Evaluation of Sir-Spheres treatment for liver metastases

Thirty patients were treated at three Australian cancer centers with selective internal radiation (SIR) spheres for liver metastases from colorectal cancer. All patients had previously had their cancer progress on 5FU (fluorouracil) treatment. At the time, neither oxaliplatin nor irinotecan was available as reimbursible treatment in Australia, but 73% of patients had previously received either oxaliplatin or irinotecan treatments and gotten worse.

Twenty-nine (29) patients were evaluated for safety and effectiveness of the SIR-spheres treatment. There were 10 partial responses (33%) that were greater than 30% decrease in tumor size. The median duration of response to treatment was 8.3 months, with a median time to progression of cancer of 5.3 months. However, among patients who had a partial response to therapy, time to progression was 9.2 months.

Some responses continued to progress over time, with one patient having a complete response (disappearance of all target lesions) at 6 months.

Fourteen (14) patients had already received all available chemotherapy treatments, but there was a lower rate of response among this group (21%) and a shorter time to disease progression (3.9 months.) No patients with a poor performance status score or who had cancer outside the liver showed a response to treatment.

Toxicity was acceptable, although there were 4 cases of late gastric ulceration. Most side effects were mild and included nausea, loss of appetite, lethargy, or abdominal pain.

The research team, headed by Lionel C. Lim, concluded,

In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond

Their results were published in [*BMC Cancer*, Volume 5](http://www.biomedcentral.com/1471-2407/5/132/abstract)

Posted by Kate Murphy on October 17th, 2005
Posted in: Research & Treatment News | No Comments »

National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health

The Office of Minority Health (OMH) will host the National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health on January 9-11, 2006 at the Grand Hyatt Hotel in Washington, D.C.

The Summit is part of the Office of Minority Health’s (OMH) broader initiative to eliminate racial and ethnic health disparities. The landmark 1985 Report of the HHS Secretary’s Task Force on Black and Minority Health created OMH and served as an impetus for addressing health inequalities for racial and ethnic minorities in the U.S. This Summit marks the 20th year since the establishment of OMH and is intended to promote best practices and collaborative actions that are vital to improving minority health in the future.

1. Highlight current and emerging research and related efforts to illuminate understanding of and solutions to eliminating racial/ethnic disparities in health;
2. Showcase promising practices, models that work and lessons learned;
3. Assess racial and ethnic minority community needs, strengths, and actions necessary to close the disparity gaps; and
4. Develop recommendations and strategies for future directions.

The Summit is designed around the following six tracks:

1. Health Care Access, Utilization, and Quality;
2. Healthcare and the Public Health Workforce;
3. Research, Data, and Evaluation;
4. Health Information Technology;
5. Health Disparities Across the Lifespan; and
6. Culture, Language, and Health Literacy.

It is expected that the Summit will bring together over 2200 leaders from all levels of government, academia, public health, mental health, minority-serving institutions, and minority communities to advance key issues and opportunities for improving minority health and closing the health gap. Information on the upcoming Summit can be accessed on the OMH’s summit website.

Posted by Dusty Weaver on October 16th, 2005
Posted in: Policy & Advocacy News | No Comments »

Breast cancer history does not increase risk for colorectal cancer

In an effort to understand conflicting information about whether breast cancer makes colorectal cancer more likely, researchers at the University of Pennsylvania reviewed information from a large group of women with breast cancer and compared their rates of colorectal cancer to women without a history of breast cancer.

Using a research database from the United Kingdom that included 17,415 women with a history of breast cancer and 69,660 women without breast cancer, the research team calculated the risk for a subsequent colorectal cancer. The relative rate for colorectal cancer among those with breast cancer was 0.80.

The team concluded

Women with a prior diagnosis of breast cancer are not at an increased risk of colorectal cancer; these women can follow average risk screening guidelines for colorectal cancer.

Their results were reported in the [October 2005 issue of the *American Journal of Gastoenterology*](http://www.amjgastro.com/showContent.asp?DID=4&SessionGUID=B97EAA8F-8AE5-4F62-B825-A7AAC2731B33&id=ajg_316102005&type=abstract)

An [article in *The Lancet*](http://www.thelancet.com/journals/lancet/article/PIIS0140673600041970/abstract) in 2001 found a slightly reduced risk for colon and rectal cancer after breast cancer, compared to what was expected in the overall population. Women with breast cancer were 5% less likely to develop colon cancer and 13% less likely to be diagnosed with rectal cancer. Reduced risk was greatest in women whose breast cancer was diagnosed over age 65, in white women, and in women with local stage cancers.

Despite these results in the overall population a [2003 study](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12825849&query_hl=1) found that certain subgroups of breast cancer survivors had an increased risk to develop colorectal cancer. That included women with

+ a family history of breast cancer
+ high body mass index (BMI) over 30 mg/m²
+ lobular rather than ductal cancer

Most women with breast cancer probably can follow colorectal screening guidelines for people of average risk but should discuss their individual risk factors with their doctors.

Posted by Kate Murphy on October 16th, 2005
Posted in: Research & Treatment News | No Comments »

Combination of trimetrexate and capecitabine for previously treated metastatic colorectal cancer

Researchers at the University of Pittsburgh tested the combination of trimetrexate (TMTX) and capecitabine (Xeloda™) in patients with metastatic colorectal cancer whose disease had already gotten worse with previous treatments. All patients had received 5FU (flourouracil) and 94% had received irinotecan (Camptosar™). This was the second or third treatment regimen for all patients in the study.

Although the combination showed some effectiveness and was tolerated by patients, there were other current treatments that were more active, the research team concluded.

In the phase I part of the study, they were able to determine a tolerable dose of 100 mg/m² and 1000 mg/m² of capecitabine. Serious side effects included abdominal pain in 12.5% of patients and vomiting in 9.4.%.

Twenty-seven patients were included in evaluation of effectiveness. One patient had a complete response, another a partial response to the combination for an overall response rate of 7.7%. The median time until the cancer progressed was 3.3 months and the median overall survival time was 5.5 months.

Khalid Matin M.D. led the research team who concluded,

The combination of TMTX and CAP is well tolerated. However, recent studies have shown more active regimens in the second- and third-line metastatic setting.

[Read the study abstract in the October 2005 *American Journal of Clinical Oncology*](http://www.amjclinicaloncology.com/pt/re/ajco/abstract.00000421-200510000-00002.htm;jsessionid=DRiuNuvn4zz9M04ZmT6mCxWyaXmmGcTVfGHCcwJk2is2iVRHDQFv!-1202648512!-949856145!9001!-1)

Posted by Kate Murphy on October 15th, 2005
Posted in: Research & Treatment News | No Comments »

NHI Seeks Applications for the Council of Public Representatives (COPR)

The Director of the National Institutes of Health (NIH) is seeking applicants to fill appointments to the Director’s Council of Public Representatives (COPR). Applications are due October 31, 2005 and are available online at http://copr.nih.gov/application.asp. New members will be appointed in April 2006.

The COPR advises the NIH Director on cross-cutting issues related to medical research and health issues of public interest that ultimately promote individual, family, and community health. Examples of such broad issues the Council has been invloved with include public trust in the research enterprise, public input and participation at the NIH, enhancing public awareness and education about NIH, clinical trails recruitment issues, and aspects of the NIH Roadmap, such as reengineering the clinical research enterprise.

The COPR consists of up to 21 individuals who are selected from among the diverse communities that benefit from, and have an interest in, NIH research, programs, and activities. Members typically serve on the COPR for three years. To be considered for the COPR, applicants must have some interest in the work of the NIH and must be in a position to communicate regularly with the broader public about COPR and NIH activities. Applicants must also be willing to fully participate in biannual COPR meetings, regular conference calls, and working group activities throughout the year.

For more information or to obtain an application online, visti the COPR Web site at http://copr.nih.gov/application.asp. To request an application by mail, contact the COPR Resource Staff by phone at (301) 650-8660, Ext. 129, by fax at (301) 650-8676, or by e-mail at COPR1@palladianpartners.com.

Applications are due on October 31, 2005. The next COPR meeting, on October 25, 2005, includes on the agenda a discussion on “exploring the inclusion and preparation of public members in the peer review process” and public trust in the research process. For details, visit http://www.copr.nih.gov/.

Posted by Dusty Weaver on October 15th, 2005
Posted in: Policy & Advocacy News | No Comments »