Annals of Oncology Advance Access originally published online on October 16, 2006
Annals of Oncology 2006 17(11):1609; doi:10.1093/annonc/mdl405
© 2006 European Society for Medical Oncology
in this issue
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Adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer
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Endocrine sensitivity of breast cancer, assessed by the expression
of the estrogen (ER) and/or progesterone (PR) receptors, has
long been the only recognized and validated predictive factor
to guide therapeutic decisions. More recently, the overexpression
of the HER-2 (c-erbB-2/neu) oncogene has been recognized as
a significant variable for the assessment of breast cancer prognosis
and response to treatments in the metastatic and adjuvant settings.
According to preliminary data, the advantage of aromatase inhibitors
over tamoxifen could be more relevant in the subgroups of ER+/PR-
and HER-2+ tumors. In this issue,
Ponzone et al. report the
results of a study that aimed to verify the influence of PR
and HER-2 status on the clinical and pathological characteristics
of a consecutive breast cancer patients and to assess whether
these two variables are associated with the outcome of patients
receiving adjuvant endocrine treatment. These authors conclude
that lack of PR expression and HER-2 overexpression are both
associated with aggressive tumour features in predominantly
ER+ breast carcinomas.
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Predicting survival of patients with colorectal cancer with FDG-PET
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Many malignancies, including colorectal carcinoma, have increased
glucose metabolism. They accumulate the positron-emitting glucose
analog [18F]fluorodeoxyglucose (FDG) and can thus be visualized
using positron emission tomography (PET). Several investigators
have speculated that the amount of FDG uptake correlates with
biologic factors such as Ki-67, proliferating cell nuclear antigen,
Glut-1, and hexokinase and that FDG uptake resembles the biological
behavior of the tumor, and might be associated with intrinsic
biologic characteristics, like hypoxia, low apoptosis rate,
cell viability, proliferative activity and p53 overexpression.
In this issue,
de Geus-Oei et al. report the results of a study
that aimed to assess the prognostic value of pretreatment metabolic
activity in metastases, as measured with FDG-PET, as an indicator
of survival in colorectal cancer. These authors report a significant
survival benefit was observed in patients with low FDG uptake
in metastases of colorectal cancer.
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Mantle irradiation alone for early-stage Hodgkin's disease
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Compared with extended-field radiation therapy, mantle irradiation
alone for early-stage Hodgkin's disease is associated with fewer
acute side effects, shorter treatment time, and reduced likelihood
of such late effects as bowel complications and second malignancies.
However, in the EORTC H5F study, comparing mantle and para-aortic
irradiation versus mantle alone in pathologic stage I-II Hodgkin's
disease patients, the 9-year disease-free survival of the mantle-alone
arm was only 69%. In this issue,
Ng et al. report the results
of a single-institution study that aimed to determine the long-term
treatment outcome and late effects of mantle irradiation alone
in selected patients with early-stage Hodgkin's disease. These
authors report that in selected patients with early-stage Hodgkin's
disease, mantle irradiation alone has an excellent long-term
survival rate, comparing favorably with extended-field radiation
therapy and the current standard of combined modality therapy.
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Health-related quality of life in lung cancer
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The majority of lung cancer patients are diagnosed with non-small-cell
lung cancer (NSCLC), with most of them presenting with locally
advanced or metastatic disease that is incurable with existing
treatment modalities. Treatment is palliative and the aim is
to prolong survival with improvement or maintenance of heath-related
quality of life (HRQOL) aspects. While previous studies have
clearly identified a robust relation between survival and HRQOL
parameters in the multivariate analysis, conflicting results
have been found with the specific HRQOL domain/s. In this issue,
Efficace et al. report the results of a study that aimed to
evaluate whether pretreatment patient's reported HRQOL data
in NSCLC patients independently predicted overall survival by
also controlling for key socio-demographic and biomedical data.
These authors conclude that self-reported HRQOL do indeed provide
independent prognostic information for survival, and they suggest
that this supports the collection of such data in routine clinical
practice.
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Quote
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"‘That's well! Now, doctor, I shall take the liberty of
administering a dose myself, on my own responsibility. I got
this cordial at Rome, of an Italian charlatan – a fellow
you would have kicked, Carter. It is not a thing to be used
indiscriminately, but it is good upon occasion: as now, for
instance. Jane, a little water.’"
Mr Rochester prescribes in Charlotte Brontë's Jane Eyre.
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