The lancet oncology
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The lancet oncology · Apr 2008
Comparative StudyIntrinsic markers of tumour hypoxia and angiogenesis in localised prostate cancer and outcome of radical treatment: a retrospective analysis of two randomised radiotherapy trials and one surgical cohort study.
Expression of intrinsic markers of tumour hypoxia and angiogenesis are important predictors of radiotherapeutic, and possibly surgical, outcome in several cancers. Extent of tumour hypoxia in localised prostate cancer is comparable to that in other cancers, but few data exist on the association of extent of tumour hypoxia with treatment outcome. We aimed to study the predictive value of intrinsic markers of tumour hypoxia and angiogenesis in localised prostate cancer, both in patients treated with radiotherapy and in those treated surgically. ⋯ To our knowledge, this is the largest study of intrinsic markers of hypoxia and angiogenesis in relation to the outcome of radical treatment of localised prostate cancer. Increased expression of VEGF, HIF-1 alpha, and, for patients treated with surgery, osteopontin, identifies patients at high risk of biochemical failure who would be suitable for enrolment into trials of treatment intensification.
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The lancet oncology · Apr 2008
ReviewTherapeutic stem-cells for cancer treatment: hopes and hurdles in tactical warfare.
As our understanding of stem-cell behaviour rapidly increases, more and more reports suggest that use of stem-cell therapy will extend well beyond regenerative medicine in the near future. Due to their inherent tumoritropic migratory properties, stem cells can serve as vehicles for the delivery of effective, targeted treatment to isolated tumours and to metastatic disease. In vitro, stem cells can readily be engineered by inserting specifically tailored transgenes with antitumour effects to create tumour-seeking therapeutic vehicles. ⋯ Many of these strategies have been validated in a wide range of studies assessing treatment feasibility or efficacy and establishing methods for real-time monitoring of stem-cell migration and fate in vivo. New insights into avenues for stem-cell sourcing have shortened the probable time to realisation of such treatments for patients. In this Review, we provide an outline of the rationale and status of stem-cell-based treatments for tumours, and we discuss prospects for clinical implementation and the factors crucial for maintaining momentum towards this goal.
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The lancet oncology · Apr 2008
Randomized Controlled Trial Multicenter StudyThe UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial.
The international standard radiotherapy schedule for breast cancer treatment delivers a high total dose in 25 small daily doses (fractions). However, a lower total dose delivered in fewer, larger fractions (hypofractionation) is hypothesised to be at least as safe and effective as the standard treatment. We tested two dose levels of a 13-fraction schedule against the standard regimen with the aim of measuring the sensitivity of normal and malignant tissues to fraction size. ⋯ The data are consistent with the hypothesis that breast cancer and the dose-limiting normal tissues respond similarly to change in radiotherapy fraction size. 41.6 Gy in 13 fractions was similar to the control regimen of 50 Gy in 25 fractions in terms of local-regional tumour control and late normal tissue effects, a result consistent with the result of START Trial B. A lower total dose in a smaller number of fractions could offer similar rates of tumour control and normal tissue damage as the international standard fractionation schedule of 50 Gy in 25 fractions.
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The lancet oncology · Apr 2008
Genomic DNA hypomethylation as a biomarker for bladder cancer susceptibility in the Spanish Bladder Cancer Study: a case-control study.
DNA hypomethylation has been suggested to cause genomic instability and increase cancer risk. We aimed to test the hypothesis that DNA hypomethylation is associated with increased risk of bladder cancer. ⋯ For the first time, to our knowledge, we have shown in a large case-control study that leucocyte DNA hypomethylation is associated with increased risk of developing bladder cancer, and this association is independent of smoking and the other assessed risk factors. Amount of global methylation in genomic DNA could provide a useful biomarker of susceptibility to certain cancer types and further research is warranted.