDA Approves Avastin For Second Line Treatment Of Colon Cancer

On June 20, 2006, the U.S. Food and Drug Administration granted approval for a labeling extension for bevacizumab (Avastin®, Genentech), administered in combination with intravenous 5-fluorouracil-based chemotherapy, for the second-line therapy of metastatic carcinoma of the colon or rectum. This recommendation is based on the demonstration of a statistically significant improvement in overall survival (OS) in patients receiving Avastin® plus FOLFOX4 (5-flourouracil, leucovorin, and oxaliplatin) when compared to those receiving FOLFOX4 alone.

The trial (E3200) supporting this approval was an open label, randomized, 3-arm, active-controlled, multi-center clinical trial evaluating AVASTIN® alone (n=244), AVASTIN® plus FOLFOX4 (n=293), and FOLFOX4 alone (n=292). Following a planned interim analysis, the AVASTIN® monotherapy arm was closed to accrual based on evidence of decreased survival in patients treated with AVASTIN® alone compared with FOLFOX4 alone. Patients entered on the trial had progressive or recurrent disease following previous 5-FU and irinotecan-based treatment. Patients (99%) received irinotecan with or without 5-FU as initial treatment for metastatic disease; those who received adjuvant irinotecan-based chemotherapy were mandatory to have recurred within 6 months of completing treatment.........

Posted by: Sue      Permalink         Source


June 21, 2006, 8:25 PM CT

The BARD1 Cys557Ser Variant and Breast Cancer Risk in Iceland

The BARD1 Cys557Ser Variant and Breast Cancer Risk in Iceland

Background

Most, if not all, of the cellular functions of the BRCA1 protein are mediated through heterodimeric complexes composed of BRCA1 and a related protein, BARD1. Some breast-cancer-associated BRCA1 missense mutations disrupt the function of the BRCA1/BARD1 complex. It is therefore pertinent to determine whether variants of BARD1 confer susceptibility to breast cancer. Recently, a missense BARD1 variant, Cys557Ser, was reported to be at increased frequencies in breast cancer families. We investigated the role of the BARD1 Cys557Ser variant in a population-based cohort of 1,090 Icelandic patients with invasive breast cancer and 703 controls. We then used a computerized genealogy of the Icelandic population to study the relationships between the Cys557Ser variant and familial clustering of breast cancer.



Methods and Findings


The Cys557Ser allele was present at a frequency of 0.028 in patients with invasive breast cancer and 0.016 in controls (odds ratio [OR] = 1.82, 95% confidence interval [CI] 1.11–3.01, p = 0.014). The alleleic frequency was 0.037 in a high-predisposition group of cases defined by having a family history of breast cancer, early onset of breast cancer, or multiple primary breast cancers (OR = 2.41, 95% CI 1.22–4.75, p = 0.015). Carriers of the common Icelandic BRCA2 999del5 mutation were found to have their risk of breast cancer further increased if they also carried the BARD1 variant: the frequency of the BARD1 variant allele was 0.047 (OR = 3.11, 95% CI 1.16–8.40, p = 0.046) in 999del5 carriers with breast cancer. This suggests that the lifetime probability of a BARD1 Cys557Ser/BRCA2 999del5 double carrier developing breast cancer could approach certainty. Cys557Ser carriers, with or without the BRCA2 mutation, had an increased risk of subsequent primary breast tumors after the first breast cancer diagnosis compared to non-carriers. Lobular and medullary breast carcinomas were overrepresented amongst Cys557Ser carriers. We found that an excess of ancestors of contemporary carriers lived in a single county in the southeast of Iceland and that all carriers shared a SNP haplotype, which is suggestive of a founder event. Cys557Ser was found on the same SNP haplotype background in the HapMap Project CEPH sample of Utah residents.........

Posted by: Scott      Permalink         Source


June 21, 2006, 7:10 AM CT

Nutrition And Twin Pregnancies

Nutrition And  Twin Pregnancies
The commonly held view that IVF is the only culprit in the steady increase in the numbers of twins born over the past thirty years was challenged by a scientist speaking at the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague, Czech Republic, Wednesday 21 June 2006. Professor Robert Jansen, Medical Director of Sydney IVF, Sydney, Australia, said that his research had shown that improved nutrition, both maternal and in the lab in the case of IVF, had produced better and stronger embryos.

"Over the last 100 years, both in the UK and Australia, there has been an increase in identical twinning through the division of the embryo into two, even without IVF", he said, "and with the move to single embryo transfer with IVF this trend is obviously set to continue." Professor Jansen went on to say that the present rate of identical twinning with IVF is between one-in-a-hundred and one-in-fifty, a little over twice the rate involved when getting pregnant naturally.

Professor Jansen and his team reviewed Australian national birth statistics from 1920 to 2003 to determine the sex of babies at birth among multiple pregnancies. They found that the rate of dizygotic (DZ) twinning - where two embryos are involved and half the twins will be of different sex - was relatively constant from 1920 until the 1960s, but there was then the well-known dramatic increase with the advent of induced ovulation and IVF - reaching 300 in every 1000 IVF conceptions by 2000. Among monozygotic (MZ) twins, caused by embryo division (so all are of like sex), the excess rate of same-sex twins among natural conceptions has risen steadily for the last 80 years. MZ twins were relatively rare among IVF babies in the 1980s - much less than occurs naturally - but then rose in the nineties to reach 14 per 1000 by the year 2000.........

Posted by: Emily      Permalink         Source


June 21, 2006, 7:01 AM CT

New Gene Mutation Linked To Breast Cancer

New Gene Mutation Linked To Breast Cancer
Most of us are familiar with the breast cancer associated genes 1 and 2 commonly called as BRCA1 and BRCA2. Mutations in these genes significantly increase risk of developing breast cancer in women who carry them. BRCA2 mutations are also associated with increased risk of breast cancer in men.

Now researchers have discovered another breast cancer gene, which may be involved with breast cancer development. Mutation in this gene greatly increases the risk of breast cancer in women of European heritage. These genes may work in combination with the well-known BRCA genes and may increase the risk of breast cancer development as much as 80 percent.

These new research findings come from Iceland's Decode Genetics, and researchers say that the study suggests that women with certain mutations in two of the genes have an almost certain risk of developing breast cancer.

The newly discovered gene is called BARD1. "The BARD1 variant works together with the BRCA2 mutation in Iceland and increases the likelihood of breast cancer from 45% in those who have only the BRCA2 mutation up towards 100% in those who also have the BARD1 variant," Decode chief executive Kari Stefansson said in a statement.

The research team has found that women who harbor BARD1 mutation tend to develop breast cancer on both breasts. The Decode team identified 1,090 women in Iceland who had breast cancer, and compared them to 703 Icelandic women who did not have breast cancer. A mutant variant of BARD1 gene was found in 5.4% of breast cancer patients and 3.1% of women who did not have breast cancer. This represents an 80% increase in risk of developing breast cancer.........

Posted by: Janet      Permalink         Source


June 21, 2006, 0:05 AM CT

A Warm Blanket Makes PET Scans More Accurate

A Warm Blanket Makes PET Scans More Accurate
Placing a warm blanket on patients undergoing PET/Computerized axial tomography scans to detect cancer makes the test more accurate, new Saint Louis University research finds.

In up to 9 percent of patients, doctors have difficulty interpreting scans because of the presence of brown adipose tissue, also known as brown fat, which may lead to a cancer misdiagnosis.

"This is a significant finding," says Medhat Osman, M.D., Ph.D., assistant professor of nuclear medicine and PET director at Saint Louis University School of Medicine. "It is a solution that not only is effective but low-cost and extremely easy for any PET facility to implement."

Osman says brown fat serves an important physiological role - it keeps the body warm in cold temperatures. But accumulations of the tracer that is used to identify malignancies during PET/Computerized axial tomography scans that appear in brown fat can mimic cancer - or even mask the appearance of cancer in areas such as the lymph nodes.

New research presented by Osman, co-author Scott Huston and other Saint Louis University Hospital researchers at the 2006 Society of Nuclear Medicine in San Diego this month suggests that covering patients with a heated blanket before the scan can reduce the brown fat uptake by 62 percent.........

Posted by: Janet      Permalink         Source


June 20, 2006, 11:59 PM CT

Children Of Diabetics Show Signs Of Atherosclerosis

Children Of Diabetics Show Signs Of Atherosclerosis
The blood vessels of people whose parents both have type 2 diabetes do not respond as well to changes in blood flow as those of people without a family history of diabetes, even if they do not have diabetes themselves, as per a new study in the June 20, 2006, issue of the Journal of the American College of Cardiology.

"We find that offspring of type 2 diabetic parents have endothelial dysfunction, even when they do not have diabetes. If early therapy can prevent progression of atherosclerosis, then identifying groups of persons at risk for diabetes in whom early atherosclerosis may be present is clinically important," said Allison B. Goldfine, M.D. from the Joslin Diabetes Center and Brigham and Women's Hospital in Boston, Massachusetts.

None of the 38 adults (mid- to late-30s) in this study had diabetes, but half of them were the offspring of two diabetic parents. The scientists restricted blood flow in the arms of the participants using a blood pressure cuff. Then, using ultrasound, they compared how blood vessels in the arms of participants responded to the surge in blood flow when the cuff was released. Blood vessel responsiveness was impaired in all 19 participants (9 men and 10 women) whose parents had diabetes.

Diabetes is a leading cause of heart disease. Other studies have linked higher blood sugar levels to impaired responsiveness of the lining of blood vessels (endothelial dysfunction); but this is the first study to demonstrate that even when blood sugar is below the diabetic range, modest increases in blood sugar can contribute to endothelial dysfunction. Endothelial dysfunction in this population shows a predisposition to atherosclerosis.........

Posted by: JoAnn      Permalink         Source


June 20, 2006, 8:49 PM CT

Animal Feeding Operations Near Schools

Animal Feeding Operations Near Schools
Children who attend school near large-scale livestock farms known as concentrated animal feeding operations (CAFOs) may be at a higher risk for asthma, as per a new study by University of Iowa researchers.

The study, led by Joel Kline, M.D., professor of internal medicine in the UI Roy J. and Lucille A. Carver College of Medicine, appears in the recent issue of Chest, the peer-reviewed journal of the American College of Chest Physicians (www.chestjournal.org).

"Prior research has shown increased rates of asthma among children living in rural areas of Iowa and the United States," said Kline, who also is deputy director of the Environmental Health Sciences Research Center (EHSRC) in the UI College of Public Health, which helped fund the study. "Given that CAFOs release inflammatory substances that can affect the health of workers at these facilities and the air quality of nearby communities, we were interested in whether there was a correlation between CAFOs and increased rates of asthma among kids in rural areas."

Scientists surveyed the parents of kindergarten through fifth-grade students attending two Iowa elementary schools to compare the prevalence of asthma among students. The "study" school was located a half-mile from a CAFO in northeast Iowa; the "control" school was in east-central Iowa, more than 10 miles away from any CAFO (generally classified as a livestock facility that houses more than 3,500 animals). Sixty-one participants responded from the study school, and 248 participants responded from the control school.........

Posted by: JoAnn      Permalink         Source


June 20, 2006, 8:45 PM CT

Predicting Recurrence Of Prostate Cancer

Predicting Recurrence Of Prostate Cancer
new prognostic test can help determine whether a prostate cancer patient will go on to have a recurrence of the disease, even if surrounding lymph nodes initially appear negative for cancer, as per a research studyby University of Southern California researchers.

The test, developed at USC, "appears to be a very powerful test and better than anything else we know of for predicting recurrence," says Richard Cote, professor of pathology and urology at the Keck School of Medicine of USC. Current trials are also using the test to find hidden metastases in lymph nodes and bone marrow for breast and lung cancers.

The study, "Detection of Occult Lymph Node Metastases in Patients with Local Advanced (pT3) Node-Negative Prostate Cancer" appears this week in the Journal of Clinical Oncology.

Prostate cancer is the most common non-skin cancer in America, as per the Prostate Cancer Foundation. One in six American men will be diagnosed with prostate cancer, making men 35 percent more likely to be diagnosed with prostate cancer than women are to be diagnosed with breast cancer.

"Thanks to greater awareness, as well as increased and improved screening, we see men increasingly diagnosed with prostate cancer in its early stages," Cote says. "Most of these patients will do very well and will not require therapy beyond surgery or radiation treatment to cure their disease."........

Posted by: Mark      Permalink         Source


June 20, 2006, 6:47 PM CT

Strategies For Melanoma Treatment

Strategies For Melanoma Treatment
Melanoma drug development has and will continue to have a strong focus on target therapy such as vaccines, monoclonal antibodies, dendritic cells, and gene therapy. In recent years, immunologic strategies including tumor vaccine and adjuvant therapy with interferon-alfa have been attempted to improve survival of patients with more advanced malignant melanoma. Another emerging strategy in anticancer therapy is the targeting of chemotherapy resistance by overcoming the antiapoptosis mechanisms of cancer cells.

An example of this approach is the novel antisense oligonucleotide Genasense that targets the antiapoptotic gene bcl-2. Recently, Genta initiated a European regulatory submission for Genasense plus chemotherapy for patients with advanced melanoma by sending a letter of intent to EMEA for Marketing Authorization Application. This in-depth analysis, 200+ pages and almost 100 figures, tables and boxes, deals with the current therapy strategies employed and opportunities for increased pharmaceutical intervention, in the context of the present competitive landscape for malignant melanoma.........

Posted by: Janet      Permalink         Source



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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.

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