Annals of Oncology 2008 19(2):199; doi:10.1093/annonc/mdm605
© 2008 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org
in this issue
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Phosphorylated AKT in breast cancer
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AKT phosphorylation is a critical step in the activation of
growth factor receptors and can mediate tumor resistance to
anthracyclines. Although activation of the AKT pathway appears
to be a potentially major event in the survival of breast cancer
cells, few studies have investigated its prognostic and predictive
value in tissue from breast cancer patients. In this issue,
Andre et al. [315–320] report the results of study that
aimed to evaluate the frequency of AKT activation in HER2-positive
and EGFR-positive human breast cancer; to determine whether
AKT pathway activation correlates with the immunophenotypical
patterns based on HER2, EGFR, estrogen receptor (ER), and cytokeratin
(CK) 5/6 expressions; and to determine the predictive value
of AKT activation for the efficacy of anthracycline-based chemotherapy
in the adjuvant setting. These authors report that AKT phosphorylation
is associated with HER2 expression but not EGFR expression in
patients with early breast cancer. Moreover, phosphorlated AKT
was not predictive for the efficacy of anthracycline-based adjuvant
chemotherapy.
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FDG-PET response evaluation in colon cancer
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There is an increasing interest in the role of
18F-fluorodeoxyglucose
(FDG) positron emission tomography (PET) beyond staging, for
the prediction of tumor response to therapy. FDG-PET cannot
only distinguish active disease from residual scar tissue but
can also quantify FDG uptake to distinguish metabolically highly
active from less active tumor tissues. However, experience with
FDG-PET in the assessment of therapy response in advanced colorectal
cancer is still limited. In this issue,
de Geus-Oei et al. [348–352]
report the results of a prospective study that aimed to evaluate
the value of FDG-PET for the early assessment of chemotherapy
response in patients with advanced colorectal cancer. These
authors performed dynamic FDG-PET before and at 2 (
n = 50) and
6 months (
n = 19) after start of treatment, assessing the predictive
value of changes in glucose metabolism with Cox proportional
regression analysis. They conclude that the degree of chemotherapy-induced
change in tumor glucose metabolism is highly predictive of patient
outcome.
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Chemotherapy in ocular adnexal lymphoma
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Ocular adnexal lymphomas (OALs) present as lesions arising from
the eyelid, orbit, lachrymal gland or conjunctiva. When confined
to the orbit, indolent non-Hodgkin's lymphoma (NHL) can often
be cured with radiotherapy, which confers a high rate of local
control with long-term efficacy. However, radiotherapy commonly
leads to acute ophthalmologic toxicities, such as moderate cutaneous
or conjunctival reactions, as well as late complications such
as constant cataract, xerophthalmia, rare ischemic retinopathy,
glaucoma or corneal ulceration. Moreover, disseminated relapses
after radiotherapy have been reported in 17% of patients. In
this issue,
Song et al. [242–246] report on a study that
aimed to examine the efficacy of cyclophosphamide, vincristine,
and prednisolone (CVP) combination therapy as a first-line treatment
for localized ocular adnexal extranodal marginal zone B-cell
lymphoma. These authors report that CVP alone resulted in an
overall response rate of 100% (complete remission [CR], 76.2%)
and that after a median follow-up of 58 months, 14 (66.7%) of
21 cases were disease free with CVP alone, while seven cases
showed disease progression, including two extra-orbital and
five local failures.
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Glycemic index, glycemic load and thyroid cancer
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Several aspects of diet have been related to thyroid cancer.
Among associations found, case–control studies have shown
increased risk for refined cereal intake, pasta or rice, bread,
pastry, and potatoes, although the issue remains open. Glycemic
index (GI) and glycemic load (GL) are indicators of the physiological
response to different carbohydrates in terms of plasma glucose
and insulin responses. High levels of GI or GL have been associated
with diabetes, coronary heart diseases, and with cancer risk
at several sites, but not specifically with thyroid cancer.
In this issue,
Randi et al. [380–383] report an analysis
of data from a case–control study conducted in Italy from
1986 to 1992 which included 399 histologically confirmed and
incident cases of thyroid cancer and 616 control subjects. Information
on dietary habits was derived through a food-frequency questionnaire
and multivariate odds ratios (ORs) for GI and GL levels were
estimated with adjustment for age, education, sex, area of residence,
history of diabetes, body mass index, smoking, alcohol consumption,
intake of fruit and vegetables, and non-carbohydrate energy
intake. These authors conclude that high dietary levels of GI
and GL are associated with thyroid cancer risk.
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Quote
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‘"Nothing could be less acceptable to me than payment
for the pleasure of entertaining a visitor," the doctor answered,
knitting his brows; "and as to my advice, you shall have it
if I like you, and not unless. Rich people shall not have my
time by paying for it; it belongs exclusively to the folk here
in the valley. I do not care about fame or fortune, and I look
for neither praise or gratitude from my patients. Any money
which you may pay me will go to the druggists in Grenoble, to
pay for the medicine required by the poor of the neighborhood."’
Dr Benassis declines payment in Honore de Balzac's The Country Doctor.
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