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This Week in the Journal of the National Cancer Institute: Apr 26, 2012

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In the Journal of the National Cancer Institute this week, researchers in the US and South Korea report on the 10-year risk for diagnostic mammograms and invasive breast surgeries for women who've had breast-conserving surgery as treatment for ductal carcinoma in situ. The team analyzed data from 2,948 women with DCIS treated with breast-conserving surgery from 1990 to 2001, with 10-year follow-up. "The estimated 10-year cumulative risk of having at least one diagnostic mammogram after initial DCIS excision was 41.0 percent; at least one invasive procedure, 65.7 percent; and either event, 76.1 percent," the authors write. "Women with DCIS treated with BCS continue to have diagnostic and invasive breast procedures in the conserved breast over an extended period. The frequency of ongoing diagnostic breast evaluations should be included in discussions about treatment."

Also in the Journal of the National Cancer Institute this week, researchers in Germany examine the therapeutic potential of an amanitin-conjugated anti-epithelial cell adhesion molecule monoclonal antibody for the treatment of various cancers. Human epithelial cell adhesion molecule, or EpCAM, is over-expressed in many cancers, the team says. For this study, the researchers covalently conjugated the DNA transcription inhibitor α-amanitin to an anti-EpCAM monoclonal called chiHEA125, and tested it on human pancreatic, colorectal, breast, and bile duct cancer cell lines. They found that the conjugated antibody reduced cell proliferation in all of those lines, and inhibited tumor growth in mouse models. Further, two increased doses of the antibody led to complete tumor regression in nine of the 10 mice the researchers studied. "This preclinical study suggests that anti-EpCAM antibody conjugates with α-amanitin have the potential to be highly effective therapeutic agents for pancreatic carcinomas and various EpCAM-expressing malignancies," the authors write.

And in an editorial in the current issue, NCI researchers Laleh Amiri-Kordestani and Tito Fojo say that a majority of phase III oncology clinical trials fail because their purpose to detect small, but important, differences in patients' health before and after a drug has been administered has given way to measuring "marginal" outcomes that don't really mean much. "The challenge in oncology is to be sure that we remain focused on true clinical benefit — prolonging life," the authors write. "Our goals must remain lofty, and we must remember that marginal benefit should never be that goal. … Conducting larger trials, doing more interim analyses, or using adaptive trial designs are not the solutions. We do not need more marginal results that are then pronounced 'new treatment paradigms' or a 'new standard of therapy.'"

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