July 15 Clinical Cancer Research Highlights

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Selected Articles from the July 15, 2006 Issue

The articles referenced in this Highlights section will be available online in HTML and PDF formats to all interested users at no charge until the next issue of Clinical Cancer Research is published. Click on the article title to view the complete article.

View the Table of Contents for the July 15 issue of Clinical Cancer Research.

Megakaryocyte Potentiation Factor Cleaved from Mesothelin Precursor Is a Useful Tumor Marker in the Serum of Mesothelioma Patients

EGFR Mutations in Esophageal and Pancreatic Cancer Key to Tyrosine Kinase Inhibitor Response

Activating mutations within the epidermal growth factor receptor identify a subset of non-small cell lung cancers with dramatic sensitivity to the tyrosine kinase inhibitors, gefitinib and erlotinib. Given recent reports of tyrosine kinase inhibitor– responsive cases of esophageal and pancreatic cancer, Kwak et al. designed a study to determine the prevalence of epidermal growth factor receptor mutations in these cancers. Mutations were identified in two of 17 esophageal cancers (11.7%), three of 21 cases of Barrett’s esophagus (14.2%), and two of 55 pancreatic cancers (3.6%). The role of genotype-directed tyrosine kinase inhibitor therapy in these gastrointestinal cancers should be tested in prospective clinical trials.

Circulating Tumor Cells at Each Follow-Up Time Point during Therapy of Metastatic Breast Cancer Patients Predict Progression-Free and Overall Survival

Monitoring patients with metastatic breast cancer to determine if systemic therapy is working can be difficult. History, physical examinations, and radiographs are often inaccurate, inconvenient, time-consuming, and expensive. Circulating tumor markers such as products of MUC-1 have been used for over 20 years, but are also fraught with inaccuracies. Recently published results from a prospective, multi-institutional clinical trial have demonstrated that analysis of circulating tumor cells may provide a convenient and accurate measure of prognosis and disease status at baseline and first follow-up after starting a new systemic therapy (Cristofanilli, New England Journal of Medicine 2004; Cristofanilli, Journal of Clinical Oncology 2005). Hayes et al. provide further results from this trial that suggest that circulating tumor cell levels are strongly predictive of future outcome at subsequent time points in a metastatic patient’s course, to the extent that circulating tumor cell levels above 5 cells/7.5 ml whole blood at any follow-up period are associated with a very high likelihood of rapid progression.