Colorectal Cancer News in Brief: June 12

Briefs are back this week after a couple of weeks off for the ASCO meeting, and we review research that finds small liver mets don’t affect survival after treatment for peritoneal carcinomatosis.  A gene has been found  that’s necessary for Celebrex to control new colon polyps.

In other headlines, chimps don’t get cancer but aren’t as smart as humans, a new clinical trial is underway for people with KRAS mutant tumors, and a subcommittee of the House Veterans Affairs Committee will be holding hearings to investigate infections from poorly sanitized colonoscopes in VA medical centers.

Two helpful publications are available online:  One provides help understanding medical abstracts; the other is an advocate’s guide to negotiating Medicare Part D appeals.

Research Reports

  • Patients with colorectal cancer that has spread both to their livers (hepatic metastases) and to their abdominal cavities (peritoneal carcinomatosis) can be helped with combination surgery that removes both.  In the past, cytoreductive surgery with heated intraperitoneal chemotherapy (IPHC or HIPEC) has been limited to patients who didn’t have mets in their liver.  However, a study of 142 patients, included 14 with liver mets, who had cytoreductive surgery for their peritoneal carcinomatosis showed no difference in overall survival.  Median survival for the patients with liver mets was 23 months.  At two and four years, 43.3 percent and 14.4 percent of patients with liver mets were still alive compared to 36.8 percent and 17.4 percent of those without spread to their livers.  Most patients had a single small liver tumor.  Oliver Varban, MD and the surgeons at Wake Forest University in North Carolina report their results in Cancer, online early June 4, 2009.
  • A gene has been identified that is necessary for Celebrex® (celecoxib) to prevent the development of adenomas (polyps) in the colon.  When mice had the 15-PGDH tumor suppressor gene, giving them celecoxib prevented 85 percent of colon tumors.  In mice bred without the gene, celecoxib had no effect on tumors.  In clinical trials to test the value of Celebrex to prevent colon polyps, all individuals who developed new polyps had low levels of 15-PGDH expression.  While Celebrex is not recommended for most average risk patients because of its cardiovascular side effects, it can be helpful to patients with many polyps or persistent polyps.  Published in the June 9, 2009 edition of the Proceedings of the National Academy of Sciences.

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