Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer
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Recent Results Cancer Res. · Jan 2003
ReviewChemoprevention of nonmelanoma skin cancer: experience with a polyphenol from green tea.
Nonmelanoma skin cancer is extremely common and is increasing in incidence. It would be very useful to have forms of therapy that would prevent precancerous changes from going on to form cancer, or to reverse the precancerous changes. Epidemiologic evidence in humans, in vitro studies on human cells, and clinical experiments in animals have identified polyphenol compounds found in tea to be possibly useful in reducing the incidence of various cancers, including skin cancer. To examine the potential for a polyphenol from green tea, epigallocatechin gallate, to act as a chemopreventive agent for nonmelanoma skin cancer, a randomized, double-blind, placebo-controlled phase II clinical trial of topical epigallocatechin gallate in the prevention of nonmelanoma skin cancer was performed.
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Recent Results Cancer Res. · Jan 2003
ReviewIs mammography screening for breast cancer really not justifiable?
The consensus that breast screening is effective for women aged 50-59 years was shattered when Gotzsche and Olsen suggested that there are no reliable data to support screening by mammography. In practice, their concerns have been difficult to address because for many studies purporting to show effectiveness, adequate data have not been published to confirm that they were valid. Further, the trials in Canada for which such data are available did not show effectiveness of screening mammography. ⋯ Whether screening will have an additional impact in the future is unclear. After reviewing the published evidence, I conclude that the additional contribution of mammography over screening by good breast physical examinations and breast self examination is to detect good prognosis breast cancers, as the benefit of screening derives from the earlier detection of relatively advanced breast cancers, providing good therapy is given. If women choose mammography screening, they should understand that their risk of dying in the next few years may not be reduced.
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Recent Results Cancer Res. · Jan 2000
ReviewAdjuvant therapy of malignant melanoma and the role of sentinel node mapping.
Controversy still exists about standard management of a primary melanoma. Over the last decades randomized phase III trials have addressed questions about the width of margin in relation to the Breslow thickness of the primary lesion, the role of prophylactic isolated limb perfusion, and the role of elective lymph node dissection. Overall these trials have demonstrated that less extensive surgery is as good as more extensive surgery. Wide excision margins, prophylactic isolated limb perfusions, or the elective lymph node dissection did not improve overall survival significantly in any of the phase III trials conducted. ⋯ Thus we now have a procedure by which the melanoma stage I-II population can be dissected in a group at truly high risk for recurrence and a group with truly low risk of recurrence. The high risk group with a greater than 75% chance for systemic disease can then be selected for trial participation of various systemic adjuvant therapy regimens that may be allowed to be toxic, considering the very high risk for relapse in these patients. The node negative group of patients can be selected for participation in trials evaluating systemic adjuvant treatment of low toxicity considering the low chance for distant metastatic disease.
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The postoperative mortality after esophagectomy still remains a major factor influencing the prognosis of esophageal cancer and largely depends on the patient's preoperative physiological status. A composite scoring system was developed to predict the risk of esophagectomy, based on quantitative assessment of preoperatively available physiological parameters. The scoring system was reviewed retrospectively on operated patients and evaluated prospectively in two subsequent patient groups. ⋯ Including this composite score into the process of patient selection and choice of procedure resulted in a decrease of postoperative mortality from 9.4% (52/553) to 1.2% (4/323) (p = 0.001). The risk of death after esophagectomy for esophageal cancer can be objectively assessed prior to surgery and quantified by a composite risk score. This score provides a useful tool in refining the criteria of patient selection for resection and choice of procedure, and markedly reduces postoperative mortality when applied prospectively.
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Recent Results Cancer Res. · Jan 1998
ReviewStrategies for the development of vaccines to treat breast cancer.
The characterization of tumor-associated antigens recognized by cellular or humoral effectors of the immune system has opened new perspectives for cancer therapy. Several categories of cancer-associated antigens have been described as targets for cytotoxic T lymphocytes (CTLs) in vitro and in vivo: "cancer-testis" (CT) antigens expressed in different tumors and normal testis, melanocyte differentiation antigens, point mutations of normal genes, antigens that are overexpressed in malignant tissues, and viral antigens. Clinical studies using peptides derived from these antigens have been initiated to induce specific CTL responses in vivo. ⋯ Recently, a strategy utilizing spontaneous antibody responses to tumor-associated antigens (SEREX) has led to the identification of a new CT antigen, NY-ESO-1. In a melanoma patient with high titer antibody against NY-ESO-1, strong HLA-A2-restricted CTL reactivity against the same antigen was also found. Clinical studies involving tumor antigens that induce both antibody and CTL responses will show whether these are better candidates for immunotherapy of cancer.