Annals of Oncology 2008 19(6):1031; doi:10.1093/annonc/mdn380
© 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
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ADAM-17 predicts adverse outcome in patients with breast cancer
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ADAM-17 is a matrix metalloproteinase-like enzyme involved in
the release of several ligands that have been shown to promote
both cancer formation and progression, including transforming
growth factor-
, amphiregulin, heparin-binding epidermal growth
factor, epiregulin and tumor necrosis factor-
. Consistent with
this, ADAM-17 has been implicated in tumor formation/progression;
work in breast cancer cell lines in culture has shown that ADAM-17
promotes both proliferation and invasion, while in human breast
tumors ADAM-17 expression levels correlate with parameters of
proliferation and invasion. In this issue,
McGowan et al. [1075–1081]
report the results of a study in which they measured the expression
of total ADAM-17 by enzyme-linked immunosorbent assay in 153
invasive breast cancers, and measured the precursor and active
forms by western blotting in 140 invasive breast cancers. These
authors report that patients with high expression of ADAM-17
had a significantly shorter overall survival compared with those
with low expression. Moreover, the prognostic impact of ADAM-17
was independent of conventional prognostic factors for breast
cancer.
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Prognosis of advanced hepatocellular carcinoma
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Hepatocellular Carcinoma (HCC) is the main form of liver cancer
and generally develops on cirrhosis or hepatitis B or C infections.
The incidence of HCC has substantially increased in developed
countries over the last three decades. Classification of patients
according to prognosis is a central issue since inclusion criteria
in clinical trials supposes that homogenous groups of patients
can be identified. Various prognostic factors of overall survival
have then been explored and several classifications have been
proposed. In this issue,
Collette et al. [1117–1126] report
on a pooled analysis of two randomized clinical trials, carried
out by the Fédération Francophone de Cancérologie
Digestive, that aimed to assess and compare the performance
of three prognostic classifications (Okuda, CLIP and BCLC) for
predicting overall survival of patients with advanced HCC. They
also considered whether the staging systems could be improved
by adding other clinical or biological variables. These authors
report that for all statistics the CLIP staging system had a
better prognostic ability.
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Bortezomib, doxorubicin and dexamethasone in multiple myeloma
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Clinical trials employing bortezomib in combination with other
agents in patients with multiple myeloma have shown additive
or synergistic activity. Partial response (PR) rates have ranged
from 27% to 50% in patients with relapsed/refractory disease.
In newly diagnosed multiple myeloma patients, the combination
of bortezomib, doxorubicin and dexamethasone has been encouraging.
However, the intensity of dexamethasone and the use of 21-day
regimen have been associated with a high incidence of infections
and peripheral neuropathy. In this issue,
Palumbo et al. [1160–1165]
report the results of a multicenter trial, that aimed to assess
the combination of bortezomib, doxorubicin and low-dose dexamethasone
(PAd) in the treatment of relapsed/refractory myeloma. These
authors report that the median event-free survival of 9 months
after PAd was similar to that observed after the previous line
of therapy, suggesting an efficacious combination with tangible
clinical benefit.
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Changes in breast cancer incidence and mortality
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Since 1985 considerable changes in breast cancer detection and
management have occurred and towards the end of the 1980s and
in the 1990s decreases in breast cancer mortality started to
be observed in western Europe, north America and Australia.
In this issue,
Héry et al. [1187–1194] present
data on an attempt to quantify and compare percentage changes
in breast cancer incidence and mortality from 1990 to 2002 in
35 countries with Caucasian-majority populations for which mortality
data are available since at least 1990, including Europe, north
America, Australia, New Zealand and Israel. These authors report
that the incidence percent change in women of all ages varied
from 2.1% in Canada to 54.2% in Lithuania. The main increases
in incidence were observed for women 50–69 years old,
varying from 12.4% in Canada until 105.3% in Norway. Decreases
in mortality of more than 20% were observed in nine countries.
Mortality decreases were highest in women 35–49 years
old and lowest in women aged 70 years or more.
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Quote
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"Being published by the Oxford University Press is rather like
being married to a duchess: the honour is almost greater than
the pleasure."
The English historian G. M. Young with food for thought for our authors.
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