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Old marker may give new insight into outcomes in kidney cancer
Unexpected catch nets a possible gain in Ewing sarcoma
A protein that was once the molecule of the moment for its ability to predict heart disease is now showing promise in predicting survival of patients with renal cell carcinoma, or kidney cancer.
According to an article in the July 14 edition of Molecular Diagnosis & Therapy, senior author Viraj Master, MD, PhD and director of urology clinical research at Winship Cancer Institute, clinicians should consider taking pre-operative levels of C-Reactive protein (CRP) into account when treating patients with localized renal cell carcinoma. CRP is a marker for inflammation, which is considered by many to be a cause of diabetes, some cancers, arthritis and other serious illnesses.
The study, which looked at 257 patients with localized RCC who underwent surgery to remove a kidney, sought to determine what effect, if any, lifestyle factors have on the prognostic value of CRP levels in patients with localized disease. The researchers looked at several variables, including tumor size, stage of disease and CRP levels. They found that CRP level “remained a robust predictive tool” — even when the analysis was controlled for other lifestyle factors.
About 30 percent of patients with localized RCC eventually develop metastatic disease, despite having potentially curative surgery. Thus, the study is significant because it may help clinicians know better how to treat those patients whose CRP levels are elevated.
“Prognostic tools are very important in the management of cancer,” says Master. “Knowing how a patient may do after surgery provides insight into knowing how to treat them before surgery. We hope this study advances that knowledge.”
Lung cancer screening available for heavy smokers aged 55 to 74
A study conducted at 33 centers nationwide showed that low-dose CT scanning of heavy smokers resulted in a 20 percent decrease in mortality from lung cancer. Between August, 2002 and April, 2004, the National Lung Screening Trial enrolled more than 53,000 people at high risk of developing lung cancer. They were randomly assigned to receive either low-dose CT scanning or a chest X-ray as a means to detect lung cancer. Data were collected on the participants through 2009. Deaths from lung cancer were reduced by 20 percent in the group who underwent the low-dose CT scans. The results were published this summer in the New England Journal of Medicine.
“I think all of us who were working on it were very pleased,” says Kay Vydareny, MD, professor emerita of thoracic radiology, who was the principal investigator at the Emory University School of Medicine site. “It seemed to have such strong conclusions for the narrow age range we were studying.” That age range was 55 to 74.
Emory Healthcare began offering low-dose CT scans in August to screen current and former heavy smokers aged 55 to 74. Vydareny explains that there is likely to be a high rate of false positives – that is, scans may suggest a lesion or mass that likely will turn out to be benign. Those who wish to be scanned should be braced for that possibility, she says, because false positives can cause anxiety and often necessitate further testing.
If you or someone you know is interested in having a low-dose CT scan, and you are between 55 and 74 and have been a heavy smoker, call 404-686-LUNG, or visit: www.emoryhealthcare.org/lungCT.
Erwin Van Meir, PhD, and research associate Shaoman Yin, PhD, started a fishing expedition with a tiny bit of bait – a small chemical molecule – and ended up reeling in a big finding – that the molecule binds with an oncoprotein at the root of Ewing sarcoma, a childhood cancer that has been particularly challenging to treat.
The Ewing sarcoma family of tumors share something in common, explains Van Meir, director of Winship’s Cancer Cell Biology scientific program and professor of neurosurgery, hematology and medical oncology. That is the unique translocation of chromosomes 11 and 22, which fuses two unrelated genes into a new chimeric gene. This abnormal gene encodes oncoprotein EWS/FLI1, which is the molecular signature of Ewing tumors and is only found in the tumor cells. That translocation is, as Van Meir describes it, “a nasty fusion.” But as it turns out, the molecule the two went fishing with reprograms the oncoprotein.
“The tumor cells don’t like it,” Van Meir says. “They start dying.” This work resulted in Van Meir and Yin receiving a $100,000 grant from the Samuel Waxman Cancer Research Foundation to study the reprogramming of Ewing sarcoma with the molecule that targets the EWSFLI1 oncoprotein. “We are very grateful to the foundation,” says Van Meir. “These are critical seed funds.”
The next step will be to understand just how the molecule reprograms the tumor cells and whether it can antagonize Ewing tumor growth in mouse models. “If all this ends up being successful, we hope it will be destined for a clinical trial,” says Van Meir.
Short-term hormone therapy in combination with radiation therapy increases survival rates for men with early-stage prostate cancer
The largest randomized trial of its kind has demonstrated that short-term hormone therapy (androgen deprivation therapy, or ADT), when given in combination with radiation therapy for men in early-stage prostate cancer increases survival rate when compared with that of those who receive the same radiation therapy alone. The study was conducted by the Radiation Therapy Oncology Group (RTOG) and published in the New England Journal of Medicine July 14. The study followed the health status of almost 2,000 men at low and intermediate risk of prostate cancer progression for a nine-year span at 212 centers in the United States and Canada. The study’s findings may have a significant effect on treatment methods for prostate cancer, a disease which is estimated to affect about 240,890 American men in 2011.
The authors of the study have also indicated that the increased radiation dosages combined with modern treatment technology, which have demonstrated high success rates, could potentially provide benefits equal to or greater than the addition of short-term ADT. “RTOG launched a trial in 2009 to examine the role of short-term ADT combined with modern radiotherapy techniques for men with intermediate-risk prostate cancer,” says Walter J. Curran, Jr., executive director of Winship Cancer Institute and RTOG Group Chair. “The results of the RTOG 0815 trial will build on the important knowledge gained from the landmark study findings.”