High Glycemic Index Associated With Increased Lung Cancer Risk

Rochman, S. Journal of the National Cancer Institute (2016) 108 (7): djw176

Baby's Healthcare

Dietary guidelines promote increased intake of fruits and vegetables, reduced consumption of meats, and the selection of whole grains over processed foods as ways to improve overall health and decrease cancer risk. Those recommendations are based on laboratory and epidemiology studies that suggest certain foods may trigger biological processes that help initiate cancers or create tumor-friendly environments. A new study by researchers at the University of Texas M. D. Anderson Cancer Center in Houston is the first to find a statistically significant association between measures of carbohydrate intake and lung cancer risk.

The March 2016 study in Cancer Epidemiology, Biomarkers, and Prevention (doi:10.1158/1055–9965.EPI-15–0765) investigated the relationship between two measures of carbohydrate intake—glycemic index and glycemic load—and lung cancer risk in non-Hispanic whites. Glycemic index scores measure the extent to which foods that contain equal amounts of carbohydrates increase glucose levels. Glycemic load takes into account both how many carbohydrates are eaten and the glycemic index of those foods. Previous studies looking at associations between glycemic index and glycemic load and cancer risk have had inconsistent findings.

Read the abstract here

Interactive summary of suspected cancer guidelines

Cancer Research UK and the Royal College of General Practitioners have launched a new interactive desk easel for GPs, which summarises the NICE referral guidelines for suspected cancer (NG12).

GPs can access the summary from their desktop computer and click through to the recommendations for each symptom group. Recommendations for adults, children and young people are covered, as well as primary care investigations.

niceeasel

image source: http://www.cancerresearchuk.org/

Revolutionising UK lung cancer management

An innovative method of carrying out lung biopsies at Barnet Hospital could free up hundreds of hospital beds and provide earlier lung cancer diagnosis by increasing tenfold the number of potentially life-saving tests carried out each year. In this guest blog for NHS England, Chest radiologist Dr Sam Hare explains why his team’s ambulatory lung biopsy method should be rolled out across the NHS.

High-tech scans spare lymphoma patients intensive chemo

Cancer Research UK. Published online: 22 June 2016

pet

Image source: CRUK

Hodgkin lymphoma patients can be spared the serious side effects of chemotherapy  thanks to high-tech scans that can predict the outcome of treatment, according to a study published in the New England Journal of Medicine

Doctors – funded by Cancer Research UK and international partners in Europe and Australasia – used positron emission tomography (PET)  to scan more than 1200 patients with advanced Hodgkin lymphoma after they had been given two cycles of standard chemotherapy. Those who had a clear PET scan were split into two groups – one group continued with chemotherapy including the drug bleomycin and the other had chemotherapy without the drug. They found that patients who stopped having bleomycin had the same survival rates as those who continued it. But, importantly, they were spared side effects. Patients on the trial who did not have a clear PET scan after two rounds of chemotherapy, suggesting they had a more resistant form of the disease, were given more intense chemotherapy treatment.

Bleomycin has been an important drug to treat Hodgkin lymphoma for 30 years, but it has a potential risk of severe effects on the lungs, with the risk of scarring, even years later, that can lead to serious breathing problems. Due to these risks the researchers wanted to explore the potential of adapting treatment by stopping bleomycin for patients with a good outlook and escalating treatment only for those at highest risk of the treatment not working.

Read the full press release here

Read the original research article here

 

An explorative study to assess the association between health-related quality of life and the recommended phase II dose in a phase I trial

Anota, A. et al. BMJ Open. 2016. 6:e010696

Image shows intermediate magnification micrograph of hepatocellular carcinoma

Objectives: The objective of this study was to explore the association between health-related quality of life (HRQoL) and the recommended phase 2 dose in a phase I clinical trial according to the Time to HRQoL deterioration approach (TTD).

Setting: This is a phase I dose-escalation trial of transarterial chemoembolisation (TACE) with idarubicin-loaded beads performed in cirrhotic patients with hepatocellular carcinoma. Patients had to complete the EORTC QLQ-C30 HRQoL questionnaire at baseline and at days 15, 30 and 60 after TACE.

Participants: Patients aged ≥18 years with HCC unsuitable for curative treatments were evaluated for the study (N=21).

Primary and secondary outcome measurements: The primary objective was to determine the maximum tolerated dose (MTD) of idarubicin loaded after a single TACE session. MTD was defined as the dose level closest to that causing dose-limiting toxicity in 20% of patients. HRQoL was the secondary end point.

Results: Between March 2010 and March 2011, 9, 6 and 6 patients were included at idarubicin dose levels of 5, 10 and 15 mg, respectively. Calculated MTD of idarubicin was 10 mg. At the 10 mg idarubicin dose, patients presented a longer TTD than at 5 mg, for global health status (HR=0.91 (95% CI 0.18 to 4.72)), physical functioning (HR=0.38 (0.04 to 3.22)), fatigue (HR=0.67 (0.18 to 2.56)) and pain (HR=0.47 (0.05 to 4.24)).

Conclusions: These HRQoL results were consistent with the estimated MTD, with a median TTD for global health status of 41 days (21 to NA) at 5 mg, 23 days (20 to NA) at 10 mg and 25 days (17 to NA) at 15 mg. These results show the importance of studying HRQoL in phase I trials.

Read the full article here

Be Clear on Cancer respiratory symptoms awareness campaign

Be Clear on Cancer: Respiratory symptoms awareness campaign

PHE has announced that it is planning this national campaign for fourteen weeks between 14th July and 16th October.

be clear

image source: campaignresources.phe.gov.uk

The campaign will be PHE’s main national broadcast campaign for 2016/17.

This will be the first time a national campaign is focused more broadly than cancer. The campaign will focus on the symptoms of a persistent cough and inappropriate breathlessness.

Resources  are available from the PHE campaign website.

Two Years of Adjuvant Tamoxifen Provides a Survival Benefit Compared With No Systemic Treatment in Premenopausal Patients With Primary Breast Cancer

Ekholm, M. et al. Journal of Clinical Oncology. July 1, 2016. 34 (19). pp. 2232-2238

tamoxifen_cancer_drug

Image source: Bill Branson – Wikimedia Commons [Public domain]

Purpose: The aim of this study was to evaluate the long-term effect of 2 years of adjuvant tamoxifen compared with no systemic treatment (control) in premenopausal patients with breast cancer over different time periods through long-term (> 25 years) follow-up.

Patients and Methods: Premenopausal patients with primary breast cancer (N = 564) were randomly assigned to 2 years of tamoxifen (n = 276) or no systemic treatment (n = 288). Data regarding date and cause of death were obtained from the Swedish Cause of Death Register. End points were cumulative mortality (CM) and cumulative breast cancer–related mortality (CBCM). The median follow-up for the 250 patients still alive in April 2014 was 26.3 years (range, 22.7 to 29.7 years).

Results: In patients with estrogen receptor–positive tumors (n = 362), tamoxifen was associated with a marginal reduction in CM (hazard ratio [HR], 0.77; 95% CI, 0.58 to 1.03; P = .075) and a significant reduction in CBCM (HR, 0.73; 95% CI, 0.53 to 0.99;P = .046). The effect seemed to vary over time (CM years 0 to 5: HR, 1.05; 95% CI, 0.64 to 1.73; years > 5 to 15: HR, 0.58; 95% CI, 0.37 to 0.91; and after 15 years: HR, 0.82; 95% CI, 0.48 to 1.42; CBCM years 0 to 5: HR, 1.09; 95% CI, 0.65 to 1.82; years > 5 to 15: HR, 0.53; 95% CI, 0.33 to 0.86; and after 15 years: HR, 0.72; 95% CI, 0.36 to 1.44).

Conclusion: Two years of adjuvant tamoxifen resulted in a long-term survival benefit in premenopausal patients with estrogen receptor–positive primary breast cancer.

Read the abstract here