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Given the abundance of new research, it can be challenging to stay current on the latest advancements and findings. Oncology Times is here to help with summaries of the newest studies to ensure you are up-to-date on the latest innovations in oncology practice.



Association between proportion of nuclei with high chromatin entropy and prognosis in gynecological cancers

Chromatin entropy nuclei was identified as a prognostic marker for patients with uterine sarcomas, ovarian carcinomas, and endometrial carcinomas, according to a recently published study (J Natl Cancer Inst 2018; doi:10.1093/jnci/djy063). Investigators found that high-chromatin entropy nuclei appeared to be associated with poor prognosis. "A texture-based biomarker that characterizes each cancer based on the proportion of high-chromatin entropy nuclei (<25% vs. >=25%) was developed on a discovery set of 175 uterine sarcomas," according to study authors. They evaluated the prognostic impact of this biomarker on a validation set of 179 uterine sarcomas, as well as on independent validation sets of 246 early-stage ovarian carcinomas and 791 endometrial carcinomas. Among the discovery set, researchers reported 5-year overall survival (OS) of 27.6 percent for high-chromatin entropy patients compared with 57.5 percent in patients with low-chromatin entropy. Patients in the sarcoma validation set had a significant difference in survival depending on if they had high- or low-chromatin entropy (28.1% and 56.5%, respectively). Data revealed a 5-year OS of 57 percent for uterine sarcoma patients with low-chromatin entropy versus 27.9 percent for those with high-chromatin entropy. "In conclusion, a novel method for detecting high-chromatin entropy nuclei was developed, and the proportion of such deviating nuclei per patient was a statistically significant prognostic marker in three gynecological cancer cohorts and could be used as a supplement in defining high-risk patients," study authors wrote.



Tau mutations serve as a novel risk factor for cancer

New research suggests that mutations to the protein tau, commonly associated with neurodegenerative disorders, may serve as a novel risk factor for cancer (Cancer Res 2018; doi:10.1158/0008-5472.CAN-17-3175). Researchers analyzed cancer incidence in 15 families bearing seven different tau mutations and affected by frontotemporal lobar degeneration (FTLD). Each tau-mutated family was matched with three reference families with superimposable pedigrees (control subject's age, gender, and native location matching the person affected with FTLD) to calculate cancer risk. Fifteen percent of subjects from tau-mutated families developed cancer, while only 9 percent of subjects from the reference families had cancer, according to study results. Types of cancer were variable in both cohort and tau mutations were not associated with specific cancers. Researchers determined, following multivariate analysis, that those from tau-mutated families were 3.72 times more likely to develop cancer compared to the reference families. Bioinformatics analysis was also utilized to gain insight into the interactions of tau protein with other proteins. Findings showed that almost a third of proteins that tau interacts with were involved in DNA metabolism and cell cycle control. "We report that the risk of developing cancer is significantly higher in families affected by genetic tauopathies, and a high proportion of tau protein interactors are involved in cellular processes particularly relevant to cancer," study authors concluded. "These findings disclose a novel role of tau as a risk factor for cancer, providing new insights in the various pathological roles of mutated tau."



Digital mammography versus digital mammography plus tomosynthesis for breast cancer screening: the Reggio Emilia Tomosynthesis randomized trial

Researchers found a combination of digital mammography and tomosynthesis detects 90 percent more breast cancers than digital mammography alone (Radiology 2018; doi:10.1148/radiol.2018172119). To learn more about the impact of digital breast tomosynthesis (DBT) on sensitivity and recall rate, results between 9,777 women randomized to undergo digital mammography and DBT and 9,783 randomized to have digital mammography alone were compared. The combination of digital mammography and DBT detected 8.6 cancers per 1,000 cases, a rate almost twice that of the 4.5 per 1,000 detected by mammography alone, according to study findings. Researchers reported a recall rate of 3.5 percent in both groups. DBT alone detected 72 of 80 cancers found in the DBT and digital mammography group. The greater detection rate for combined digital mammography and DBT was notable for small and medium invasive cancers, but not for large ones. More research is needed to further weigh the benefits of improvements in prognosis and reductions in breast cancer-related mortality from DBT against any undesired effects, according to investigators.



Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society

New guidelines developed by the American Cancer Society (ACS) recommend that screening for colorectal cancer for average-risk adults begin at age 45, 5 years earlier than the previous recommendation (CA Cancer J Clin 2018; doi:10.3322/caac.21457). ACS based these recommendation in part on research that showed an increased incidence of colorectal cancer in younger adults. There was a 51-percent increase in the incidence of colorectal cancer among adults younger than 55 years from 1994 to 2014, as well as an 11 percent increase in deaths 2005 to 2015. A recent analysis found that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with adults born around 1950, who have the lowest risk. Studies suggest that the increased risk for younger people will remain as they age. The new guidelines recommend focusing on people at average risk. Those at high risk for colorectal cancer, including those with a family history, a personal history of inflammatory bowel disease, or polyps diagnosed before age 60, should discuss their risk and appropriate screening with their physicians. The Guideline Committee also developed materials to facilitate conversations between clinicians and patients to help patients decide which test is best for them. "The American Cancer Society recommends that all U.S. adults at average risk of colorectal cancer undergo regular screening with any of the six options outlined in this guideline, beginning at age 45 years. Adults in good health should continue screening until age 75 years, beyond which the decision to continue screening should be individualized based on patient preferences, health status, life expectancy, and screening history," the authors concluded.


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