Annals of Oncology 2008 19(11):1819; doi:10.1093/annonc/mdn704
© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org
in this issue
 |
CNS relapse related to adjuvant taxane treatment in node-positive breast cancer
|
|---|
Node-positive breast cancer is a disease with a significant
risk of relapse and death. Anthracycline-containing adjuvant
chemotherapy has been shown to increase disease-free survival
(DFS) and overall survival. However, breast cancer central nervous
system (CNS) metastases are an increasingly important problem
because of high CNS relapse rates in patients treated with trastuzumab
and/or taxanes. In this issue, Pestalozzi et al. [pp. 1837–1842],
on behalf of the BIG 02-98 Collaborative Group, report an evaluation
of 2887 node-positive breast cancer patients randomized in the
BIG 02-98 trial comparing anthracycline-based adjuvant chemotherapy
(control arms) to anthracycline–docetaxel-based sequential
or concurrent chemotherapy (experimental arms). After a median
follow-up of 5 years, 403 patients had died and detailed information
on CNS relapse was collected for these patients. These authors
report that CNS relapse occurred in 4.0% of control patients
and 3.7% of docetaxel-treated patients.
|
Telomere shortening, DNA damage response and telomeric protein downregulation in colorectal preneoplastic lesions
|
|---|
Telomere length abnormality appears to be one of the earliest
and most prevalent genetic alterations in the multistep process
of malignant transformation. However, it remains unclear whether
telomere dysfunction induces chromosomal instability, initiating
certain human epithelial malignancies. It has recently been
shown that DNA damage repair is activated early in most human
epithelial carcinogenic processes. In this issue, Raynaud et
al. [pp. 1875–1881] report an evaluation of telomere length
and telomere protein levels and their relationship to the DNA
damage repair pathway activation in the multistep process of
colorectal carcinogenesis. These authors report that telomere
attrition occurs early in carcinogenic progression in the colon
model, with telomere shortening observed in low-grade dysplasia.
This attrition peaks in high-grade dysplasia, and it is only
when the full invasive potential of the tumor has been reached
that telomere length returns to levels close to those observed
in normal tissue.
|
CD5 expression as a predictor of outcome in patients with DLBCL receiving rituximab plus CHOP therapy
|
|---|
Recently, it has been recognized that addition of rituximab
to anthracycline-based regimens may alter the previously identified
prognostic factors, in view of the markedly improved outcome
of patients with diffuse large B-cell lymphoma (DLBCL). Although
several studies analyzing the prognostic significance of individual
biomarkers have been carried out since the introduction of rituximab,
none has investigated outcome by considering these biomarkers
together. In this issue, Ennishi et al. [pp. 1921–1926]
report the results of a retrospective study that aimed to investigate
the predictive value of three biomarkers—BCL2, germinal
center (GC) phenotype, and CD5—in 121 DLBCL patients treated
with rituximab plus cyclophosphamide, doxorubicin, vincristine
and prednisone. These authors report that CD5 expression was
the only significant prognostic factor among the biomarkers
examined in this study.
|
Euthanasia, life sustaining treatment and acceleration of death
|
|---|
The percentage of physicians who approve of euthanasia and assisted
suicide is increasing and ranges from 35% to 88% in different
countries; this is in agreement with findings from the general
population. In this issue, Catania et al. [pp. 1947–1954]
report the results of a study that aimed to evaluate the awareness
and personal opinions of members of the Italian Association
of Medical Oncology (AIOM) regarding advance directives, acceleration
of death, euthanasia and ‘life-sustaining treatment’.
These authors report that 63% of respondents felt culturally
and psychologically prepared to face these issues. 54% believed
that what had been decided while the patient enjoyed good health
is no longer applicable in an advanced state of terminal illness.
39% believed that doctors should abide by these directives,
while 49% believed that this should be discussed on a case-by-case
basis. 14% of oncologists were favourable towards euthanasia
and 42% only in particular circumstances. 56% had received at
least one request for accelerating death. The authors call for
a debate within the medical world and for a shared judicial
regulation.
|
Quote
|
|---|
"Now in my morning the weariness of death
Sends me to sleep. Had I made coffins
I might have lived singing to three score."
Condemned to die for love Bilhana Kavi considers his fate in the Chauraspanchasika, from E. Powys Mathers's translation Black Marigolds
CiteULike 
Connotea 
Del.icio.us What's this?
Top
CNS relapse related to...
Telomere shortening, DNA damage...