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.

Other Headlines

• Do human beings get more cancer because they are smarter than chimpanzees?  This is a theory being developed by John McDonald in the School of Biology at Georgia Tech. McDonald’s gene studies show that chimps appear to have more efficient programmed cell death or apoptosis, which may protect them against cancer.  Humans, on the other hand, have developed larger brains and better cognitive ability.  Dr. McDonald says, “We believe this difference may have evolved as a way to increase brain size and associated cognitive ability in humans, but the cost could be an increased propensity for cancer.”
• A phase II clinical trial has just opened for patients with mutated KRAS that combines Erbitux® (cetuxumab) with a new immunotherapy drug Imprime PGG®.  Although by itself, Erbitux is not effective in KRAS mutated tumors, it may be able to harness Imprime PGG to attract immune system cells (neutrophils) to cancer cells specifically.  The neutrophils can then kill the cancer.  A video demonstrates how this works. For more information contact trial sites in New York, Minneapolis, or Dallas.
• C3 Research and Treatment News often provides links to medical journal or conference abstracts.  Cancer.Net, an ASCO-sponsored website with information for patients and consumers, has help reading and understanding medical abstracts. How to Read a Medical Abstract in a Research Study.
• The Subcommittee on Oversight and Investigations of the House Committee on Veterans Affairs will hold hearings on June 16 to examine the problems with HIV and hepatitis infections possibly related to improperly cleaned endoscopes.  At this point six patients treated at one of three VA hospitals in Tennessee, Florida and Georgia where endoscopy equipment was not processed properly have been identified with HIV infection and 45 with hepatitis. . Endoscopy Procedures at the U.S. Department of Veterans Affairs: What Happened, What Has Changed?
• Medicare Part D Appeals: An Advocate’s Manual to Navigating the Medicare Private Drug Plan Appeals Process is available free online from the Medicare Rights Center.  It has very specific information about appealing when coverage of a needed drug is denied by a Medicare Part D insurance company.