October 27, 2008 (Philadelphia, Pennsylvania) — Patients hospitalized with solid tumors who are also on statin therapy have a significantly lower risk for venous thromboembolism (VTE) than those not taking the lipid-lowering agents, according to research presented here at CHEST 2008, the American College of Chest Physicians 74th Annual Scientific Assembly.

Results of a retrospective case–control study were presented by principal investigator Danai Khemasuwan, MD, a resident in the Department of Internal Medicine at Albert Einstein Medical Center in Philadelphia, Pennsylvania.

The study involved 740 consecutive patients admitted with a variety of solid tumors, including breast, lung, colon, prostate, stomach, esophagus, pancreas, ovary, kidney, and brain cancer, between October 2004 and September 2007. Mean age was 65 years. The study population was roughly half men and half women, and 76% were African American. Patients treated with anticoagulation therapy before hospitalization were excluded from the study.

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NEW YORK (Reuters Health) Oct 27 - Bisphenol A at nanomolar concentrations confers chemoresistance in breast cancer cells in culture, according to a report in the October 6th issue of Environmental Health Perspectives.

Bisphenol A is an additive in many plastic products, including drinking bottles and the lining of food cans, and has been in the news lately as a potential health hazard. It has been suspected to promote carcinogenesis, based on its structural similarity to diethylstilbestrol (DES), the authors explain, but few studies have examined its potential effects on chemotherapeutic efficacy.

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NEW YORK (Reuters Health) Oct 27 - The results of a small study suggest that nearly a third of patients who undergo allogeneic hematopoietic stem cell transplantation will develop Clostridium difficile infection, and that those with leukemia are at much greater risk than patients with lymphoma.

“To our knowledge, this is the first study to examine the rates of Clostridium difficile infection in the allogeneic stem cell transplantation population,” Dr. Sharon S. Leung, from Albert Einstein College of Medicine in New York, told Reuters Health.

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October 28, 2008 — Mutations in the BRAF gene limit the response to anti-epidermal growth-factor receptor (anti-EGFR) therapy in patients with metastatic colorectal cancer, researchers reported at the 20th Annual European Organization for Research and Treatment of Cancer (EORTC)–National Cancer Institute (NCI)–American Association for Cancer Research (AACR) Symposium on Molecular Targets and Cancer Therapeutics, in Geneva, Switzerland. BRAF-mutation status can therefore help identify patients who are most likely to benefit from treatment with the monoclonal antibodies cetuximab (Erbitux; ImClone, Merck) and panitumumab (Vectibix, Amgen).

“Our data clearly point out BRAF mutations as another determinant of resistance to EGFR-targeted monoclonal antibodies,” said lead author Federica Di Nicolantonio, PharmD, PhD, from the Institute for Cancer Research and Treatment at the University of Turin School of Medicine, in Italy.

She pointed out that none of the patients in their study who had tumors containing BRAF mutations responded to anti-EGFR treatment. Conversely, none of the patients who responded to treatment had BRAF mutations.

Panitumumab and cetuximab are effective in an estimated 10% to 20% of chemotherapy-refractory metastatic colorectal cancer patients. Mutations in the KRAS gene are associated with resistance to both cetuximab and panitumumab, as previously reported by Medscape Oncology, and account for approximately 30% to 40% of resistant patients.

“None of the KRAS-mutated patients had BRAF mutations; mutations in these 2 genes are known to be mutually exclusive in colorectal cancer,” Dr. Di Nicolantonio told Medscape Oncology. “The overall frequency of BRAF-V600E mutations in our entire cohort was 10%, which is well within the published range.”

The goal of this study was to retrospectively analyze objective tumor responses, time to progression, overall survival, and the mutational status of KRAS and BRAF in 114 tumors from patients with advanced colorectal cancer who had been treated with cetuximab or panitumumab. Their secondary objective was to assess the effect of mutated BRAF on cetuximab or panitumumab response in cellular models of colorectal cancer.

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October 29, 2008 — In an observational study, the use of cholesterol-lowering statins was associated with a 4% median decline in prostate-specific antigen (PSA) levels in men without prostate cancer, from a mean of 0.9 ng/mL to 0.86 ng/mL. The decline is statistically significant, according to a report published online October 28 in the Journal of the National Cancer Institute.

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NEW YORK (Reuters Health) Oct 28 - A new strategy that improves survival in stage III ovarian cancer patients is not cost-effective in the short term but would be cost-effective in the long term if the survival advantage persists, according to a paper in the September issue of the Journal of Clinical Oncology.

The new approach, employed in women with optimally resected ovarian cancer, uses a combination of intraperitoneal and intravenous chemotherapy. Dr. Laura J. Havrilesky of Duke University Medical Center in Durham, North Carolina, and colleagues explain that in a previous trial in women with stage III ovarian cancer, intraperitoneal cisplatin and paclitaxel plus intravenous paclitaxel yielded a survival advantage of more than a year compared with intravenous cisplatin and paclitaxel alone.

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NEW YORK (Reuters Health) Oct 28 - A cluster of gene variants on chromosome 15 associated with lung cancer risk also appear to affect risk for nicotine dependence, epidemiologists at the University of Texas M. D. Anderson Cancer Center report.

Three independent genome-wide association studies previously identified single nucleotide polymorphisms strongly associated with risk of lung cancer, Dr. Margaret R. Spitz and colleagues explain in the November 5 Journal of the National Cancer Institute.

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October 29, 2008 — Editor’s note: Widespread prevalence of human papillomavirus (HPV), as well as increasing recognition of the role of HPV in cervical and other cancers, has led to a public-health strategy of vaccinating girls and women 9 to 26 years old against HPV. Presentations at the National Association of Nurse Practitioners in Women’s Health (NPWH) meeting, held from October 15 to 18 in Seattle, Washington, described how the nurse practitioner is uniquely positioned to counsel patients about the importance of following vaccination recommendations and to ensure follow-through with screening and management.

To learn more about practical management of HPV, Medscape interviewed Nancy R. Berman, MSN, APRN, BC, a nurse practitioner in women’s health and colposcopist with the Millennium Medical Group, PC, in Southfield, Michigan. Ms. Berman, who presented at NPWH, is also a member of the Michigan Cervical Cancer Consortium and the Governor’s Task Force on Cervical Cancer, and Cochair of the Patient Education Committee for the American Society for Colposcopy and Cervical Pathology.

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