Weekly Review of oncology literature compiled by Giuseppe Curigliano, Division of Medical Oncology, Istituto Europeo di Oncologia, Milan, Italy

Randomized Trial of Tamoxifen Versus Combined Tamoxifen and Octreotide LAR Therapy in the Adjuvant Treatment of Early-Stage Breast Cancer in Postmenopausal Women: NCIC CTG MA.14

Kathleen I Pritchard et al 2011 JCO

The NCIC CTG MA.14 trial randomly assigned postmenopausal women to 5 years of TAM 20 mg daily or TAM plus 2 years of octreotide 90 mg depot monthly as adjuvant therapy. The primary end point was event-free survival (EFS). Among 667 women with a median follow-up of 7.9 years, 220 events occurred—108 with TAM-OCT and 112 with TAM. Octreotide did not add significant clinical benefit.

Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene rearrangement: a retrospective analysis

Alice T Shaw et al 2011 The Lancet Oncology

Among 82 ALK-positive patients who were given crizotinib, median overall survival from initiation of crizotinib has not been reached (95% CI 17 months to not reached); 1-year overall survival was 74% (95% CI 63—82), and 2-year overall survival was 54% (40—66). Survival in 30 ALK-positive patients who were given crizotinib in the second-line or third-line setting was significantly longer than in 23 ALK-positive controls given any second-line therapy ([95% CI 14 months vs 6 months [4—17], 1-year overall survival 70% [95% CI 50—83] vs 44% [23—64], and 2-year overall survival 55% [33—72] vs 12% [2—30]; p=0·004). In patients with advanced, ALK-positive NSCLC, crizotinib therapy is associated with improved survival compared with that of crizotinib-naive controls.

Adjuvant Chemotherapy for Stage II Colon Cancer With Poor Prognostic Features

Erin S. O'Connor et al 2011 JCO

Adjuvant chemotherapy is typically considered for patients with stage II colon cancer characterized by poor prognostic features, including obstruction, perforation, emergent admission, T4 stage, resection of fewer than 12 lymph nodes, and poor histology. Of the 24,847 patients with stage II cancer, 75% had one or more poor prognostic features. Adjuvant chemotherapy was received by 20% of patients with stage II disease and 57% of patients with stage III disease. After adjustment, 5-year survival benefit from chemotherapy was observed only for patients with stage III disease (hazard ratio [HR], 0.64; 95% CI, 0.60 to 0.67). No survival benefit was observed for patients with stage II cancer with no poor prognostic features (HR, 1.02; 95% CI, 0.84 to 1.25) or stage II cancer with any poor prognostic features (HR, 1.03; 95% CI, 0.94 to 1.13).

Intravenous delivery of a multi-mechanistic cancer-targeted oncolytic poxvirus in humans

Caroline J. Breitbach et al 2011 Nature

JX-594 is an oncolytic poxvirus engineered for replication, transgene expression and amplification in cancer cells harbouring activation of the epidermal growth factor receptor (EGFR)/Ras pathway, followed by cell lysis and anticancer immunity. Here we show in a clinical trial that JX-594 selectively infects, replicates and expresses transgene products in cancer tissue after intravenous infusion, in a dose-related fashion. Normal tissues were not affected clinically. This platform technology opens up the possibility of multifunctional products that selectively express high concentrations of several complementary therapeutic and imaging molecules in metastatic solid tumours in humans.