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This Week in Lancet Oncology: Mar 9, 2011


In Lancet Oncology this week, an international team of researchers present their findings from a four-year follow-up of a randomized control trial to determine the effectiveness of treatment with trastuzumab for one year in patients with HER-2 positive early breast cancer who've had adjuvant chemotherapy. Using results from participants in the HERA trial, the researchers found that 78.6 percent of patients treated with trastuzumab had a four-year disease-free survival compared with 72.2 percent of patients in the control group. "Treatment with adjuvant trastuzumab for one year after chemotherapy is associated with significant clinical benefit at four-year median follow-up," the authors write. "The substantial selective crossover of patients in the observation group to trastuzumab was associated with improved outcomes for this cohort."

Researchers in the US and UK teamed up to determine the prognostic value of an RNA expression signature derived from cell cycle proliferation genes in patients with prostate cancer. They measured the expression of 31 genes involved in cell cycle proliferation, and found that, after prostatectomy, this measurement and prostate-specific antigen concentration were the most important variables and more significant than any other clinical variant in determining a prostate cancer patient's prognosis. "The results of this study provide strong evidence that the cell cycle proliferation score is a robust prognostic marker, which, after additional validation, could have an essential role in determining the appropriate treatment for patients with prostate cancer," the authors write.

Also in Lancet Oncology this week, Emory University's Brian Leyland-Jones and Brian Smith from the VM Institute of Research in Canada say the end is near for serum HER2 testing in patients with HER2-positive breast cancer. In examining data from 63 studies of patients with breast cancer, Leyland-Jones and Smith found that some studies showed an association between raised concentrations of serum HER2 and poor prognosis, while other studies showed no such association. "Examination of existing data showed that concentrations of HER2 ECD are not consistently related to patient outcomes; therefore, there is insufficient evidence to support the clinical use of serum HER2 ECD testing," the authors write. "Oncologists should continue to adhere to national guidelines for determining HER2 status. Furthermore, oncologists should continue to use clinical parameters when making decisions about initiation, continuation, and discontinuation of HER2-targeted treatments."