The Lancet Oncology ~ Volume 10 Number 5 May 2009 pp431-528 Oncology, Lancet, Volume, The, Number

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The Lancet Oncology " Volume 10 Number 5 May 2009 pp431-528

by:?Elsevier Limited
en?|?Elsevier Limited   


  
Leading Edge
431
Male circumcision: a cancer prevention strategy?  
The Lancet Oncology   

On March 26, 2009, the New England Journal of Medicine reported findings from a Ugandan trial on the effect of male circumcision on the prevalence of viral sexually transmitted infections, showing reduced incidence of HSV2 infection by 25% and of HPV infection by 35%. Previously, the same study group reported that male circumcision decreased HIV infection by 50–60%. In low-to-middle income countries cancer burden is increasing substantially, and infection is often the underlying cause. Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer?
Keynote Comment
432
EGFR testing in lung cancer is ready for prime time  
Fred R Hirsch, Paul A Bunn   

The epidermal growth factor receptor (EGFR) protein is widely expressed in non-small cell lung cancers (NSCLC), and the EGFR oncogene is sometimes amplified, often increased in copy number, and less frequently mutated with activating mutations.
Reflection and Reaction
434
A silver lining on the horizon for glioblastoma  
Jonathan P Knisely, Joachim M Baehring   

Glioblastoma multiforme is one of the worst diagnoses that a doctor can communicate to a patient; and despite the encouraging news included in the update on the European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups and the National Cancer Institute of Canada (EORTC-NCIC) intergroup study1 published in this issue of The Lancet Oncology, this remains the case. However, the nihilistic attitude toward this diagnosis should begin to dissipate as trials with in-depth pathological investigations continue to hew away at fundamental questions of the ontogenesis and management of this complex and refractory malignant disease.
435
Could it be that less is more?  
Brian E Lally, James J Urbanic, A William Blackstock   

Why is prophylactic cranial irradiation (PCI) used in small-cell lung cancer (SCLC)? The answer is simple: something seems to be better than nothing. A meta-analysis by Auperin and colleagues1 showed that PCI increases survival for patients with limited-stage small-cell lung cancer (LS-SCLC). A recent randomised trial of PCI versus no PCI for patients with extensive-stage small-cell lung cancer (ES-SCLC) came to a similar conclusion.2 Radiation is a very effective treatment that, when applied to a clinically negative brain, will increase the survival for patients with SCLC.
437
Radical prostatectomy: what have we learned?  
Joel B Nelson   

The primary goal of radical prostatectomy is to cure prostate cancer, and it is usually successful. The challenge is to remove this inhospitably located gland without irrevocably harming the patient. Buried deep in the bony pelvis, the prostate rests on the muscles of the pelvic floor, the sole source of postoperative urinary continence; it is enveloped by the fragile, hair-like nerves required for penile erections. Preserving these structures while simultaneously removing the gland is made more challenging by the abundant pelvic vascularity.
439
Population-based clinical epidemiology of familial cancer: lessons for oncologists  
Jeanette Falck Winther, John J Mulvihill   

In this issue of The Lancet Oncology, Hemminki and co-authors1 present the findings of a registry-based cohort study on familial risk of nervous-system tumours by histology with data from nationwide Swedish and Norwegian databases. In this population-based setting, including more than 54?000 patients with a nervous-system tumour, a little more than 22?000 patients belonged to the offspring generation, 709 of whom were familial cases—ie, the child and proband(s) (a parent, a sibling, or both) being affected.
440
Immune reconstitution after HLA mismatched haemopoietic stem-cell transplantation  
Olle Ringdén, Helen Karlsson, Brigitta Omazic   

As shown by graft-versus-leukaemia effects induced after haemopoietic stem-cell transplantation, the immune system can be used in the control of cancer.1 During the past three decades, haemopoietic stem-cell transplantation has progressed from being an experimental procedure to a curative option for many patients;2,3 and graft-versus-cancer effects have been noted for renal carcinoma, colon carcinoma, and other tumours.3
442
Concurrent hormone and radiation therapy in patients with breast cancer: how does chemotherapy affect treatment?  
Ke-Da Yu, Zhi-Ming Shao   

We read with great interest the Review by Chargari and colleagues,1 published in a recent issue of The Lancet Oncology. This content-rich paper is one of the best available reviews to elaborate on the rationale for concurrent hormone and radiation therapy in patients with breast cancer; however, an important issue was not addressed. In clinical practice, the addition of a chemotherapy regimen can affect the administration of concurrent radiation and hormone therapy, and so we discuss this topic here.
444
Concurrent hormone and radiation therapy in patients with breast cancer: how does chemotherapy affect treatment?  
Fernand Labrie, Céline Martel   

In a recent review in The Lancet Oncology, Chargari and colleagues1 conclude that “as long as there is no proof-of-principle study that demonstrates any benefit to adding endocrine therapy concurrently with breast or chest radiotherapy, hormonal therapy should be delayed until after completion of adjuvant radiation therapy in breast cancer patients”. However, preclinical studies of human breast-cancer xenografts in nude mice show an optimum reduction in breast-tumour size with simultaneous administration of the selective oestrogen receptor modulator, acolbifene (EM-800), with radiotherapy.
445
Concurrent hormone and radiation therapy in patients with breast cancer: how does chemotherapy affect treatment? – Authors' reply  
Cyrus Chargari, Nicolas Magné   

The sequencing of adjuvant therapies has become an important issue in the treatment of patients with breast cancer. There is considerable uncertainty whether radiotherapy and systemic therapies should be given concurrently.1 As highlighted in the letter from Shao and Yu, some studies suggest that concurrent radiotherapy with cyclophosphamide, methotrexate, and fluorouracil-based chemotherapy is better than sequential treatment, in terms of local recurrence, in patients with node-positive breast cancer.
Errata
446
Erratum  
?  
Hackethal A, Brueggman D, Bohlmann MK, Franke FF, Tinneberg H-R, Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol 2008; 9: 1173–80. In table 1, a ten-fold discrepancy in tumour size was caused by a conversion error of the cyst size from cm to mm. Furthermore, the patients with squamous-cell carcinoma in situ should have been excluded (Peuchmaur et al, 1989; Tobon et al, 1991; Dadhwal et al, 2002): these publications provided only limited data and exclusion does not change results significantly.
News
447
European laws on assisted suicide move in opposite directions  
Talha Burki   

On March 17, 2009, laws permitting voluntary euthanasia and assisted suicide came into force in Luxembourg. It became the third European country—after Belgium and the Netherlands—to enact such legislation. Switzerland permits assisted suicide (where the patient is provided with the means to die but has to administer it themselves) but not voluntary euthanasia (where a second party administers the means of death at the patient's request). All other European nations maintain bans against both practices.
448
US cancer centres hit hard by deteriorating economy  
Bryant Furlow   

12 million Americans have cancer and more than 560?000 die each year from the disease—figures that will climb as baby boomers age. But the global economic recession and 6 years of flat federal government funding for cancer research might leave US cancer centres moribund for the foreseeable future, the directors of several centres tell The Lancet Oncology.
450
No cure in sight for the world's drug problem  
David Holmes   

If you are a woman with ERBB2-positive advanced breast cancer that has failed to respond to therapy, lapatinib treatment could give you the chance to control your disease. Unless, that is, you are a patient of the UK National Health Service (NHS). Because on March 4, 2009, the UK National Institute of Clinical Excellence (NICE) ruled that the NHS should not prescribe lapatinib treatment as it is “not a cost-effective use of NHS resources”.
451
Sperm is subject to product liability laws in the US  
Norra MacReady   

When donor G738 gave his semen to Idant Laboratories, a sperm bank in New York City (NY, USA), he probably couldn't predict that it would become the focus of a landmark lawsuit testing the jurisdiction of product liability laws passed in different states. And, most likely, he was unaware of the genetic mutation he carried that set the lawsuit in motion.
452
UN declaration is the first step to counter racism in cancer care  
Georgina Kenyon  

Australia's formal adoption of the UN Declaration of the Rights of Indigenous Peoples in early April, 2009, is a step toward closing the gap on cancer care for Aborigines and Torres Straits Islanders throughout the country. But many health campaigners say that complex issues surrounding racism are the main barriers to receiving better cancer care for indigenous people.
453
A review of human carcinogens—Part C: metals, arsenic, dusts, and fibres  
Kurt Straif, Lamia Benbrahim-Tallaa, Robert Baan, Yann Grosse, Béatrice Secretan, Fatiha El Ghissassi, Véronique Bouvard, Neela Guha, Crystal Freeman, Laurent Galichet, Vincent Cogliano, on behalf of the WHO International Agency for Research on Cancer Monograph Working Group   

In March, 2009, 27 scientists from eight countries met at the International Agency for Research on Cancer (IARC) to reassess the carcinogenicity of metals, arsenic, dusts, and fibres previously classified as “carcinogenic to humans” (Group 1) and to identify additional tumour sites and mechanisms of carcinogenesis (table). These assessments will be published as part C of Volume 100 of the IARC Monographs.Members
Cancer and Society
455
Teenage Cancer Trust: pursuing equality  
Rob Brierley, David Holmes, Audrey Ceschia, Jill Jouret   

For many, the transition from childhood to adulthood is a difficult period of life. Physical and psychological changes can be rapid and at times overwhelming. Imagine, then, if these issues are compounded by the shadow of a life-threatening illness. Cancer in young people is not as uncommon as one might initially think—every year, some 2100 individuals aged 13–24 are diagnosed in the UK. Indeed, cancer is the most common cause of non-accidental death in this age group. Despite this, teenagers with cancer often find themselves being treated either on paediatric wards or with older patients, potentially leaving them feeling isolated, without their physical, psychological, and emotional needs being fully met.
Articles
459
Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial  
Roger Stupp, Monika E Hegi, Warren P Mason, Martin J van den Bent, Martin JB Taphoorn, Robert C Janzer, Samuel K Ludwin, Anouk Allgeier, Barbara Fisher, Karl Belanger, Peter Hau, Alba A Brandes, Johanna Gijtenbeek, Christine Marosi, Charles J Vecht, Karima Mokhtari, Pieter Wesseling, Salvador Villa, Elizabeth Eisenhauer, Thierry Gorlia, Michael Weller, Denis Lacombe, J Gregory Cairncross, René-Olivier Mirimanoff, on behalf of the European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups , the National Cancer Institute of Canada Clinical Trials Group   

Benefits of adjuvant temozolomide with radiotherapy lasted throughout 5 years of follow-up. A few patients in favourable prognostic categories survive longer than 5 years. MGMT methylation status identifies patients most likely to benefit from the addition of temozolomide.
467
Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 22003-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trial  
Cécile Le Péchoux, Ariane Dunant, Suresh Senan, Aaron Wolfson, Elisabeth Quoix, Corinne Faivre-Finn, Tudor Ciuleanu, Rodrigo Arriagada, Richard Jones, Rinus Wanders, Delphine Lerouge, Agnès Laplanche, on behalf of the Prophylactic Cranial Irradiation (PCI) Collaborative Group   

No significant reduction in the total incidence of brain metastases was observed after higher-dose PCI, but there was a significant increase in mortality. PCI at 25 Gy should remain the standard of care in limited-stage SCLC.
475
The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study  
Andrew J Vickers, Caroline J Savage, Marcel Hruza, Ingolf Tuerk, Philippe Koenig, Luis Martínez-Pi?eiro, Gunther Janetschek, Bertrand Guillonneau  

Increasing surgical experience is associated with substantial reductions in cancer recurrence after laparoscopic radical prostatectomy, but improvements in outcome seem to accrue more slowly than for open surgery. Laparoscopic radical prostatectomy seems to involve skills that do not translate well from open radical prostatectomy.
481
Familial risks in nervous-system tumours: a histology-specific analysis from Sweden and Norway  
Kari Hemminki, Steinar Tretli, Jan Sundquist, Tom B Johannesen, Charlotta Granstr?m   

Our results suggest a complex genetic background for nervous-system tumours, which differs depending on the age of onset and histological subtype of the tumour. High sibling risks might suggest recessive inheritance. As the high-penetrant multiplex families only accounted for about 5% of familial nervous-system tumours, most familial cases are probably caused by low-penetrance genes.
489
Infusion of suicide-gene-engineered donor lymphocytes after family haploidentical haemopoietic stem-cell transplantation for leukaemia (the TK007 trial): a non-randomised phase I–II study  
Fabio Ciceri, Chiara Bonini, Maria Teresa Lupo Stanghellini, Attilio Bondanza, Catia Traversari, Monica Salomoni, Lucia Turchetto, Scialini Colombi, Massimo Bernardi, Jacopo Peccatori, Alessandra Pescarollo, Paolo Servida, Zulma Magnani, Serena K Perna, Veronica Valtolina, Fulvio Crippa, Luciano Callegaro, Elena Spoldi, Roberto Crocchiolo, Katharina Fleischhauer, Maurilio Ponzoni, Luca Vago, Silvano Rossini, Armando Santoro, Elisabetta Todisco, Jane Apperley, Eduardo Olavarria, Shimon Slavin, Eva M Weissinger, Arnold Ganser, Michael Stadler, Evangelia Yannaki, Athanasios Fassas, Achilles Anagnostopoulos, Marco Bregni, Corrado Gallo Stampino, Paolo Bruzzi, Claudio Bordignon   

Infusion of TK-cells might be effective in accelerating immune reconstitution, while controlling GVHD and protecting patients from late mortality in those who are candidates for haploidentical stem-cell transplantation.
Review
501
Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement  
Jack Cuzick, Florian Otto, John A Baron, Powel H Brown, John Burn, Peter Greenwald, Janusz Jankowski, Carlo La Vecchia, Frank Meyskens, Hans J?rg Senn, Michael Thun   

Evidence clearly shows a chemopreventive effect for aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) on colorectal cancer and probably other cancer types; however, data on the risk–benefit profile for cancer prevention are insufficient and no definitive recommendations can be made. Aspirin has emerged as the most likely NSAID for use in chemoprevention because of its known cardiovascular benefit and available safety and efficacy data. Other traditional NSAIDs, particularly sulindac, and selective COX-2 inhibitors are now given to patients at high risk of colorectal cancer, although these drugs do not provide cardioprotection.
508
Mechanisms in the pathogenesis of malignant tumours in neurofibromatosis type 1  
Hilde Brems, Eline Beert, Thomy de Ravel, Eric Legius   

Neurofibromatosis type 1 (NF1) is a familial tumour syndrome. Malignant tumours can arise in the nervous and non-nervous system in either childhood or adulthood, with malignant peripheral nerve sheath tumours being most common. Rhabdomyosarcoma and neuroblastoma are paediatric neoplasms that are more common in children with NF1 than in those without the syndrome. Gastrointestinal stromal tumours, somatostatinomas, breast cancer, and phaeochromocytomas are seen in adults with NF1. Several pathways are thought to be involved in the development of tumours associated with NF1: rat sarcoma viral oncogene homologue (RAS)–mitogen activated protein kinase (MAPK), mammalian target of rapamycin (mTOR), and P21 protein (Cdc42/Rac)–activated kinase 1 (PAK1).
516
Melanoma of the small intestine  
Marko Lens, Veronique Bataille, Zoran Krivokapic   

Intestinal melanomas can be primary tumours or metastases of cutaneous, ocular, or anal melanomas. Primary intestinal melanoma is extremely rare, whereas metastatic melanoma of the small bowel is common because of the tendency for cutaneous melanoma to metastasise to the gastrointestinal tract. Because distinguishing between primary and metastatic intestinal melanoma can be difficult, the main features of each are discussed, and the diagnostic images used to detect intestinal melanoma are assessed.
Personal View
522
Should we be surprised at the paucity of response to EGFR inhibitors?  
Barry A Gusterson, Keith D Hunter   

Data suggest that neither our current understanding of the function and signalling of epidermal growth factor receptor (EGFR), nor measurements of receptor expression are reliably predictive of therapeutic responses to EGFR inhibitors. The time has now come to consider whether such poor correlation between receptor expression and clinical response is caused by poor assays or by more fundamental issues relating to the in-vivo function of EGFR. Revisiting some of the early findings of the biology of EGFR function and understanding the limitations of immunohistochemistry as a quantitative technique might provide some clues.
From the Archives
528
The bacterium that could cause cancer  
Sandro Vento, Matthew N Tanko                    http://rapidshare.com/files/246813733/The_Lancet_Oncology_Volume_10__Issue_5_May_2009a.rar