What we are reading this week at the European Institute of Oncology

3 Nov 2010

A review of oncology literature compiled by Giuseppe Curigliano, Division of Medical Oncology, IEO, Milan, Italy

Distant metastasis occurs late during the genetic evolution of pancreatic cancer
Shinichi Yachida et al. Nature 467, 1114–1117 (October 2010)

We find that clonal populations that give rise to distant metastases are represented within the primary carcinoma, but these clones are genetically evolved from the original parental, non-metastatic clone. …. At least five more years are required for the acquisition of metastatic ability and patients die an average of two years thereafter. 


The patterns and dynamics of genomic instability in metastatic pancreatic cancer
Peter J. Campbell et al. Nature 467, 1109–1113 (October 2010)

We find evidence that there is genetic heterogeneity among metastasis-initiating cells, that seeding metastasis may require driver mutations beyond those required for primary tumours, and that phylogenetic trees across metastases show organ-specific branches.


Anaplastic Lymphoma Kinase Inhibition in Non–Small-Cell Lung Cancer
Eunice L. Kwak et al. N Engl J Med 363, 1693-1703 (2010)

82 patients with advanced ALK-positive disease who were eligible for the clinical trial. Crizotinib: 250 mg twice daily in 28-day cycles.

At a mean treatment duration of 6.4 months, the overall response rate was 57% (47 of 82 patients, with 46 confirmed partial responses and 1 confirmed complete response); 27 patients (33%) had stable disease. A total of 63 of 82 patients (77%) were continuing to receive crizotinib at the time of data cutoff, and the estimated probability of 6-month progression-free survival was 72%, with no median for the study reached.


Teriparatide and Osseous Regeneration in the Oral Cavity
Jill D. Bashutski et al. NEJM (2010)

Intermittent administration of teriparatide, a drug composed of the first 34 aminoacids of parathyroid hormone, has anabolic effects on bone.

A total of 40 patients with severe, chronic periodontitis underwent periodontal surgery and received daily injections of teriparatide (20 μg) or placebo, along with oral calcium (1000 mg) and vitamin D (800 IU) supplementation, for 6 weeks.

Clinical improvement was greater in patients taking teriparatide than in those taking placebo, with a reduction in periodontal probing depth of 33% versus 20% (2.42 mm vs. 1.32 mm) and a gain in clinical attachment level of 22% versus 7% (1.58 mm vs. 0.42 mm) in target lesions at 1 year (P = 0.02 for both comparisons).