Research Highlights | Nature Reviews Cancer

You have full access to this article via your institution. Download PDF IMPROVING THE TOLERANCE OF DOSE-DENSE CHEMOTHERAPY Maintaining dose-dense chemotherapy is often hindered by various

adverse events, and treatment delay risks reducing treatment efficacy. One such adverse event is severe fatigue, and tumour necrosis factor-α (TNFα) is one of the cytokines responsible for

this. So, J. Paul Monk and colleagues investigated whether a TNFα decoy receptor, etanercept, would enable the maintenance of dose-dense docetaxel in patients with advanced tumours.

Initially, 12 patients were randomized to either docetaxel alone at a dose of 43 mg m−3 a week (cohort A) or the same dose of docetaxel plus 25 mg of etanercept subcutaneously twice a week

(cohort B). Patients were asked to record their levels of fatigue on a weekly basis. More doses of docetaxel (35 of 36 doses) were given to patients in cohort B, than to patients in cohort A

(29 of 36 doses; P = 0.055), and, owing to the absence of disease progression or severe toxicity, 3 of the cohort B patients were able to receive additional cycles of treatment. In another

set of patients the weekly dose of docetaxel was increased to 52 mg m−3 with etanercept, and neutropaenia rather than fatigue was the dose-limiting toxicity. Patients who received docetaxel

and etanercept self reported significantly less fatigue (P < 0.001), and biochemical analyses indicate that etanercept does not affect the pharmacokinetics of docetaxel. Tumour responses

to docetaxel were seen only in the patients who received etanercept. So, adding a TNFα inhibitor to dose-dense chemotherapy regimens improved patient tolerability of the treatment and helped

to preserve the dose intensity. ORIGINAL RESEARCH PAPER Monk, J. P. _et al_. Assessment of tumour necrosis factor α blockade as an intervention to improve tolerability of dose-intensive

chemotherapy in cancer patients. _J. Clin. Oncol._ 24, 1852–1859 (2006) TESTING FOR EARLY BREAST CANCER Biomarker Technologies, a breast cancer diagnostic company in the United States, has

received approval from the Western Institutional Review Board to begin a clinical trial on the early detection of breast cancer using a blood test. The blood test evaluates the levels of

expression of 5 biomarkers — prostate-specific antigen, interleukin 6, interleukin 8, vascular endothelial growth factor and tumour necrosis factor-α. These biomarkers, when combined and

adjusted for age, have greater than 95% sensitivity and specificity, and an accuracy of greater than 88% in identifying women with non-treated breast cancer, according to the company's

web site. The trial aims to recruit more than 930 women, and the study is expected to take 4 to 6 months to complete. The company hopes that this, the first molecular test for breast cancer,

will prove more widely applicable than mammography, particularly for women in their 20s and 30s. WEB SITEShttp://media.prnewswire.com; http://www.biomarkertech.com/btdiagnostictest.htm

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