A Phase l Study of a Tumor-targeted Systemic Nanodelivery System, SGT-94, in Genitourinary Cancers.

Gene therapy development has been limited by our inability to target multifocal cancer with systemic delivery. We developed a systemically administered, tumor-targeted liposomal nanodelivery complex (SGT-94) carrying a plasmid encoding RB94, a truncated form of the RB gene. In preclinical studies, RB94 showed marked cytotoxicity against tumor but not normal cells. SGT-94 was administered intravenously in a first-in-man study in metastatic genitourinary cancer. Minimal side effects were observed; dose-limiting toxicity (DLT) has not been reached in 11 evaluable patients. There was evidence of clinical activity at the 2.4 mg dose with one complete remission (CR) and one partial remission (PR). The patient in CR was retreated upon progression and had a second PR. Furthermore, there was tumor-specific targeting of the SGT-94 complex. One patient had wedge resections of two lung metastases which demonstrated RB94 expression at the DNA level by polymerase chain reaction (PCR) and at the protein level by Western blotting, with no RB94 present in normal contiguous lung. In conclusion, systemically delivered SGT-94 showed evidence of selective tumor targeting and was well tolerated with evidence of clinical activity. Additional studies are warranted to explore the activity of this drug as a single agent and in combination therapy.

Pap smear screening among Asian Pacific Islander women in a multisite community-based cancer screening program.

This study assessed screening completion rates (SCR) and sociodemographic factors associated with Pap test screening among previously nonadherent, foreign-born Asian Pacific Islander (API) women across four sites participating in a community-based cancer screening program called ENCOREplus. At intake, 926 out of 1,140 women were nonadherent to recommended Pap test screening guidelines. Most participants were age 51 and older, had a high school education or higher, had been in the U.S. less than a decade, had annual household incomes less than $10,000, and were uninsured. Women with limited resources were more likely to get a Pap test after participating in ENCOREplus. Women from the Glendale site were almost 18 times more likely to get a Pap test than API women in other sites. Over half of the women in Glendale reported that help getting low cost Pap tests and having translators available were instrumental in completing screening.

Correlates of breast cancer screening among Asian Americans enrolled in ENCOREplus.

This study examines the correlates of mammogram utilization among predominantly low income Asian American women using cross sectional data of women recruited through the ENCORE(plus) program (n = 1,695) between July 1996 and June 1998. Logistic regression was used to examine the independent effect of variables corresponding to Andersen's behavioral model of health services utilization on mammography screening behavior. Foreign-born women living in the U.S. < 5 years and between 5 and 10 years were significantly less likely to have ever had a mammogram than women who were born in the U.S. (OR 0.22; CI 0.12, 0.40 and OR 0.48; CI 0.27, 0.86, respectively). Women 40-49 years old were half as likely to adhere to mammography screening recommendations as women 50-64 years (CI 0.33, 0.76). Health insurance was positively associated with adherence to mammography screening guidelines (OR 1.59; CI 1.02, 2.48). The results of this study highlight the need for health education about breast cancer and mammography among Asian American women. Policy work also needs to be directed toward improving access to health care in this community.

Repeat mammography screening among low-income and minority women: a qualitative study.

Regular mammography screening can reduce breast cancer mortality, yet low-income African American and Hispanic women underutilize mammography screening and are often diagnosed at a later stage, resulting in increased mortality. We used qualitative research methods to identify factors influencing regular breast cancer screening among African American and Hispanic women. Predisposing factors (including fear of mastectomy and lack of knowledge), enabling factors (including cost and social support) and a reinforcing factor were identified and categorized utilizing the PRECEDE framework. The study identified factors associated with the decision to complete regular mammography screening, and examined differences between African American and Hispanic women who participated in the interviews. Future research should seek to better understand the influence of family/friends, risk perception, and fatalistic beliefs on the decision to obtain regular mammograms.