Peripheral neuropathy refers to numbness and tingling of the extremities (hands and feet) and is caused by damage to the nerves between the extremities and the central nervous system (CNS). About 20 to 40 percent of patients treated with neurotoxic chemotherapy agents such as taxanes, platinums, and vinca alkaloids will experience this painful condition. Because the condition can have a lasting impact on day-to-day life, researchers continue to search for ways to mitigate this pain.

Cymbalta is a serotonin-norepinephrine reuptake inhibitor (SNRI) that works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain.

Researchers conducted a phase 3, randomized, double-blinded, placebo-controlled crossover trial to test the effectiveness of Cymbalta on pain associated with painful chemotherapy-induced peripheral neuropathy. The study included 220 adult patients (age 25 or older) with grade I or higher chemotherapy-induced peripheral neuropathy.

Patients were randomized one-to-one to receive either Cymbalta or placebo for five weeks and then after a two-week “washout” period, they were switched to receive the opposite treatment for five weeks. Cymbalta dosing started at 30 mg daily for the first week and then increased to 60 mg daily for 4 weeks.

Over the course of five weeks, patients receiving Cymbalta experienced a significantly larger reduction in pain compared to those receiving placebo. What’s more, a larger proportion of patients initially treated with Cymbalta than with placebo reported pain decreases of any amount (59% vs. 38%). Patients who received platinum-based chemotherapy experienced more benefit from Cymbalta than those who received taxane-based chemotherapy.

Cymbalta also appeared to reduce the impact of pain on daily life. The interference scores (indicating impact on activity, mood, walking, work, relationships, sleep, and enjoyment of life) declined significantly more in the Cymbalta group.

The researchers concluded that among patients with painful chemotherapy-induced peripheral neuropathy, the use of Cymbalta compared with placebo for 5 weeks resulted in a greater reduction in pain.

Reference:

Lavoie-Smith EM, Pang H, Cirrincione C, et al. Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: A randomized clinical trial. JAMA. 2013; 309(13):1359-1367.

Copyright © 2013 CancerConsultants. All Rights Reserved.

Breast-conserving therapy involves lumpectomy (removal of the cancer and some surrounding tissue) followed by radiation therapy. Studies have found that breast-conserving therapy produces survival rates that are similar to those achieved with mastectomy (removal of the entire breast) among women with early-stage breast cancer.

To evaluate outcomes by type of surgery among women with triple-negative breast cancer, researchers at Memorial Sloan-Kettering Cancer Center collected information about 646 women who were treated between 1999 and 2008. All of the women had T1 or T2 tumors (tumors that were 5 cm or less in size) and no evidence of cancer in the lymph nodes.

A total of 448 women underwent breast-conserving therapy and 198 underwent mastectomy without post-mastectomy radiation. Women who had mastectomies tended to be younger and to have larger tumors.

Most women also received adjuvant (post-surgery) chemotherapy.

• Five-year risk of a cancer recurrence in or near the breast (a locoregional recurrence) was 4.2% among women treated with breast-conserving therapy and 5.4% among women treated with mastectomy.
• The two groups were also similar with respect to risk of distant metastases and overall survival.
• Factors that were linked with worse survival were lack of chemotherapy and higher tumor stage.

These results show that both breast-conserving therapy and mastectomy provided effective treatment in this group of women with early-stage triple-negative breast cancer.

Reference: Zumsteg ZS, Morrow M, Arnold B et al. Breast-conserving therapy achieves locoregional outcomes comparable to mastectomy in women with T1-2N0 triple-negative breast cancer. Annals of Surgical Oncology. Early online publication May 19, 2013.

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Of the more than one million new diagnoses of skin cancer each year, roughly 68,000 involve melanoma. More than 8,000 people die of melanoma each year in the United States. What makes melanoma so dangerous is that it is more likely than other types of skin cancer to spread (metastasize) to other parts of the body.

In order to provide more individualized and more effective cancer therapy, much research has been focused on determining specific pathways involved in cancer cell growth or survival. The BRAF gene is known to play a part in cell growth, and mutations in BRAF are common in several types of cancer. Approximately half of all melanomas carry a specific BRAF mutation known as V600E and in those patients, the nearby MEK pathway is also highly active.

Currently, Zelboraf is the only BRAF inhibitor approved for treating melanoma. Zelboraf has been shown to improve outcomes among patients with advanced melanoma with a BRAF gene mutation, but also accelerates the development of secondary skin cancers in some patients.[2] Furthermore, most patients eventually develop resistance to the drug.

Researchers have investigated the drug resistance mechanism in mice and found that the tumors not only develop a resistance to Zelboraf, but they also become dependent on the drug to grow. Tumors stopped growing and regressed when Zelboraf treatment was stopped in the animals.

In order to determine whether this drug dependency translated from animals to humans, researchers evaluated 42 patients with Zelboraf-resistant tumors at the Royal Marsden Hospital in London, United Kingdom. They examined computed tomography (CT) scans of tumors (available for 19 patients) after treatment was stopped and found that 14 patients experienced a decreased rate of tumor growth.

After determining that the same phenomenon occurs in mice and humans, the researchers implanted mice with human patient-derived tumors and treated them with either continuous or intermittent Zelboraf. Intermittent treatment was delivered for four weeks on and two weeks off. They found that none of the tumors in the intermittent group developed drug resistance.

The researchers concluded that treatment cessation decreased tumor growth in patients with Zelboraf-resistant melanoma and that an intermittent treatment regimen might help overcome drug resistance. Further research is warranted.

References:

Copyright © 2013 CancerConsultants. All Rights Reserved.

LEXINGTON, Mass., May 22, 2013 (GLOBE NEWSWIRE) — Agenus Inc. (Nasdaq:AGEN) today announced enrollment has started for a large, randomized Phase 2 study of Prophage G-200 (Heat Shock Protein Peptide Complex-96 or HSPPC-96) vaccine in combination with bevacizumab (Avastin(R)) for treatment of recurrent glioblastoma multiforme (GBM) in adult patients. The study is being sponsored by the Alliance for Clinical Trials in Oncology (ALLIANCE), a cooperative group of the National Cancer Institute (NCI). The trial is expected to enroll 222 patients in treatment centers across the United States, and is the largest brain tumor vaccine trial ever funded by NCI and the largest vaccine study ever conducted with Avastin.

“The initiation of enrollment in this groundbreaking trial to evaluate the efficacy of treatment with HSPPC-96 in conjunction with bevacizumab in recurrent GBM represents a major milestone in efforts to develop effective vaccines for people living with brain tumors. The significant commitment to this trial from the NCI is also a reflection of the rapidly emerging promise of vaccines as potential treatment options for millions of people with different forms of cancer,” said Andrew T. Parsa, MD, Ph.D., study chair for the trial and newly appointed chair of the Department of Neurological Surgery at Northwestern University.

At the American Society for Clinical Oncology meeting in 2011, Dr. Parsa presented data indicating that the Prophage G-200 vaccine may help recurrent GBM patients live longer and suggesting a possible clinical benefit. These research findings, along with other preclinical and clinical data, were used to support further testing of Prophage G-200 and were key considerations in the decision by the NCI to sponsor a clinical trial involving Prophage G-200 combined with Avastin in the treatment of recurrent GBM.

“Our research shows that Prophage Series vaccines have the potential to play an important role in the treatment of gliomas and other forms of cancer,” said Garo Armen, Ph.D., CEO and chairman of Agenus. “We are very pleased to be collaborating with the Alliance and NCI on this landmark research effort.”

About the ALLIANCE Trial

The ALLIANCE trial will investigate the benefits of treatment with a combination of HSPPC-96 and bevacizumab in a three-arm design of 222 patients with surgically resectable recurrent GBM using a primary endpoint of overall survival. The study will compare efficacy of the HSPPC-96 vaccine administered with bevacizumab either concomitantly or at progression, versus treatment with bevacizumab alone. This study design is supported in part by previous research indicating a potential synergistic effect between the mechanisms of action behind both
HSPPC-96 and bevacizumab.

For additional information about the Alliance Trial visit http://www.clinicaltrials.gov/ct2/show/NCT01814813?term=HSPPC-96&rank=6

About Glioblastoma Multiforme (GBM)

The incidence rates of primary malignant brain and central nervous system (CNS) cancers have increased by 25 percent over the last three decades.[1] The American Cancer Society estimates that approximately 23,000 malignant tumors of the brain or spinal cord will be diagnosed during 2013 in the U.S. and approximately 14,000 people will die from these tumors. Glioblastoma is the most common primary malignant brain tumor and has been associated with a particularly poor prognosis, with survival rates at one and five years equaling 33.7% and 4.5%, respectively.[2] The current standard of care for patients with newly diagnosed glioblastoma is surgical resection followed by fractionated external beam radiotherapy and systemic temozolomide[3] resulting in a median overall survival (OS) of 14.6 months[4] based on data from a randomized Phase III trial. Although this treatment can prolong survival, it is not curative and the vast majority of patients with glioblastoma experience recurrent disease, with a median time to recurrence of seven months.[5] Currently, there is no standard treatment for patients with recurrent glioblastoma, although additional surgery, chemotherapy (i.e., CCNU, temozolomide), bevacizumab, and radiotherapy are used.

About the Prophage Series Cancer Vaccines

Prophage series cancer vaccines are autologous therapies derived from cells extracted from the patient’s tumor. As a result, Prophage Series vaccines contain a precise antigenic ‘fingerprint’ of the patient’s particular cancer and are designed to reprogram the body’s immune system to target only cells bearing this fingerprint, reducing the risk that powerful anti-cancer agents will target healthy tissue and cause debilitating side effects often associated with chemotherapy and radiation therapy. The Prophage Series G vaccines are currently being studied in two different settings of glioma: newly diagnosed and recurrent disease.

In addition to the recurrent GBM study in G-200, a Phase 2 trial testing Prophage Series G-100 in patients with newly diagnosed glioma is ongoing. In this trial, G-100 is being used with the standard of care, which includes Temodar (Merck; temozolomide) and radiation.

Dr. Parsa has not received any financial support or travel expense reimbursement for this work or for consulting activities on behalf of Agenus. Dr. Parsa does not have an equity interest in Agenus or a financial relationship with the company.

About the Alliance for Clinical Trials in Oncology at NCI

The Alliance for Clinical Trials in Oncology is an NCI cooperative group formed by the merger of the American College of Surgeons Oncology Group (ACOSOG), Cancer and Leukemia Group B (CALGB), and the North Central Cancer Treatment Group (NCCTG).

About Agenus

Agenus Inc. is a biotechnology company working to develop treatments for cancers and infectious diseases. The company is focused on immunotherapeutic products based on strong platform technologies with multiple product candidates advancing through the clinic, including several product candidates that have advanced into late-stage clinical trials through corporate partners. Between Agenus and its partners, 19 programs are in clinical development. For more information, please visit www.agenusbio.com.

Forward-Looking Statement

This press release contains forward-looking statements, including statements regarding potential clinical trial activities, outcome benefits, and funding sources. These forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially. These risks and uncertainties include, among others, the factors described under the Risk Factors section of our Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission for the period ended March 31, 2013. Agenus cautions investors not to place considerable reliance on the forward-looking statements contained in this release. These statements speak only as of the date of this document, and Agenus undertakes no obligation to update or revise the statements. All forward-looking statements are expressly qualified in their entirety by this cautionary statement. Agenus’ business is subject to substantial risks and uncertainties, including those identified above. When evaluating Agenus’ business and securities, investors should give careful consideration to these risks and uncertainties.

References

–  Cancer Statistics Registrations, England (Series MB1), No. 41 2010 release. http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations–england–series-mb1-/no–41–2010/sty-brain-cancer-awareness.html
–  Central Brain Tumor Registry of the United States (CBTRUS) 2010 CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2004-2006. http://www.cbtrus.org/reports/reports.html
–  National Comprehensive Cancer Network clinical practice guidelines in oncology-central nervous system cancers. v.1.2010.
–  Stupp, R., et al., Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med, 2005. 352(10): p. 987-96.
–  Wen PY, DeAngelis LM. Chemotherapy for low-grade gliomas: emerging consensus on its benefits. Neurology. 2007;68(21):1762–1763. doi: 10.1212/01.wnl.0000266866.13748.a9.

Avastin is a registered trademark of Genentech.

CONTACT: Media and Investors:
Jonae R. Barnes
Vice President
Investor Relations &
Corporate Communications
617-818-2985

Copyright © 2013 CancerConsultants. All Rights Reserved.

HER2 is a protein involved in normal cell growth. Approximately 20-25% of breast cancers overexpress (make too much of) the HER2 protein, and this over-expression contributes to cancer cell growth and survival. HER2-targeted therapies such as Herceptin have dramatically improved outcomes for women with HER2-positive breast cancer, but researchers continue to explore new approaches to treatment.

Kadcyla is part of a new class of drugs called antibody-drug conjugates, which consist of an antibody attached to a toxic chemotherapy. It combines Herceptin and a chemotherapy drug (emtansine or DM1) that interferes with cancer cell growth. Kadcyla delivers Herceptin and DM1 directly to HER2-positive cells, and limits exposure of the rest of the body to the chemotherapy.

The EMILIA study was a phase III clinical trial that led to FDA approval of Kadcyla. It showed that Kadcyla prolonged progression-free survival and overall survival for patients with HER2-positive metastatic breast cancer compared to Tykerb® (lapatinib) plus Xeloda® (capecitabine).

Among women with HER2-positive cancer, the degree of HER2 expression differs from patient to patient. Researchers performed a sub-analysis on the data from the EMILIA study to analyze tissue samples from patients in the study and examine whether tumor levels of HER2 as assessed by the amount of HER2 messenger ribonucleic acid (mRNA), affected treatment response. Patients with tumor samples expressing greater than the median amount of tumor HER2 mRNA were considered to have high levels of HER2. Those with tumor samples expressing the median amount of tumor HER2 mRNA or less were considered to have low levels of HER2.

The results of the analysis indicated that patients with tumor expressing higher levels of HER2 derived greater benefit from Kadcyla than those with tumors expressing lower levels of HER2. Overall survival was 34.1 months for patients with high levels of HER2 compared with 26.5 months for those with lower levels. Among patients with tumors expressing higher levels of HER2, those receiving Kadcyla had a 47 percent decreased risk of death compared with those receiving Tykerb/Xeloda.

What’s more, the researchers also evaluated whether tumor mutations in the PIK3CA gene affected treatment response because patients with this mutation typically do not respond as well to HER2-targeted therapies as their counterparts without the mutation. However, the analysis revealed that PIK3CA mutation status did not diminish treatment response.

The researchers concluded that women with the highest tumor HER2 levels benefit the most from the drug Kadcyla, regardless of PIK3CA mutation status. Measuring HER2 levels may help physicians individualize treatment among this population.

Reference:

Baselga J, Verma S, Ro J, et al. Relationship between tumor biomarkers (BM) and efficacy in EMILIA, a phase III study of trastuzumab emtansine (T-DM1) in HER2-positive metastatic breast cancer (MBC). Presented at the AACR Annual Meeting 2013, held in Washington, D.C., April 6-10. Abstract LB-63.

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Ovarian cancer has the highest mortality rate of all gynecologic cancers. It is the fifth leading cause of cancer death among U.S. women, with roughly 22,000 new cases and 15,000 deaths predicted for 2012. Outcomes for women diagnosed with advanced disease remain poor, and researchers continue to evaluate new approaches to treatment.

In two consecutive trials, researchers evaluated a novel immunotherapeutic strategy with two steps — dendritic cell vaccination and adoptive T-cell therapy. The first step of the immunotherapy approach is to preserve the patient’s tumor at the time of surgery so it can be used to manufacture a personalized vaccine that teaches the patient’s own immune system to attack the tumor. Next, researchers isolated immune cells called dendritic cells from the blood of 31 patients with recurrent, progressive, stage 3 and 4 ovarian cancer. They then prepared the vaccine by exposing each patient’s dendritic cells to her own tumor tissue. The first six patients were assigned to the first version of a vaccine while the other 25 were assigned to an enhanced vaccine.

After vaccine treatment, 19 patients showed clinical benefit and developed an antitumor immune response. Of these 19 patients, 8 had no measurable disease at the end of the study and remained on maintenance therapy and one of these eight remained disease-free for 42 months after vaccine treatment.

Eleven patients who responded to the vaccine treatment but still had residual disease moved to the second step of the immunotherapy: adoptive T-cell therapy. At this point, the researchers removed immune cells called T cells from patients’ blood, stimulated and expanded the cells in the laboratory, and then reinjected them into the patients. The researchers found that because the T-cells had already been “educated” by the dendritic cell vaccine to attack the tumor cells, the adoptive T-cell transfer amplified the antitumor immune response. Of these 11 patients, seven had stable disease and one had a complete response.

Both treatments were given in conjunction with Avastin® (bevacizumab), a targeted therapy that blocks a protein known as VEGF, which plays a key role in the development of new blood vessels. By blocking VEGF, Avastin deprives the cancer of nutrients and oxygen and inhibits its growth. The researchers noted that Avastin and immunotherapy was a powerful combination.

The vaccination therapy alone showed about a 61 percent clinical benefit and the combination of therapies showed about a 75 percent benefit. The researchers concluded that the therapy was effective and offered potential for good quality of life and minor side effects. They note that the approach warrants further investigation.

Reference:

Kandalaft LE, Tanyi J, Chiang C, et al. Autologous whole-tumor antigen vaccination in combination with adoptive T cell therapy for patients with recurrent ovarian cancer. Presented at the AACR Annual Meeting 2013, held in Washington, D.C., April 6-10. Abstract LB-335.

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In 2007, the WCRF and the AICR issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. The 10 recommendations are as follows:

• Be as lean as possible within the normal range of body weight.
• Be physically active as part of everyday life.
• Limit consumption of energy-dense foods. Avoid sugary drinks.
• Eat mostly foods of plant origin.
• Limit intake of red meat and avoid processed meat.
• Limit alcoholic drinks.
• Limit consumption of salt. Avoid moldy grains or legumes.
• Aim to meet nutritional needs through diet alone (by avoiding supplements).
• Mothers to breastfeed; children to be breastfed.
• Follow the recommendations for cancer prevention. 

In order to determine whether these recommendations were associated with a reduced risk of death, researchers conducted a study to investigate 378,864 people in nine European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. Over a period of 12 years, researchers examined the subjects’ diet and lifestyle to see how closely they complied with six or seven (for women) of the ten recommendations: body fat, physical activity, consumption of foods and drinks that promote weight gain, consumption of plant foods, meat, alcoholic drinks and breastfeeding. Participants were given a score from 0 to 6 (or 7 for women); higher scores indicated greater compliance with the recommendations.

They then compared the group of participants with the strongest adherence to the guidelines to those with the weakest adherence to calculate the level of risk reduction that would come from compliance with the recommendations. When compared to the group with the lowest level of compliance, those who most closely followed the WCRF/AICR recommendations had a 34 percent reduced risk of death overall—and specifically, a 50 percent reduced risk of dying from respiratory disease, 44 percent reduced risk of dying from circulatory disease, and a 20 percent reduced risk of dying from cancer.

Being lean and eating foods mostly of plant origin appeared to have the greatest impact on reducing the risk of death from disease. Limiting alcohol consumption and eating mostly plant foods had the greatest impact on reducing the risk of cancer death. Women who breastfed for at least six months had a reduced risk of death from cancer and circulatory disease.

The researchers concluded that following the WCRF/AICR lifestyle recommendations could reduce the risk of cancer death and death from other diseases.

Reference:

Vergnaud AC, Romaquera D, Peeters PH, et al. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study. The American Journal of Clinical Nutrition. Published early online April 3, 2013. doi: 10.3945/ajcn.11

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Each year in the United States, more than 240,000 men are diagnosed with prostate cancer and more than 27,000 die of the disease. Prostate cancer is typically a disease of aging. It may persist undetected for many years without causing symptoms. In fact, most men die with prostate cancer not from prostate cancer. Approximately 20% of men will develop prostate cancer during their lifetime, yet only 3% will actually die of the disease.

The treatment of early-stage prostate cancer is controversial because thus far there is no clear proof that aggressive treatment prolongs survival compared with deferred treatment. Furthermore, treatment can cause lasting side effects, such as impotence and incontinence. Some men opt for a more conservative approach, called active surveillance or watchful waiting—which defers treatment until symptoms appear and/or there is evidence of progression. This approach can help some men avoid unnecessary treatment and potentially long-lasting side effects; however, until now, it wasn’t possible to predict which cancers were aggressive and required treatment and which were slow-growing and could be watched until treatment was necessary.

The Oncotype DX prostate cancer test measures the level of expression of 17 genes across four biological pathways to predict prostate cancer aggressiveness. The test results are reported as a Genomic Prostate Score (GPS) that ranges from 0 to 100 and is combined with other clinical factors to further clarify a man’s risk prior to treatment intervention.

The validation study led by researchers at the University of California, San Francisco (UCSF) included 395 patients whose GPS was assessed using tissue from a single needle biopsy. The results indicated that the information provided by the GPS significantly increased—tripled, in fact—the number of patients identified as having low-risk disease who were thus eligible for active surveillance rather than treatment. What’s more, approximately 10 percent of patients originally classified as very low or low risk by clinical factors were identified by GPS as having more aggressive disease, which would be considered for immediate treatment.

The researchers concluded that the Oncotype DX GPS strongly predicted disease aggressiveness, offering information beyond currently available clinical factors, such as PSA and biopsy Gleason Score, to help physicians and their prostate cancer patients confidently choose the most appropriate treatment based on an individualized risk assessment. What’s more, the test has been validated to guide treatment decisions with the prostate needle biopsy sample—meaning low-risk patients could avoid invasive treatments such as surgery or radiation. The test is now available to patients and the researchers speculate that it could increase the use of active surveillance and help avoid overtreatment.

Reference:

Cooperberg M, Simko J, Falzarano S, et al. Development and validation of the biopsy-based genomic prostate score (GPS) as a predictor of high grade or extracapsular prostate cancer to improve patient selection for active surveillance. Presented at the 2013 annual meeting of the American Urological Association. May 4-8, 2010. San Diego, CA. Abstract 2131.

Copyright © 2013 CancerConsultants. All Rights Reserved.

The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and detoxification of numerous substances. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatitis C is an infection of the liver and one of the leading causes of liver cancer.

Statins are cholesterol-lowering drugs and are the most commonly prescribed class of prescription drugs in the United States. Some studies have suggested that in addition to their cardiovascular effects, statins may help to reduce the risk of certain cancers, including prostate cancer and colorectal cancer.[2][3] However, other studies have demonstrated little evidence that statins reduce risk.[4][5]

To examine the relationship between statins and liver cancer among individuals with hepatitis C (HCV), researchers conducted a population-based cohort study of 260,864 HCV-infected patients enrolled in the Taiwan National Health Insurance Research Database. Patients were followed from 1999 to 2010, during which time about 13 percent of patients (35,023) filled a prescription for statins.

During the course of follow-up, there were 27,883 cases of liver cancer in the cohort. Among the 35,023 patients using statins, 1,378 had liver cancer. Among the 225,841 patients not using statins, 26,505 developed liver cancer. After the researchers accounted for patients’ age, gender and other diseases, they found those who took statins were about half as likely to get cancer as non-statin users. Higher doses of statins, as well as longer-term use, were linked to a further drop in cancer risk.

The researchers concluded that among people with hepatitis C, statin use was associated with a reduced risk of liver cancer; however, they are quick to point out that this doesn’t prove that statins prevent cancer. The data isn’t strong enough to warrant prescribing statins for liver cancer prevention; however, the researchers did not find a link between statins and any complications in this population—meaning that doctors do not need to avoid prescribing statins in people with hepatitis C.

References:

Copyright © 2013 CancerConsultants. All Rights Reserved.

Anal cancer is an uncommon type of cancer that occurs in the anal canal, the opening at the end of the rectum. The rate of anal cancer in the United States has been rising since 1940. The most common type of anal cancer is squamous cell carcinoma of the anal canal (SCCA), which accounts for about 85 percent of cases.

Some groups are at a higher risk of developing anal cancer, including gay men, individuals with multiple sex partners over their lifetime, individuals with genital warts, and those who have had anal intercourse. Infection with the human papillomavirus (HPV) is one of the major risk factors for anal cancer and in fact, is estimated to cause about 85 percent of all anal cancer cases. Individuals with compromised immune systems—including those with HIV—are at a higher risk of developing HPV, and subsequently HPV-related cancers.

Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, researchers found that the rate of anal cancers went from approximately one person per 100,000 between 1973 and 1996 to three per 100,000 between 1997 and 2009. They identified 11,231 cases of SCCA between 1973 and 2009 and analyzed the trends among these cases. They observed a large rise in incidence in 1997. In the 23 years prior to 1997, 4,224 people were diagnosed, whereas 7,007 people were diagnosed in the 13 years following 1997. Anal cancer rates rose for both genders, but more dramatically for men. Rates for both SCCA and anal carcinoma in situ (CIS) rose, whereas rates for adenocarcinoma remained stable.

The researchers concluded that the incidence of SCCA and CIS increased dramatically after 1997 for both men and women, although men were more likely to be diagnosed with CIS. They speculated that the increase could be the result of more available screening and an increased effort to identify high-risk individuals who may benefit from screening.

Reference:

Nelson RA, Levine AM, Bernstein L, et al. Changing patterns of anal canal carcinoma in the United States. Journal of Clinical Oncology. 2013; 31(12): 1569-1575.

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