The orphan nuclear receptor EAR-2 (NR2F6) inhibits hematopoietic cell differentiation and induces myeloid dysplasia in vivo.

Background: In patients with myelodysplastic syndrome (MDS), bone marrow cells have an increased predisposition to apoptosis, yet MDS cells outcompete normal bone marrow (BM)-- suggesting that factors regulating growth potential may be important in MDS. We previously identified v-Erb A related-2 (EAR-2, NR2F6) as a gene involved in control of growth ability.

Methods: Bone marrow obtained from C57BL/6 mice was transfected with a retrovirus containing EAR-2-IRES-GFP.

Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial.

Importance: Optimizing radiation therapy techniques for localized prostate cancer can affect patient outcomes. Dose escalation improves biochemical control, but no prior trials were powered to detect overall survival (OS) differences.

Objective: To determine whether radiation dose escalation to 79.

Association of p27 and Cyclin D1 Expression and Benefit from Adjuvant Trastuzumab Treatment in HER2-Positive Early Breast Cancer: A TransHERA Study.

To assess the prognostic and predictive value of selected biomarkers involved in cell-cycle regulation or proliferation in patients with HER2-positive early breast cancer. Protein expression of TOP2A, Ki67, cyclin D1, and p27 was immunohistochemically determined in tissue microarrays of surgical specimens from 862 patients randomized to trastuzumab (1 or 2 years; = 561) and observation ( = 301) arms of the HERA trial. The primary analysis endpoint was disease-free survival (DFS).

Osteoporosis therapy and outcomes for postmenopausal patients with hormone receptor-positive breast cancer: NCIC CTG MA.27.

Background: Breast cancer patients in the MA.27 trial had similar outcomes with steroidal aromatase inhibitor (AI) exemestane and nonsteroidal anastrozole. AIs increase the risk of osteoporosis.

Validation of the Predictive Value of Modeled Human Chorionic Gonadotrophin Residual Production in Low-Risk Gestational Trophoblastic Neoplasia Patients Treated in NRG Oncology/Gynecologic Oncology Group-174 Phase III Trial.

Objectives: In low-risk gestational trophoblastic neoplasia, chemotherapy effect is monitored and adjusted with serum human chorionic gonadotrophin (hCG) levels. Mathematical modeling of hCG kinetics may allow prediction of methotrexate (MTX) resistance, with production parameter "hCGres." This approach was evaluated using the GOG-174 (NRG Oncology/Gynecologic Oncology Group-174) trial database, in which weekly MTX (arm 1) was compared with dactinomycin (arm 2).

RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.

Purpose: The Radiation Therapy Oncology Group 9804 study identified good-risk patients with ductal carcinoma in situ (DCIS), a breast cancer diagnosis found frequently in mammographically detected cancers, to test the benefit of radiotherapy (RT) after breast-conserving surgery compared with observation.

Patients And Methods: This prospective randomized trial (1998 to 2006) in women with mammographically detected low- or intermediate-grade DCIS, measuring less than 2.5 cm with margins ≥ 3 mm, compared RT with observation after surgery.

Personal navigation increases colorectal cancer screening uptake.

Background: Prior randomized, controlled trials (RCTs) indicate that patient navigation can boost colorectal cancer screening rates in primary care. The sparse literature on pragmatic trials of interventions designed to increase colorectal cancer screening adherence motivated this trial on the impact of a patient navigation intervention that included support for performance of the participants' preferred screening test (colonoscopy or stool blood testing).

Materials And Methods: Primary care patients (n = 5,240), 50 to 74 years of age, with no prior diagnosis of bowel cancer and no record of a recent colorectal cancer screening test, were identified at the Group Health Centre in northern Ontario.

Differential Angiogenic Gene Expression in TP53 Wild-Type and Mutant Ovarian Cancer Cell Lines.

Objectives: Underlying mechanisms regulating angiogenesis in ovarian cancer have not been completely elucidated. Evidence suggests that the TP53 tumor suppressor pathway and tumor microenvironment play integral roles. We utilized microarray technology to study the interaction between TP53 mutational status and hypoxia on angiogenic gene expression.

Active idiotypic vaccination versus control immunotherapy for follicular lymphoma.

Purpose: Idiotypes (Ids), the unique portions of tumor immunoglobulins, can serve as targets for passive and active immunotherapies for lymphoma. We performed a multicenter, randomized trial comparing a specific vaccine (MyVax), comprising Id chemically coupled to keyhole limpet hemocyanin (KLH) plus granulocyte macrophage colony-stimulating factor (GM-CSF) to a control immunotherapy with KLH plus GM-CSF.

Patients And Methods: Patients with previously untreated advanced-stage follicular lymphoma (FL) received eight cycles of chemotherapy with cyclophosphamide, vincristine, and prednisone.

The orphan nuclear receptor Ear-2 (Nr2f6) is a novel negative regulator of T cell development.

We describe a novel role for the orphan nuclear receptor Ear-2 in regulating T cell development. Retrovirus-mediated overexpression of Ear-2 (EAR-2++) in a bone marrow (BM) transplantation assay resulted in limited T cell development and a greater than tenfold decrease in thymus size and cellularity relative to controls. Ear-2-transduced murine BM hematopoietic stem cells (HSCs) in OP9-DL1 cultures showed a proliferation deficit during days 1-5 after induction of differentiation, which corresponded to increased expression of the cell cycle regulators p21 (cdkn1a) and p27 (cdkn1b), as well as increased expression of Hes1, Notch3, Egr1, and Scl (Tal1) and decreased expression of Gli1, Gfi-1, HoxA9, PU.

Patient adherence to aromatase inhibitor treatment in the adjuvant setting.

Improvements in adjuvant systemic therapy and detection of early disease have resulted in a decline of breast cancer death rates across all patient age groups in Canada. Non-adherence to adjuvant hormonal therapy in the setting of early breast cancer may significantly affect patient outcome. Factors associated with medication adherence are complex and may be patient-related, therapy-related, and health care provider-related.

Supportive care needs of individuals with lung cancer.

The main purpose of this study was to identify the range of supportive care needs of patients diagnosed with lung cancer who attended an outpatient, regional cancer centre. Lung cancer has more than a physical impact on those who are diagnosed with the disease, yet relatively little has been reported on their needs beyond those for physical symptom management. A total of 88 patients participated in this study by completing a self-report questionnaire.

Adjuvant chemotherapy and timing of tamoxifen in postmenopausal patients with endocrine-responsive, node-positive breast cancer: a phase 3, open-label, randomised controlled trial.

Background: Tamoxifen is standard adjuvant treatment for postmenopausal women with hormone-receptor-positive breast cancer. We assessed the benefit of adding chemotherapy to adjuvant tamoxifen and whether tamoxifen should be given concurrently or after chemotherapy.

Methods: We undertook a phase 3, parallel, randomised trial (SWOG-8814, INT-0100) in postmenopausal women with hormone-receptor-positive, node-positive breast cancer to test two major objectives: whether the primary outcome, disease-free survival, was longer with cyclophosphamide, doxorubicin, and fluorouracil (CAF) given every 4 weeks for six cycles plus 5 years of daily tamoxifen than with tamoxifen alone; and whether disease-free survival was longer with CAF followed by tamoxifen (CAF-T) than with CAF plus concurrent tamoxifen (CAFT).

Patients' experiences with cognitive changes after chemotherapy.

Being diagnosed with cancer and undergoing treatment can be a daunting experience. The side effects of treatment often influence a person's quality of life. One side effect that has been identified more recently is known as "chemobrain.

Two cases of acrometastasis to the hands and review of the literature.

This paper reports two cases of acrometastasis to the hands. The first case involved a 78-year-old woman with a permeative osteolytic lesion in her proximal second metacarpal. A biopsy of this lesion suggested a diagnosis of non-small-cell lung carcinoma with secondary osseous metastasis.

Update on radiation treatment for cancer pain.

Purpose Of Review: This review addresses the latest advances in radiation treatment for cancer pain.

Recent Findings: There is reluctance worldwide to adopt single fraction radiotherapy as standard practice. This is well summarized by a review article reporting on surveys on practice patterns among radiation oncologists worldwide.

Young women's experiences with breast cancer: an imperative for tailored information and support.

This work was undertaken to provide a basis for determining the type of assistance young women living with breast cancer would find useful. In-depth interviews were conducted with 28 women diagnosed with breast cancer before the age of 45 years about their experiences with breast cancer. They ranged in age from 28 to 42 years at the time of diagnosis.

Symptom clusters in patients with advanced-stage cancer referred for palliative radiation therapy in an outpatient setting.

Purpose: The aim of this study was to explore the presence of symptom clusters in patients with advanced cancer.

Patients And Methods: Patients with metastatic cancer referred to an outpatient palliative radiation therapy clinic were asked to rate their symptom distress using the Edmonton Symptom Assessment Scale (ESAS). Baseline demographic data were obtained.

Patient expectation of the partial response and response shift in pain score.

Purpose: The aim of this study was to define the minimum reduction in pain level that patients would expect and to examine whether response shift exists in the treatment of bone metastases with palliative radiation therapy (RT).

Patients And Methods: Patients with bone metastases were asked to quantify the minimal level of pain reduction by 2 months that they considered would justify the palliative RT based on their current pain (on a scale of 0-10 and a 4-point scale of none, mild, moderate, or severe). At the 2-month follow-up, they were asked the conventional "post-test" question, ie, what is their level of pain now? In addition, they were asked to retrospectively reevaluate their baseline "pretest" level of pain, which is referred to as a "then-test," ie, how would they now rate their level of pain before RT?

Results: Two hundred seventeen patients were enrolled.

Reasons for poor accrual in palliative radiation therapy research studies.

Background: Patients with advanced-stage cancer commonly have multiple symptoms, poor performance status, and limited life expectancies. Despite the need for evidence-based practice and guidelines for palliative radiation therapy (RT), conducting clinical palliative research has proven to be a challenge in the past because of low accrual rates and high patient attrition. We explore the change in accrual rates, reasons for nonparticipation in palliative RT clinical research trials, and factors that contributed to the increase in accrual over a 3-year period.

Level of Concordance Between Proxy and Cancer Patient Ratings in Brief PainInventory.

Background: The objective of this study was to assess whether caregivers serve as valid and reliable proxies for the assessment of a patient's pain level using the Brief Pain Inventory (BPI) assessment tool.

Patients And Methods: Twenty-seven patients with cancer with pain, referred for health care management to the Toronto Sunnybrook Regional Cancer Centre and the Sunnybrook and Women's College Health Sciences Centre, and their proxies participated in this study. Patient and proxy completed the BPI independently, with proxies given explicit instructions to rate and answer the questions from the perspective of the patient.

The correlation among patients and health care professionals in assessing functional status using the karnofsky and eastern cooperative oncology group performance status scales.

This study evaluated the correlation between Karnofsky performance status (KPS) and Eastern Cooperative Oncology Group (ECOG) performance status (PS) scores assigned by doctors (MDs), nurses (RNs), radiation therapist (RTT), radiation therapy student (RTS), and patients (PTs) in assessing functional status of patients with cancer. Patients admitted to the general oncology and palliative care wards at our institution participated in the study. Data were gathered from survey forms completed by MDs, RNs, RTT, RTS, and PTs.

Quality of life after local external beam radiation therapy for symptomatic bone metastases: a prospective evaluation.

This study was designed to prospectively evaluate quality of life in patients treated with local external beam radiation therapy for symptomatic bone metastases. Patients with symptomatic bone metastases treated with palliative radiation therapy were followed with Edmonton Symptom Assessment Scale (ESAS) at baseline and at 1, 2, 4, 8, and 12 weeks after the delivery of radiation therapy. The ESAS evaluates 10 symptoms: global pain, index pain (pain at the irradiated site), fatigue, nausea, depression, anxiety, drowsiness, appetite, sense of well-being, and shortness of breath on a categorical score of 0 to 10 (0 = absence of symptom, 10 = worst possible symptom).

Sci-Sat AM(2): Brachy-02: Image guided brachytherapy (IGBT) for HDR prostate treatment : Pre-treatment verification using cone beam imaging to determine catheter displacement.

Purpose: Prostate HDR brachytherapy utilizes flexible catheters for treatment delivery. Catheters are inserted under US guidance and planning performed on CT images. This study investigates the efficacy of performing kV cone beam imaging prior to treatment to quantify catheter displacement and dose delivered.

Living after cancer: challenges in being a survivor.

Concerns about survivorship and the needs of cancer survivors are occurring with increasing frequency (Ferral, Virani, Smith & Juarez, 2003; Curtiss & Haylock, 2006). Advances in the diagnosis and treatment of cancer have resulted in an ever-growing cadre of individuals who are survivors of the disease. In United States alone, there are more than 10 million cancer survivors (ACS, 2005).