© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 4, 287,
February 16, 2000
© 2000 Oxford University Press
IN THIS ISSUE |
In many patients, ductal carcinoma in situ (DCIS) lesions of the breast recur, and recurrence may indicate residual disease. Waldman et al. (p. 313) examined the relationship between initial and recurrent DCIS tumors by using comparative genomic hybridization, which looks at comparatively large-scale alterations in chromosomes. They found that, in 17 of 18 tumor pairs studied, the initial and recurrent DCIS lesions appeared to be clonally related. This result is based on the number of chromosomal alterations that the tumor pairs shared. In addition, most of the tumor pairs showed similar histologic features. The authors note that these results support the need for careful treatment—especially wide surgical margins—of DCIS lesions to avoid recurrence.
In an accompanying editorial, Fisher and Fisher (p. 288) look at research on the biology of DCIS from a historical perspective. They note that the difference between residual disease and true recurrence is not always apparent in DCIS tumors.
"We conclude that most DCIS recurrences result from growth of persistent neoplastic cells."
—Waldman et al.
ATP and Advanced Lung Cancer
Extracellular adenosine triphosphate (ATP) is involved in regulation of a variety of biologic processes, including neurotransmission, muscle contraction, and liver glucose metabolism. In a randomized clinical trial, Agteresch et al. (p. 321) investigated potential beneficial effects of ATP infusions in patients with advanced non-small-cell lung cancer (stage IIIB or IV). Over the 28-week study period, the 28 patients receiving ATP infusions showed overall less deterioration in body weight, serum albumin concentration, and arm and leg muscle strength compared with 30 patients who did not receive ATP infusions. The stabilizing effects of ATP were especially marked in patients with prior cachexia. The quality-of-life scores at 4-week intervals in patients receiving ATP showed overall less deterioration than the scores of patients not receiving ATP. The authors conclude that the beneficial results obtained warrant further clinical trials of ATP treatment that include placebo arms.
In an editorial, Jatoi et al. (p. 290) point out some limitations of the study and note that supportive care trials have many methodologic challenges. However, they agree that weight loss and associated morbidity are major concerns for cancer patients and that physicians need to be more attentive to these problems.
"We conclude that ATP has potential in the palliative management of lung cancer."
—Agteresch et al.
Hormone Replacement Therapy and Risk of Breast Cancer
Estrogen replacement therapy’s role as a risk factor for endometrial cancer and breast cancer is well documented. To lessen the endometrial cancer risk, recent practices have favored combination regimens that include progestin and estrogen. However, the combination regimen may alter breast cancer risk. Ross et al. (p. 328) determined the effects of estrogen–progestin replacement therapy on breast cancer risk in a population-based case–control study. They showed that hormone replacement therapy overall was associated with a 10% higher breast cancer risk for each 5 years of use. Risk was substantially higher after receiving combination therapy compared with estrogen alone. The authors conclude that these findings may have important implications on the risk–benefit equation for hormone replacement therapy.
"Women who are candidates for HRT should be provided with this information and also be told where uncertainty still exists in the risk-benefit equation."
—Ross et al.
Cigar Smoking and Cancer Deaths
Cigar consumption in the United States has increased dramatically since 1993, yet there are limited prospective data on the risk of cancer associated with cigar smoking. Shapiro et al. (p. 333) examined the association between cigar smoking and death from tobacco–related cancers in a large prospective cohort of U.S. men in the American Cancer Society’s Cancer Prevention Study II. Current cigar smoking at baseline, as compared with never smoking, was associated with an increased risk of death from cancers of the lung, oral cavity/pharynx, larynx, and esophagus. There was also an increased risk of mortality from pancreatic and bladder cancers among the current cigar smokers who reported inhaling the smoke. The authors conclude that the results support a strong association between cigar smoking and mortality from several types of cancer.
"[I]f these young people become regular cigar smokers, a sizable number will develop a smoking-related cancer later in life."
—Shapiro et al.
Fhit Protein and Cervical Cancer
Allelic losses in the short arm of chromosome 3 are common in cervical carcinoma. The fragile histidine triad (FHIT) gene at chromosome region 3p14.2 may be a tumor suppressor gene, but the evidence so far is indeterminate. Wu et al. (p. 338) used recombinant retroviruses and plasmid DNA to restore Fhit protein expression in cervical cancer cell lines that do not normally express this protein. They found that restoration of Fhit expression did not suppress the tumorigenicity of the cell lines. However, the authors note that their analysis does not exclude the possibility that FHIT is a candidate tumor suppressor gene and that additional studies are required to understand the role of FHIT in human cancer.
"FHIT may suppress tumorigenesis in ways distinct from those measured by the assays employed in this study."
—Wu et al.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||