10/18/2005 Mark El-Deiry, MD et al. Arch Otolaryngol Head Neck Surg. 2005;131:879-885 Objective: To compare the long-term, health-related quality-of-life outcomes in patients with advanced head and neck cancer (HNC) treated with surgery and postoperative radiation therapy (SRT) or concurrent chemotherapy and radiation therapy (CRT). Design: Matched-pair study comparing patients with advanced HNC treated with SRT or CRT at least 12 months after treatment. Patients completed 2 validated surveys addressing HNC-specific outcomes and depressive symptoms and provided information on employment and tobacco and alcohol use. Results for the 2 groups were compared using paired-sample t test and 2 analysis. Setting: University-based study. Patients: Patients with stage III or IV squamous cell carcinoma of the oropharynx, hypopharynx, and larynx who underwent SRT or received CRT. Main Outcome Measures: Head and neck cancer–specific health-related quality of life from the Head and Neck Cancer Inventory and level of depressive symptoms from the Beck Depression Inventory. Results: The matching process resulted in 27 patients in each treatment group. The HNC-specific domain scores (with higher scores representing better outcomes) for CRT vs SRT were eating, 37.8 vs 40.8 (P = .69); speech, 65.1 vs 56.0 (P = .23); aesthetics, 80.3 vs 69.2 (P = .14); and social disruption, 69.7 vs 70.6 (P = .90). Overall health-related quality of life was 64.0 with SRT and 55.0 with CRT (P = .142). For the Beck Depression Inventory (with higher scores representing worse outcomes), patients who underwent SRT had a mean score of 9.6 compared with 11.6 for patients [...]

10/18/2005 Denver, CO Robert Preidt Forbes (www.forbes.com) A new combination of radiation therapy and chemotherapy may offer a much greater chance of survival for head and neck cancer patients who develop a second tumor or whose disease recurs in an area that's already been treated with radiation, says a study by Canadian and American researchers. Few treatment options currently exist for these patients, according to background information from the study. This study included 99 patients who received split-course hyperfractionated radiation therapy twice a day for five days every two weeks for four cycles. The patients also received chemotherapy with cisplatin (daily every two weeks for four cycles) and paclitaxel (daily every two weeks for four cycles). The median follow-up for surviving patients was 23.6 months and the median survival was 12.1 months. The median survival for patients treated with the current standard of chemotherapy alone is six to eight months, and one-year survival rates are typically less than 35 percent, the researchers said. Fifty percent of the patients in this study survived for at least a year while 26 percent survived two years. The findings were presented Monday at the American Society for Therapeutic Radiology and Oncology annual meeting, in Denver. "The side effects from this experimental regimen were significant, but these patients were among those with the most serious cancers," Dr. Eric Horwitz, study co-principal investigator and clinical director in the radiation oncology department at Fox Chase Cancer Center in Philadelphia, said in a prepared statement. Eight of the [...]

10/18/2005 Louisville, CO press release PRNewswire (www.prnewswire.com) RxKinetix, Inc., a specialty pharmaceutical company developing new therapeutics focused in oncology care, today announced completion of their Phase 2 clinical trial of RK-0202 in oral mucositis. The Independent Data Monitoring Committee (IDMC) for the Phase 2 trial recommended stopping enrollment in order to expedite development of the drug. The IDMC found no significant safety issues associated with the use of RK-0202. The Phase 2 trial was double-blind, randomized and placebo controlled, 114 out of a planned total of 130 patients receiving radiotherapy for head and neck cancer were enrolled. The preliminary data at 50 Gy cumulative radiation shows that, compared with placebo, RK-0202 showed a 32% reduction in the incidence of WHO Grade mucositis greater than or equal to 3, which is a measure of the patient's inability to eat solid food. Furthermore, the percentage of patients requiring nutritional support via external feeding tubes was 21% in the placebo group compared with 3% in the group taking RK-0202. "We were delighted to receive this recommendation to conclude our Phase 2 trial for RK-0202 in oral mucositis," said Harry Ross, M.D., CEO and President of RxKinetix, Inc. "These results provide a strong signal for RK-0202 against oral mucositis allowing us to move forward with our goal of achieving a safe and effective treatment for this debilitating disorder." The Company will now complete the data gathering for the remaining patients who were active at the time of the IDMC review and move forward with [...]

10/18/2005 Houston, TX Bradley A. Schiff, MD et al. Arch Otolaryngol Head Neck Surg. 2005;131:874-878 Objectives: To assess the role of selective neck dissection in patients with squamous cell carcinoma (SCC) of the oral tongue with advanced nodal disease, and to assess the role of postoperative radiotherapy in patients with SCC of the oral tongue with pathologically N1 necks. Design: Retrospective study of the medical records of all patients who underwent neck dissection for SCC of the oral tongue from January 1, 1980, to December 31, 1995. Median follow-up was 5.7 years. Setting: The University of Texas M. D. Anderson Cancer Center, Houston, a tertiary care cancer hospital. Patients: A total of 220 patients with SCC of the oral tongue who received surgical treatment of both the primary tumor and the neck and who had an identifiable type of neck dissection, no synchronous or metachronous lesions, and no evidence of local recurrence. Interventions: All patients underwent resection of the primary tumor and neck dissection. The extent of neck dissection was determined by surgeon preference. Some patients received radiotherapy to the neck as well. Main Outcome Measures: Clinical and pathological nodal status, type of neck dissection, and use of radiotherapy. The end points evaluated included the regional control rates. Results: For clinically N+ patients, 5 of 45 treated with selective neck dissection and 1 of 19 treated with radical or modified radical neck dissection had recurrences in the ipsilateral neck. If only patients with significant tumor burden on final pathological examination [...]

10/17/2005 Denver, CO press release PharmaLive (www.medadnews.com) ImClone Systems Incorporated today announced the launch of a first-of-its-kind, independent national registry of patients with head and neck cancer known as LORHAN (Longitudinal Oncology Registry of Head And Neck carcinoma) at the 2005 American Society of Therapeutic Radiology and Oncology (ASTRO) Annual Meeting in Denver. LORHAN will gather together detailed information, including treatment and supportive care choices as well as recurrence and survival outcomes, into a national database via a confidential Web-based system. The registry will then allow physicians participating in the registry to compare the treatment outcomes of their patients to a national database. LORHAN will also determine whether the results of treatment-changing clinical studies are being incorporated effectively into daily practice, and compare treatment practices in community and academic settings. An estimated 26,400 patients will be eligible to enter the system each year, of which approximately 1,000 are expected to be enrolled. The American Board of Internal Medicine (ABIM) has approved use of LORHAN for medical oncologists wishing to satisfy a part of their re-certification related to practice performance. ABIM Certification is designed to assure the public that a medical specialist possesses the knowledge, experience, and skills requisite to the provision of high quality patient care. "This registry is unique in that it is the first time that the overall management of head and neck cancer will be tracked across academic centers and community settings," said Eric K. Rowinsky, M.D., Senior Vice President and Chief Medical Officer of ImClone Systems. [...]

10/17/2005 London, England staff BBC News (news.bbc.co.uk) An invention that helps throat cancer patients to speak has won first prize at the national NHS Innovation Awards. The Sunderland Air Pressure Meter allows doctors to choose the right prosthetic speech valve for patients who have had their larynx removed. Until this breakthrough, speech and language therapists relied on trial and error to select the right valve. The meter was developed by Regional Medical Physics Department (RMPD) staff based at Sunderland Royal Hospital. 'Monitor progress' The device is the result of five years of research and development, and will now be sold to hospitals around the country. It beat 17 other regional finalists to the award, which will be presented to consultant medical physicist who led the RMPD team, Bill Allan, by the Health Minister responsible for innovation, on Monday. Mr Allan said: "The valves are used by the speech and language therapists on patients who have had a total laryngectomy. "Using modern technology, we can put a small prosthetic valve in the oesophagus that allows them to speak. "Our device measures the air pressure and helps choose a valve that is right for the patient. It also helps us monitor a patient's progress."

10/17/2005 Houston, TX ER Gritz, C Dresler, and L Sarna Cancer Epidemiol. Biomarkers Prev., October 1, 2005; 14(10): 2287-93 Tobacco use is universally recognized as the foremost preventable cause of cancer in the United States and globally and is responsible for 30% of all cancer-related deaths in the United States. Tobacco use, including exposure to secondhand smoke has been implicated as a causal or contributory agent in an ever-expanding list of cancers, including lung, oral cavity and pharynx, pancreas, liver, kidney, ureter, urinary bladder, uterine cervix, and myeloid leukemia. In addition to and independent of the etiologic effects of tobacco carcinogens in numerous cancers, there is a growing literature on the direct and indirect effects of smoking on treatment efficacy (short-term and long-term outcomes), toxicity and morbidity, quality of life (QOL), recurrence, second primary tumors (SPT), and survival time as summarized below. Oncology health professionals have called for increased advocacy for tobacco control. Despite the critical relevance of smoking to cancer outcomes, most oncology clinical trials do not collect data on smoking history and status unless the malignancy is widely acknowledged as smoking related (e.g., lung or head and neck cancer). Usually, these data are collected only at trial registration. Changes in smoking status during treatment or follow-up are monitored in very few trials and are infrequently reported in sample descriptions or included in analysis plans as a potential moderator of outcomes. Based on mounting evidence that tobacco use affects cancer treatment outcomes and survival, we recommend that smoking history [...]

10/17/2005 Pittsburgh, PA Miranda Hitti WebMDHealth (mywebmd.com) The process of diagnosing cancer can be tricky, and when it goes wrong, it could impact patients, a new study shows. The report, published in Cancer, examines cancer diagnosis data from four unnamed U.S. institutions. The vast majority of cancer diagnoses had no errors. However, some errors in cancer diagnosis did show up, and experts had different opinions about how those errors might have affected patients. The researchers included Stephen Raab, MD. He works in the pathology department of the University of Pittsburgh's medical school. Diagnostic Errors The frequency of cancer diagnosis errors varied between the institutions, Raab's team notes. Errors were rare across the board. For gynecological cases, error frequency ranged from less than 2% to about 9%. For nongynecological cases, the range was nearly 5% to 12%, the researchers write. All four institutions showed a "relatively high number" of nongynecological errors from specimens taken from the urinary tract and lung, the researchers note. The Big Picture The researchers estimated how common diagnostic errors might be in the U.S., assuming similar figures nationwide. Take the Pap test, for example. The Pap test can screen for cancerous or precancerous abnormalities of the cervix, which is part of women's reproductive system. If 50 million U.S. women get Pap tests in a year, at least 150,000 of them would have a diagnostic error in their test's results, write the researchers. Or, let's say 5 million people got a nongynecological test, such as one from the [...]

10/14/2005 Simon Frantz [email protected] Forget drugs carefully designed to hit one particular molecule — a better way of treating complex diseases such as cancer may be to aim for several targets at once, says Simon Frantz. It's not often that a science lecture can turn a person on to the idea of promiscuity. But when Michael Heinrich heard a talk about a promising new cancer drug, it triggered a transformation of his ideas about how to target disease. It sounds heretical, but Heinrich and others are now saying that 'magic bullet' drugs designed to hit single biological targets might not be the answer to treating complex illnesses such as cancer and cardiovascular disease. The future, they say, could be in drugs that are less picky about their molecular partners. Heinrich's turning point was a seminar given in early 1998 at the Oregon Health and Science University Cancer Institute in Portland, where he worked. Brian Druker, a molecular biologist in the medical department at the same university, was talking about the revolutionary leukaemia treatment Gleevec (imatinib mesylate). Made by Swiss drug company Novartis, Gleevec was designed to zero in on a single protein in cancerous cells, specifically killing them while leaving healthy cells unharmed. It proved to be spectacularly effective and non-toxic. Compared with the relatively indiscriminate action and distressing side effects of conventional cancer treatments, Gleevec seemed to vindicate the single-target approach to drug discovery. But it soon became clear that Gleevec was not as specific as its creators had [...]

10/11/2005 Italy staff Medicinenews.net (www.xagena.it) A relatively common cancer susceptibility gene appears to be frequently acquired in metastatic lesions from colorectal cancer, and give cancer cells a growth advantage. Transforming growth factor beta ( TGF-beta ) is a potent naturally occurring inhibitor of cell growth. It exerts its action by binding to type I ( TGFBR1 ) and type II ( TGFBR2 ) receptors located on the cell membrane. Increased cell growth due to decreased TGF-beta growth inhibition may contribute to cancer development. TGFBR1*6A is a common polymorphism of TGFBR1. Previous studies have shown that TGFBR1*6A is one of the first candidate tumor susceptibility alleles that is found in a large proportion of the general population 13.7 percen) and significantly increases cancer risk by approximately 24 percent. How TGFBR1*6A contributes to cancer development is largely unknown. Boris Pasche, of Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a study that included 531 patients with a diagnosis of head and neck cancer, colorectal cancer, or breast cancer recruited from 3 centers in the United States and from 1 center in Spain from June 1, 1994, through June 30, 2004. Multiple genetic testing of the cancer cells was conducted. The researchers found that TGFBR1 mutated into TGFBR1*6A, i.e. was somatically acquired, in 13 of 44 ( 29.5 percent ) colorectal cancer metastases, in 4 of 157 ( 2.5 percent ) of colorectal tumors, in 4 of 226 ( 1.8 percent ) head and neck primary tumors, and in none of [...]