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This Week in Lancet Oncology: Apr 15, 2011

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Published in advance online inLancet Oncology this week, researchers in Asia present their development and validation of a predictive score for risk estimation of hepatocellular carcinoma for patients with chronic hepatitis B. While the treatment for chronic hepatitis B reduces the risk for patients to develop hepatocellular carcinoma, there is no suitable means to assess risk, the authors write. The team used a Cox multivariate proportional hazard model to predict hepatocellular carcinoma risk at three, five, and 10 years, with variables like sex, age, serum alanine aminotransferase concentration, HBeAg status, and serum HBV DNA level included in the risk assessment. "A simple-to-use risk score that uses baseline clinical variables was developed and validated. … Clinicians can use this score to assess risk of hepatocellular carcinoma in patients with chronic hepatitis B and subsequently make evidence-based decisions about their clinical management," the researchers write.

Also in Lancet Oncology this week, the journal's editors say that a long-term solution is needed to solve the shortage of cancer drugs in the US. Drug shortages have increased in recent years, with 211 new shortages identified in 2010. These affect clinicians' ability to treat cancer, particularly as some drugs do not have suitable alternatives, the authors write. Recommendations from a November 2010 Drug Shortages Summit include the need for improved communication between manufacturers and FDA as well as increased transparency as to manufacturing and inventory problems, the authors add.

Finally, researchers in the US and Europe present findings from a case-controlled genetic analysis of a 3′-untranslated region KRAS variant and triple-negative breast cancer. The researchers, who had previously identified a functional variant in a let-7 miRNA complementary site in the 3′-untranslated region of the KRAS oncogene, assessed frequency distributions of the KRAS variant in 415 patients with breast cancer and 457 controls. They found that 33 percent of premenopausal women with ER- or PR-negative cancer had the KRAS variant, compared with 13 percent of the premenopausal controls. "Gene-expression analysis of triple-negative breast cancer tumors suggested that KRAS-variant positive tumors have significantly altered gene expression, and are enriched for the luminal progenitor and BRCA1 deficiency signatures," the authors write in Lancet Oncology. "The KRAS variant might be a genetic marker for development of triple-negative breast cancer in premenopausal women, and altered gene and miRNA expression signatures should enable molecular and biological stratification of patients with this subgroup of breast cancer."

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