Risk factors for second primary tumours in breast cancer survivors.

Breast cancer (BC) survivors have an increased risk of developing second primary cancer (SPC). The aim of this study was to detect and compare SPC predictors linked to the host, the first BC and its treatment. Two hundred and seventeen patients with a nonbreast SPC and 465 matched controls, nested in the cohort of BC patients diagnosed in a Spanish region between 1975 and 2003, were involved in a case-control study. The Tumour Registry database provided information about the host, BC and its treatment factors. Their contribution to the risk of developing SPC was measured by means of a conditional logistic regression. After controlling for differences between cases and controls at baseline, obesity [odds ratio (OR): 7.48; 95% confidence interval (CI): 1.25-44.88], smoking (OR: 3.16; 95% CI: 1.23-8.15), high blood pressure (OR: 1.68; 95% CI: 1.04-2.71) and having first-degree relatives suffering from cancer (OR: 1.69; 95% CI: 1.05-2.72) were the best SPC predictors. The risk of SPC increases by 1% per month of survival from BC (OR: 1.01; 95% CI: 1.007-1.012), while having metastases (OR: 0.23; 95% CI: 0.14-0.37) and being premenopausal at diagnosis of the BC (OR: 0.44; 95% CI: 0.247-0.792) diminish the risk, probably decreasing survival. The treatments were the regression model's worst predictors. Controlling modifiable factors linked to lifestyle such as obesity and smoking is essential to prevent SPC in survivors of BC. Health education to remove persistent risk factors should be included in the treatment protocol of BC patients, because they are important predictors of SPC.

Aplicación de los Tissue Microarrays en el estudio inmunohistoquímico de los tumores / Applying Tissue Microarrays in tumor immunohistochemistry studies

Los tissue microarrays (TMAs) hacen posible agruparmás de 1.000 tumores en una sola laminilla, y ser utilizadospara el análisis de numerosos marcadores de interés diagnóstico,pronóstico o de ayuda en la decisión terapéutica yselección de estudios moleculares. Así hace posible ladetección y estudio de DNA y RNA (por hibridación in situo FISH) y proteínas (inmunohistoquímica).El objetivo de este estudio fue comprobar la representatividadde los TMAs en el estudio morfológico de diferentestumores y valorar los TMAs como herramienta para elestudio inmunohistoquímico. Los TMA se realizaron enadenocarcinomas de pulmón, adenocarcinomas de colon,carcinomas escamosos y oat-cell pulmonares, en el HospitalUniversitario Central de Asturias. Pudimos comprobarque los TMAs con tres cilindros por cada caso, son representativosdel tumor, tanto cuantitativamente como cualitativamente.La utilización de esta técnica tiene grandes ventajas quehacen posible efectuar un estudio en un tiempo escaso. Ellose halla motivado por una rápida velocidad en el procesamientode las muestras, la posibilidad de análisis simultáneoy estandarizado de múltiples muestras y la existencia de unárea de tamaño suficiente para analizar

Tissue microarrays (TMAs) allow the congregation ofmore than 1000 tumors in a single microscope slide. It canbe used for diagnostic and/or prognostic biomarker analysisthat permits the evaluation of therapeutic strategies or selectionof molecular studies. The TMAs allow the detection ofDNA and RNA by fluorescent in situ hybridization and proteindetection by immunohistochemistry.The purpose of this study was to evaluate the ability ofTMAs to differentiate tumors in morphologic studies and toassess the potential of the TMAs as a tool for immunohistochemistry.The TMAs were performed in lung adenocarcinoma,colon adenocarcinoma, squamous carcinomas andlung oat-cell carcinoma. The study was carry out on theHospital Universitario Central de Asturias in Spain. Wefound that 3 cylinder cuts of each sample provided a quantitativeand qualitative representation of each tumor. Thequick processing time of the samples, the ability to analyzemultiple samples at the same time, and wide area for analysisare the advantages of this technique. In conclusion theTMAs is a promising tool for investigation that will help ingetting results in a shorter period of time

Phase II Clinical Trial With Pegylated Liposomal Doxorubicin (CAELYX(R)/Doxil(R)) and Quality of Life Evaluation (EORTC QLQ-C30) in Adult Patients With Advanced Soft Tissue Sarcomas: A study of the Spanish Group for Research in Sarcomas (GEIS).

BACKGROUND: Pegylated liposomal doxorubicin (PLD), a formulation with pharmacokinetic differences with respect to doxorubicin (DXR), might benefit patients with advanced soft tissue sarcoma (STS) pretreated with DXR. PATIENTS AND METHODS: Patients with measurable and progressive STS received PLD at 35 mg/(2) every 3 weeks. Quality of life before and during treatment was assessed with EORTC QLQ-C30. RESULTS: Twenty-eight patients, 22 DXR-pretreated, were given 140 cycles (median 3, range 1-18). Activity in 27 patients (5 GIST): one complete and one partial remission (both non-GIST and without prior DXR), 12 stabilizations and 13 progressions (response rate 7.4%, 95% CI: 0-17%). Grade 3 toxicity: palmar-plantar erythrodysesthesia (19% of patients), stomatitis (4%) or cutaneous (4%). Neutropenia grade>/=3 was detected in 16% of patients. Median relative dose intensity was 95%. Progression-free rate at 3 and 6 months was, respectively, 48 and 22%, median progression-free survival 5.8 months and median overall survival 8.7 months. QLQ-C30 at baseline and at weeks 6-11 in 23 and 13 patients, respectively, showed good reliability and validity. Quality of life did not seem to worsen during therapy. CONCLUSIONS: PLD did not induce objective remissions in 22 STS patients pretreated with DXR, but progression-free rate figures support the use of this agent in patients who have not progressed under a DXR-containing regimen. The toxicity observed was comparable to that of other PLD schedules.