5/21/2008 Robert Langreth Forbes.com ImClone Systems' breakthrough colon cancer drug Erbitux has become a billion-dollar best seller as a one-size-fits-all drug for patients who have failed treatment with chemotherapy. But emerging new gene findings indicate that the high-priced drug may be useless in nearly half of colon cancer patients--and that a simple gene test could allow doctors to predict in advance which patients are likely to benefit. The drug, co-marketed by ImClone and Bristol-Myers Squibb, costs $38,000 for a four-month course of treatment. The result is one of the first examples of personalized medicine in colon cancer. It helps explain why tumors shrink dramatically in a minority of patients who get the drug while most others get little benefit. The new gene test could allow doctors to give the drug only to patients who are likely to benefit, and avoid those who are likely to just get side effects. Side effects of the drug include skin rashes and infections in the fingers and toes. A series of studies published over the last several months indicate that about 35% to as much as 45% of colon patients probably should not be taking Erbitux or a similar drug from Amgen called Vectibix. These patients have tumors with a mutation in a growth-promoting gene called kras that may render the drugs ineffective. Erbitux and Vectibix are antibodies that bind to receptors on the cell surface called EGF and blocks signals that turn kras on. But the mutations apparently cause kras to become permanently [...]

5/21/2008 Charleston, SC Theodore R McRackan et al. Laryngoscope, May 9, 2008 Objective: To investigate the association between initial body mass index (BMI) and chemoradiation therapy (CRT) outcomes in head and neck cancer patients. Methods:: Retrospective study of 72 patients with American Joint Committee on Cancer stage III or IV squamous cell carcinoma of the oropharynx, hypopharynx, or larynx treated with primary concurrent CRT with curative intent over a 5 year period. Logistic and Cox regression analyses were used to determine the association between initial BMI and percutaneous endoscopic gastrostomy tube dependence, tumor recurrence, disease-free survival, and overall survival while controlling for the independent variables of age, sex, race, site, stage, and smoking and alcohol use. Results: Patients with normal or low BMI (BMI Conclusion: The present study suggests that CRT patients with BMI greater than 25 have improved swallowing outcomes, longer time to disease recurrence, and improved survival when compared with similar patients with lower BMI. BMI at presentation may be an important clinical factor to consider when determining the optimal treatment modality for a head and neck cancer patient. Further investigation is required to determine whether primary surgery should be the preferred treatment in normal or low BMI patients. Authors: Theodore R McRackan, John M Watkins, Amy E Herrin, Elizabeth M Garrett-Mayer, Anand K Sharma, Terry A Day, and M Boyd Gillespie Authors' affiliations: From the Department of Otolaryngology?Head and Neck Surgery (t.r.m., t.a.d., m.b.g.), the Department of Radiation Oncology (j.m.w., a.k.s.), and the Department of Biostatistics, Bioinformatics, [...]

5/21/2008 web-based article Vince Darcangelo DailyCamera.com Growing up in Long Island, N.Y., local guitarist/mandolinist Greg Schochet's earliest memories involve listening to his dad's Bob Dylan records. Dylan turns 67 on May 24, and in honor of the folk legend's big day Schochet -- who has performed with such local favorites as Runaway Truck Ramp, the All Night Honky Tonk All Stars and Hit and Run Bluegrass, and currently plays with the Expedition Quartet and Halden Wofford and the Hi-Beams -- is hosting An All-Star Tribute to Bob Dylan at the Gold Hill Inn on Wednesday. "It's a musical tour of his career from start to the present," Schochet says. It's the third such party Schochet has organized, including celebrations in 2005 and 2007. The event has brought together big-name local acts like Yonder Mountain String Band, Danny Shafer and Rose Hill Drive in the past. This year's party includes Spring Creek Bluegrass, KC Groves, Flatfoot and others, as well as Schochet's bands the Expedition Quartet and Halden Wofford and the Hi-Beams. "Bob Dylan's music means a lot to me musically and historically," Schochet says. But the event means even more as its origin lies not in Dylan's music but in Schochet's Long Island roots. Growing up, Schochet's best friend, and fellow Dylan fan, was Dan Roth, and a few years ago Roth was diagnosed with oral cancer. He came to Colorado to visit Schochet and the two spent a day just jamming on Dylan tunes and discussed the possibility of [...]

5/16/2008 Ann Arbor, MI staff eMaxHealth.com Researchers at the University of Michigan Comprehensive Cancer Center have found a series of markers that indicate which patients are more likely to survive cancers of the base of the tongue and tonsils. Most notably, they found that cancers linked to HPV, or human papillomavirus, are the most responsive to current chemotherapy and radiation treatments, while tumors that express high levels of a certain growth factor receptor are the least responsive and most deadly. The researchers call these and other markers a promising step in the direction of tailored, individualized treatment for a type of cancer that can have dramatic impact on essential abilities such as swallowing and speaking. Results of the study appear in two papers published May 12 online in the Journal of Clinical Oncology. The papers will be published in the journal's July 1 print issue. "The chemotherapy and radiation therapy we use to treat this type of cancer is very aggressive. If we can identify those patients most likely to respond, we could reduce the intensity of the therapy for those likely to have the best outcomes. At the same time, we hope to identify new treatments that specifically target those tumors that we know are not responding to current therapies," says Thomas Carey, Ph.D., Professor and Distinguished Research Scientist at the U-M's Kresge Hearing Research Institute and co-director of the head and neck oncology program at the U-M Comprehensive Cancer Center. Carey was the senior author on both papers. [...]

5/16/2008 web-based article staff CBC.ca There's growing evidence that the virus that causes cervical cancer in women is also linked to cancers in men, leading health professionals to call for an HPV vaccination program for boys. Janet Dollin, the president of the Federation of Medical Women of Canada, said public health officials in Canada should consider vaccinating both girls and boys against HPV. "Start thinking about immunizing everybody who is at risk — it makes no sense to vaccinate only the girls," Dollin said. Recent research found more than half of some oral cancers in men are associated with the human papilloma virus. While many Canadian provinces fund programs to vaccinate girls against HPV to prevent cancer, there are none for boys. Researchers at the University of Michigan studied treatments for men with tongue and tonsil cancers. Their study was published Monday in the Journal of Clinical Oncology. They discovered that 64 per cent of the tumours they looked at were HPV-positive. Dr. Thomas Carey, the study's lead author, believes the virus plays a major role in the development of cancer. "We believe that the HPV, which we know is capable of transforming cells in vitro, is the causative factor for these HPV-positive cancers," he told CBC News. The good news that emerged from the study was that those men whose tonsil and tongue cancers had HPV markers had significantly better survival rates and responded better to chemotherapy than tumours with other markers. Almost all of the HPV-positive tumours responded [...]

5/16/2008 web-based article staff ScienceDaily.com Celecoxib, the anti-inflammatory medication also known by the trade name Celebrex, has proven to be safe and reduces a specific proliferation measurement of precancerous lesions in the lung, according to a study from The University of Texas M. D. Anderson Cancer Center. This finding demonstrates the significance of COX-2 inhibition toward preventing lung cancer in individuals at higher risk of developing the disease. The study is the first large randomized trial of Celebrex in lung cancer prevention; the findings will be presented at the American Society for Clinical Oncology's (ASCO) upcoming annual meeting as an oral presentation. "With this study, in principal, we've been able to demonstrate the importance of COX-2 and the implications on inflammation pathway in lung cancer development," said Edward Kim, M.D., assistant professor in M. D. Anderson's Department of Thoracic Head and Neck Medical Oncology. "We've also been able to demonstrate that this drug class is safe and tolerable for this patient population. As we move forward in lung cancer chemoprevention, the importance of this class of drugs cannot be ignored." From November 2001 to September 2006, the M. D. Anderson study enrolled 212 individuals, all of whom were current or former smokers with at least a 20-pack-year smoking habit. Most participants did not have any history of cancer; however, patients with a history of cancer who had been disease-free for six months could participate. The median age of participants was 53. The study examined levels of KI-67, a biomarker associated [...]

5/15/2008 United Kingdom staff Dentistry.co.uk Gruesome photos showing how deadly a habit smoking can be will be slapped on every cigarette packet sold in the UK from 30 September. And the move is being welcomed by the Mouth Cancer Foundation who are 'delighted that the UK is introducing picture warnings on tobacco packs'. After a public consultation last year, 15 images – including ones of diseased lungs and another of a man with an advanced cancerous tumour on his throat – were chosen to accompany text warnings about lung cancer and heart disease. Dr Vinod Joshi, founder of the Mouth Cancer Foundation, said: 'Evidence shows that graphic picture warnings lead to greater awareness of the risks associated with smoking. 'This will help encourage young people to cut down or quit altogether before they get addicted. 75% of mouth cancers occur in patients who use tobacco. He added: 'The gruesome picture showing a mouth cancer will help smokers quit and deter the young smoker.' The government believe there was enough evidence from other countries that the new images would help people quit. Ministers promised it would introduce picture warnings on cigarette packets in its public health white paper in 2004. In recent years, the European Commission has been urging member countries to do so as well. Under the rules, it is expected that cigarette packs with written warnings only will not be allowed on sale past 30 September. For other tobacco packets, the deadline will be September 30 2009. Ministers have [...]

5/14/2008 San Diego, CA staff ScienceDaily.com Scientists at UC San Diego, UC Santa Barbara and MIT have developed nanometer-sized “nanoworms” that can cruise through the bloodstream without significant interference from the body’s immune defense system and—like tiny anti-cancer missiles—home in on tumors. Their discovery, detailed in this week’s issue of the journal Advanced Materials, is reminiscent of the 1966 science fiction movie, the Fantastic Voyage, in which a submarine is shrunken to microscopic dimensions, then injected into the bloodstream to remove a blood clot from a diplomat’s brain. Using nanoworms, doctors should eventually be able to target and reveal the location of developing tumors that are too small to detect by conventional methods. Carrying payloads targeted to specific features on tumors, these microscopic vehicles could also one day provide the means to more effectively deliver toxic anti-cancer drugs to these tumors in high concentrations without negatively impacting other parts of the body. “Most nanoparticles are recognized by the body's protective mechanisms, which capture and remove them from the bloodstream within a few minutes,” said Michael Sailor, a professor of chemistry and biochemistry at UC San Diego who headed the research team. “The reason these worms work so well is due to a combination of their shape and to a polymer coating on their surfaces that allows the nanoworms to evade these natural elimination processes. As a result, our nanoworms can circulate in the body of a mouse for many hours.” “When attached to drugs, these nanoworms could offer physicians the [...]

5/14/2008 web-based article staff ScienceDaily.com Positron emission tomography with a radioactive tracer (18F-FDG PET) may not improve the detection of small metastases in patients with head and neck cancer who have no clinical evidence of disease in neighboring lymph nodes, according to a meta-analysis published online May 13 in the Journal of the National Cancer Institute. A key prognostic factor for head and neck squamous cell cancer patients is whether their disease has spread to the nearby lymph nodes. Unfortunately, some patients who appear clinically to be free of such metastases, referred to as cN0, actually have small metastases. Clinicians use magnetic resonance imaging (MRI), commuted tomography (CT), and FDG-PET to try to detect these lesions, but strong data supporting the use of FDG-PET are lacking. To systematically examine the value of FDG-PET for diagnosing clinically node-negative patients, John P. A. Ioannidis, M.D., of the University of Ioannina School of Medicine in Greece and colleagues performed a meta-analysis of 32 previously published studies that tested FDG-PET in head and neck cancer patients with one or fewer nodal metastases. FDG-PET failed to identify 50 percent of the occult lesions in clinically node-negative patients and incorrectly identified normal tissue as being cancerous 13 percent of the time. When the researchers compared the sensitivity and specificity of FDG-PET with MRI and CT, they found that there was a trend for a small improvement in detection with FDG-PET, but the differences were not statistically significant. The false positive rate was similar for all three [...]

5/13/2008 New York, NY Nicholas Bakalar New York Times (nytimes.com) Dental cavities are not good news, but when it comes to preventive oral health, they may be among the smaller problems. The advice is familiar: brush and floss regularly, use fluoride mouthwash, limit snacks and sweet drinks, visit the dentist twice a year. Good suggestions, even if not everyone follows them: by age 12, 50 percent of children have cavities. But there are two much more serious problems, common dental diseases that can lead not only to loss of teeth but also to loss of life: periodontal disease and oral cancer. Periodontal disease — a chronic bacterial infection of the gums that destroys the bone and tissues that hold the teeth — is the leading cause of tooth loss in adults. Some people are genetically susceptible, and the problem can be aggravated by smoking, taking certain medications, stress and other factors. Several studies have found that gum disease is associated with an increased risk for heart attack. “It isn’t nailed down yet,” said Dr. Martin J. Davis, professor of clinical dentistry at the College of Dental Medicine at Columbia, “but there seems to be a link between the inflammation of gums and the inflammatory markers of heart disease.” It may be that oral bacteria enter the bloodstream, attach to fatty plaques in the coronary arteries and cause clots to form. Or maybe inflammation itself increases plaque buildup. A 2007 study showed that periodontal disease increased the risk of heart disease [...]