According to a new meta-analysis, consolidation therapy for patients with acute myeloid leukemia (AML) that includes autologous bone marrow transplantation is associated with a modest improvement in disease-free survival but not with an improvement in overall survival, results that do not support the routine use of autologous bone marrow transplantation in patients who are in their first remission of the disease.
About 80% of patients with AML will go into remission after chemotherapy treatment. To prevent a relapse, many patients then receive consolidation therapy with allogeneic (meaning cells are taken from a sibling) bone marrow transplantation, autologous (meaning cells are taken from the patient) bone marrow transplantation, or intensive chemotherapy. However, it is unclear which of these is optimal.
Paul C. Nathan, Lillian Sung, M.D., and colleagues from the Hospital for Sick Children, Toronto, conducted a meta-analysis of six studies to compare the efficacy of autologous bone marrow transplantation with that of non-myeloablative chemotherapy alone or no further treatment. They found that, compared with patients who received chemotherapy or no further treatment, patients who received autologous bone marrow transplantation had a better disease-free survival but a similar overall survival. "Our results do not support the routine use of autologous bone marrow transplantation in adult acute myeloid leukemia patients in first remission," the authors write.
Contact: Laura Greer, Hospital for Sick Children, 416-813-5046, laura.greer@sickkids.ca.
Imatinib Interferes With Growth of Neuroblastoma Cells
The cancer drug imatinib inhibited the growth of neuroblastoma cells in culture and in a mouse model, suggesting that the drug should be tested as a possible treatment for advanced neuroblastoma, a new study concludes.
Neuroblastoma is the most common solid extracranial tumor of early childhood, and patients with advanced disease have few treatment options and a poor prognosis. Neuroblastoma cells express platelet-derived growth factor (PDGF), stem cell factor (SCF), and vascular endothelial growth factor (VEGF) and their respective receptors, PDGFR, c-Kit, and Flk-1. Kiichiro Beppu, Carol J. Thiele, Ph.D., and colleagues from the Pediatric Oncology Branch at the National Cancer Institute evaluated the effects of imatinib--a selective inhibitor of the tyrosine kinase activities of c-Kit and PDGFR--on the growth of neuroblastoma cells in culture and in a mouse model.
They found that neuroblastoma cell lines treated with imatinib displayed concentration-dependent decreases in cell viability. Neuroblastoma tumor-bearing mice that were treated with imatinib had smaller tumors than similar mice treated with saline. The authors conclude that the growth inhibition of neuroblastoma cells was associated with suppression of PDGFR and c-Kit phosphorylation and VEGF expression.
Contact: NCI Press Office, 301-496-6641; ncipressofficers@mail.nih.gov
Study Quantifies Risk of Rare Uterine Cancers Associated With Tamoxifen Use
There is a known increase in risk of endometrial cancer among women who have been treated with tamoxifen for breast cancer. Some studies have indicated that that risk is substantially higher for rare, aggressive forms of uterine tumors. In a Brief Communication, Rochelle E. Curtis and colleagues from the Division of Cancer Epidemiology and Genetics at the National Cancer Institute report their calculated estimates of that risk.
Using data from NCI's Surveillance, Epidemiology, and End Results (SEER) program, the authors calculated that among breast cancer patients diagnosed from 1980 through 2000 who were initially treated with tamoxifen, the overall risk of subsequent uterine corpus cancer was increased more than twofold relative to the general SEER population. The relative risk was substantially higher for malignant mixed mullerian tumors (MMMTs) than for endometrial adenocarcinomas, although the excess absolute risk was smaller--an additional 1.4 versus 8.4 cancers per 10,000 women per year, respectively. Among those who survived for 5 years or longer, there was an eightfold relative risk for MMMTs and a 2.3-fold risk for endometrial adenocarcinomas, with patients developing MMMTs having a worse prognosis. According to the authors, these findings indicate that tamoxifen may have delayed effects, such as the increased risk of MMMTs, rare but aggressive tumors of unclear pathogenesis.
Contact: NCI Press Office, 301-496-6641; ncipressofficers@mail.nih.gov
Titles of additional articles appearing in the January 7 JNCI:
- BRCA1 and BRCA2 founder mutations and the risk of colorectal cancer, and Frequency of BRCA1 and BRCA2 mutations in unselected Ashkenazi Jewish patients with colorectal cancer: http://www.eurekalert.org/emb_releases/2004-01/jotn-bmn122903.php
- A prospective study of aspirin use and the risk of pancreatic cancer in women: http://www.eurekalert.org/emb_releases/2004-01/jotn-aum122903.php
- Active smoking, passive smoking, and breast cancer: Evidence from the California Teachers Study: http://www.eurekalert.org/emb_releases/2004-01/jotn-asa122903.php
- Anticancer chemosensitization and radiosensitization by the novel poly(ADP-ribose) polymerase 1 inhibitor AG14361; Christopher Calabrese, Nicola J. Curtin, et al., Northern Institute for Cancer Research, University of Newcastle upon Tyne, U.K.
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