Other highlights in the February 15 JNCI

Parallel administration of chemotherapy and an anti-anemia drug called darbepoetin alfa every 3 weeks is safe and effective, according to a new study.

Chemotherapy can reduce the bone marrow's ability to produce red blood cells leading to anemia. Anemia is a common side effect among cancer patients receiving chemotherapy. There are drugs available that are often given in conjunction with chemotherapy to counteract anemia. In the United States, one such drug, called darbepoetin, is often given to cancer patients once every week or every other week. In Europe, some anemic cancer patients receive darbepoetin every third week, synchronizing the treatment with chemotherapy administration. However, past studies have not investigated whether dual administration of chemotherapy and darbepoetin every 3 weeks is as safe and effective as the established weekly regimen.

Jean-Luc Canon, M.D., at the Centre Hospitalier Notre Dame et Reine Fabiola in Charleroi, Belgium, and colleagues performed a phase III clinical trial in which 705 anemic cancer patients were randomly assigned to receive darbepoetin treatment every week or every third week at 110 European medical centers.

Compared with patients who received weekly treatment, a fewer number of patients who received treatment every 3 weeks required blood transfusions from week 5 of treatment onwards. Patients taking darbepoetin every third week, synchronized with chemotherapy, had similar hemoglobin levels, and experienced equivalent side effects as patients taking darbepoetin weekly.

The authors conclude that patients with anemia can effectively be treated with darbepoetin every third week with no additional health risks.

Contact: Jean-Luc Canon, M.D., 0032-7128-1681, canon.jl@chndrf.be

Gene Expression Profiling Identifies Certain High-Risk Breast Cancer, Study Suggests

Measuring gene expression may provide more accurate information for certain breast cancers than classification based on laboratory examination of tumor tissue, or histologic grade, alone, according to a new study.

Thirty to sixty percent of all breast cancer tumors are typed as histologic grade 2, with an intermediate rate of recurrence. However, this information does not help doctors make better clinical decisions about the type of therapy a patient should receive.

Christos Sotiriou, M.D., Ph.D., of the Jules Bordet Institute in Brussels, Belgium, and colleagues examined microarray data from 189 invasive breast cancers and three published sets of gene expression data in breast cancers to determine if gene expression profiling might help doctors make clinical decisions more accurately than histologic grade. The researchers identified a 97-gene expression score associated with the tissue grade of the tumor. A high expression score meant the patient was at higher risk of breast cancer recurrence, whereas a low score meant a patient had a lower risk of breast cancer recurrence.

Gene expression profiling may improve the accuracy of tumor grading and thus its prognostic value, the authors conclude.

Contact: Christos Sotiriou, 32-2-541-34-28, christos.sotiriou@bordet.be

Study Examines Gene Silencing in Prostate Cancer

The observation that specific genes are silenced in both tumor tissue and in surrounding stromal tissue in prostate cancer patients suggests that studying this silencing mechanism--called promoter methylation, an epigenetic change that shuts down or diminishes the expression of the gene--may help scientists better understand prostate carcinogenesis and provide information about therapeutic targets, a new study concludes.

Karen Woodson, Ph.D., and colleagues at the National Cancer Institute, studied gene methylation in three genes--GSTP1, RARbeta2, and CD44--that are known to play a role in the development of prostate cancer. They looked at the methylation status of these genes in the tumor epithelia, tumor-associated stroma and normal adjacent tissues of five patients with prostate cancer and in the normal epithelia and stroma of five patients without prostate cancer. The authors observed more frequent gene methylation in the non-malignant tissue from the prostate cancer patients. "Our findings suggest that epigenetic events may play an important role in the development of the activated stroma phenotype," they write.

Contact: NCI Press Officers, National Cancer Institute, 301 496-6641, ncipressofficers@mail.nih.gov

Specific Gene Variant Associated With Early-Onset Colorectal Cancer

A variation of the region of the MDM2 gene that promotes its expression, called SNP309, may be associated with early-onset colorectal cancer among people with a normal p53 gene, a new study suggests. Chiara Menin, Ph.D., at the Sezione di Oncologia in Padova, Italy, and colleagues genotyped 153 colorectal cancer patients and found that patients with a normal p53 gene and the SNP309 mutation were diagnosed with colorectal cancer at an median age of 61, compared with age 71.5 among those with normal p53 and without the SNP309 mutation.

Contact: Chiara Menin, 39-049-821-5882, Chiara.menin@unipd.it

Also in the February 15 JNCI: