Taxane Followed by Anthracycline or Vice Versa—Reply

In Reply Dr Altundag suggests that giving a taxane first followed by an anthracycline, as was done in the FinXX trial, might be beneficial to patients who also receive capecitabine in the adjuvant setting. In the FinXX trial, the patients were randomly allocated to either 3 cycles of docetaxel followed by 3 cycles of cyclophosphamide, epirubicin, and fluorouracil or to 3 cycles of docetaxel plus capecitabine followed by 3 cycles of cyclophosphamide, epirubicin, and capecitabine. Therefore, the patients who participated in this trial received a taxane (docetaxel) first, followed by an anthracycline (epirubicin).

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VHL and Pancreatic Neuroendocrine Tumor in von Hippel–Lindau Disease

This study evaluates the natural history of von Hippel–Lindau disease–associated pancreatic lesions to determine the factors associated with pancreatic neuroendocrine tumor phenotype and prognosis.

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Hypermetabolic Vocal Cord Focus With Recurrent Oral Cancer History

A woman in her 80s with a history of recurrent oral cancer was diagnosed with squamous cell carcinoma located at the margin of a palatal graft; surveillance imaging reveals metabolic activity in her left vocal cord. What is your diagnosis?

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HER3 and Panitumumab Efficacy in Advanced Colorectal Cancer

This biomarker study examines the efficacy of irinotecan plus panitumumab in patients with advanced colorectal cancer whose tumors had high HER3 messenger RNA expression.

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Error in Kaplan-Meier Curves

In the Original Investigation titled "Proton Beam Radiotherapy and Concurrent Chemotherapy for Unresectable Stage III Non–Small Cell Lung Cancer: Final Results of a Phase 2 Study," published online July 20, 2017, there were errors in Figure 2a in the Kaplan-Meier curves. This article was previously corrected in September 2017 to fix the numbers at risk in Figure 2a. This article was corrected online.

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Taxane Followed by Anthracycline or Vice Versa

To the Editor I want to congratulate Joensuu and colleagues for their article in which they investigated the effect of adjuvant capecitabine in combination with docetaxel, epirubicin, and cyclophosphamide for early breast cancer. They reported that capecitabine with docetaxel, epirubicin, and cyclophosphamide did not prolong recurrence-free survival or overall survival compared with a regimen that contained only standard agents. Patients with triple-negative breast cancer had favorable survival outcomes when treated with the capecitabine-containing regimen in an exploratory subgroup analysis. Herein, I want to touch on the sequential order of taxane and anthracycline therapy in breast cancer. Pachmann et al hypothesized that a neoadjuvant regimen of a taxane followed by an anthracycline may result in a greater decline in the amount of circulating breast cancer cells than the regimen of an anthracycline followed by a taxane. The study showed that neoadjuvant chemotherapy with paclitaxel in patients with breast cancer interestingly causes the release of breast cancer cells into circulation, while at the same time reducing tumor size. In this study, during the applied combination therapy, 3 different phases were observed: an initial decline in the number of circulating tumor cells during the epirubicin-containing part of the regimen, followed by a steep increase during paclitaxel treatment, and a subsequent redecrease if a third regimen with the cyclophosphamide-methotrexate-fluorouracil combination was administered. This, in turn, might lead to longer-term survival benefit if the taxane is administered first in the neoadjuvant setting. Taken all together, I assume that giving a taxane first followed by an anthracyline as in the current FinXX Trial might show additional benefit with adjuvant capecitabine in patients with high-risk breast cancer.

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Incorrect Hazard Ratio in Figure 2

In the article titled "Prognostic and Predictive Relevance of Primary Tumor Location in Patients With RAS Wild-Type Metastatic Colorectal Cancer: Retrospective Analyses of the CRYSTAL and FIRE-3 Trials," an incorrect hazard ratio on the right panel of Figure 2B has been corrected from 1.44 to 1.31. The article was corrected online.

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Association of 70-GS Findings With Treatment Guidance for Patients With Early Breast Cancer

This study determines whether 70-gene signature assay findings are associated with physicians' adjuvant treatment recommendations among patients with early breast cancer.

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Where is the Road-Map for Glioblastoma?

Muscoe was an architect with an impeccable sense of direction and we were lost on the way to our son's soccer game, a route we had navigated many times before. That should have been my first clue. But the signs and symptoms of glioblastoma multiforme (GBM) emerge slowly and intermittently, and they are easy to explain away, at first. Why was he not paying attention to me—drifting off in the middle of a response when I asked him a question. Was he having an affair? Lyme disease was a much more acceptable diagnosis, so when the astute primary care physician we went to see for a Lyme titer test suggested a computed tomographic scan of the head, "just to be sure," I dropped my husband at the hospital for the scan and pushed on to work. He called me a couple of hours later reporting that they saw something. I raced to the hospital to meet him, but when I got there, he was gone.

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Legionnaires' Effect on Smell

Condition:   Legionnaires' Disease
Intervention:   Other: The University of Pennsylvania Smell Identification Test (UPSIT)
Sponsor:   University of Pennsylvania
Recruiting

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Adjuvant Pembrolizumab for Patients With Locally Advanced Esophageal Squamous Cell Carcinoma at High Risk of Recurrence

Condition:   Esophageal Squamous Cell Carcinoma
Intervention:   Drug: Pembrolizumab
Sponsors:   National Taiwan University Hospital;   Merck Sharp & Dohme Corp.
Not yet recruiting

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Perioperative Tonsillectomy Protocol Development

Condition:   Tonsillitis
Interventions:   Drug: Acetaminophen and High-Dose Dexamethasone;   Drug: Acetaminophen and Low-dose Dexamethasone;   Drug: Placebo and Low-dose Dexamethasone
Sponsor:   London Health Sciences Centre
Not yet recruiting

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Phase I/II Trial of Epacadostat, Intralesional SD101, Radiotherapy in Patients With Lymphoma

Conditions:   Advanced Solid Tumors;   Lymphoma
Interventions:   Drug: epacadostat;   Drug: SD-101;   Radiation: Radiotherapy
Sponsor:   University of California, Davis
Not yet recruiting

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EPR Tumor Oximetry With CE India Ink

Conditions:   Neoplasms, Malignant;   Breast Neoplasm;   Carcinoma, Basal Cell;   Carcinoma, Squamous Cell;   Melanoma;   Skin Neoplasm;   Head and Neck Neoplasms
Interventions:   Device: Carlo Erba Ink Injection;   Other: EPR Oximetry Measurement
Sponsors:   Harold M. Swartz;   National Cancer Institute (NCI)
Recruiting

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Epigenetic reprogramming in liver fibrosis and cancer

Publication date: Available online 25 October 2017
Source:Advanced Drug Delivery Reviews
Author(s): Caroline L. Wilson, Derek A. Mann, Lee A. Borthwick
Novel insights into the epigenetic control of chronic liver diseases are now emerging. Recent advances in our understanding of the critical roles of DNA methylation, histone modifications and ncRNA may now be exploited to improve management of fibrosis/cirrhosis and cancer. Furthermore, improved technologies for the detection of epigenetic markers from patients' blood and tissues will vastly improve diagnosis, treatment options and prognostic tracking. The aim of this review is to present recent findings from the field of liver epigenetics and to explore their potential for translation into therapeutics to prevent disease promoting epigenome reprogramming and reverse epigenetic changes.

Graphical abstract

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Effect of Post-operative Ibuprofen After Surgery for Chronic Rhinosinusitis

Condition:   Chronic Rhinosinusitis (Diagnosis)
Interventions:   Drug: Ibuprofen 400 mg;   Drug: Acetaminophen 650 mg;   Drug: OxyCODONE 5 Mg Oral Tablet
Sponsor:   University of Washington
Recruiting

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Diabetes: the disease of the 10 D

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Diabetes: the disease of the 10 D

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Serum exosomal miR-301a as a potential diagnostic and prognostic biomarker for human glioma

Abstract

Purpose

Exosomal miRNAs that play an important role in cell-cell communication have attracted major attention as potential diagnostic and prognostic biomarkers for various cancers. The aim of this study was to determine the diagnostic/prognostic significance of serum exosomal miR-301a in glioma patients.

Methods

Quantitative real-time PCR was used to determine the serum exosomal expression levels of miR-301a. Kaplan-Meier survival analyses, Cox regression analyses and ROC working curve analyses were applied to assess the diagnostic and prognostic values of miR-301a in glioma patients. Also, several in vitro assays were used, including proliferation, invasion and cell signaling assays.

Results

First, we established that serum exosomal miR-301a extracted from grade IV glioblastoma (GBM) patients was biologically active, i.e., promoted the proliferation and invasion of glioma-derived H4 cells. Subsequently, we found that serum exosomal miR-301a levels were significantly up-regulated in glioma patients compared to healthy controls. Additionally, we found that increased serum exosomal miR-301a levels were correlated with ascending pathological grades and lower Karnofsky performance status (KPS) scores. Importantly, we also found that the serum exosomal miR-301a levels were significantly reduced after surgical resection of primary tumors and increased again during GBM recurrence. Kaplan-Meier analysis of patients with an advanced pathological grade (III or IV) and an increased serum exosomal miR-301a level revealed a longer overall survival (OS) compared to those with a lower level (p < 0.01). Both univariate and multivariate Cox regression analyses confirmed that serum exosomal miR-301a levels are independently associated with OS. Finally, we found that miR-301a may activate the AKT and FAK signaling pathways by down regulating PTEN.

Conclusions

Our data indicate that serum exosomal miR-301a levels may reflect the cancer-bearing status and pathological changes in glioma patients. Serum exosomal miR-301a expression may serve as a novel biomarker for glioma diagnosis and as a prognostic factor for advanced grade disease.

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A RHIM with a View: FLYing with Functional Amyloids

Publication date: 17 October 2017
Source:Immunity, Volume 47, Issue 4
Author(s): Sunny Shin, Sara Cherry
Recognition of bacterial peptidoglycan by the Drosophila IMD pathway triggers NF-κB activation and an associated immune response. In this issue of Immunity, Kleino et al. (2017) show that proteins in the IMD pathway form functional amyloids via a cryptic motif resembling the RHIM motif found in mammalian RIPK proteins. Amyloid formation can be negatively regulated, suggesting that it presents a regulatory point in multiple biological processes.

Teaser

Recognition of bacterial peptidoglycan by the Drosophila IMD pathway triggers NF-κB activation and an associated immune response. In this issue of Immunity, Kleino et al. (2017) show that proteins in the IMD pathway form functional amyloids via a cryptic motif resembling the RHIM motif found in mammalian RIPK proteins. Amyloid formation can be negatively regulated, suggesting that it presents a regulatory point in multiple biological processes.


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