A review of oncology literature compiled by Giuseppe Curigliano, Division of Medical Oncology, IEO, Milan, Italy

Suppression of Antitumor Immunity by Stromal Cells Expressing Fibroblast Activation Protein–α

Matthew Kraman et al. Science, 05.11.2010

The stromal microenvironment of tumors, which is a mixture of hematopoietic and mesenchymal cells, suppresses immune control of tumor growth. A stromal cell type that was first identified in human cancers expresses fibroblast activation protein–α (FAP).

The team created a transgenic mouse in which FAP-expressing cells can be ablated. Depletion of FAP-expressing cells, which made up only 2% of all tumor cells in established Lewis lung carcinomas, caused rapid hypoxic necrosis of both cancer and stromal cells in immunogenic tumors by a process involving interferon-α and tumor necrosis factor–β. Therefore, FAP-expressing cells are a nonredundant, immune-suppressive component of the tumor microenvironment.

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Denosumab Compared With Zoledronic Acid for the Treatment of Bone Metastases in Patients With Advanced Breast Cancer: A Randomized, Double-Blind Study

Alison T. Stopeck et al. JCO, early release

This randomized study compared denosumab, a fully human monoclonal antibody against receptor activator of nuclear factor κ B (RANK) ligand, with zoledronic acid in delaying or preventing skeletal-related events (SREs) in patients with breast cancer with bone metastases.

Patients were randomly assigned to receive either subcutaneous denosumab 120 mg and intravenous placebo (n: 1,026) or intravenous zoledronic acid 4 mg adjusted for creatinine clearance and subcutaneous placebo (n: 1,020) every 4 weeks. All patients were strongly recommended to take daily calcium and vitamin D supplements.

Denosumab was superior to zoledronic acid in delaying or preventing SREs in patients with breast cancer metastatic to bone and was generally well tolerated. With the convenience of a subcutaneous injection and no requirement for renal monitoring, denosumab represents a potential treatment option for patients with bone metastases.

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Multicenter, Randomized, Cross-Over Clinical Trial of Venlafaxine Versus Gabapentin for the Management of Hot Flashes in Breast Cancer Survivors

Louise Bordeleau et al. JCO, early release

Sixty-six patients were randomly assigned, 56 of whom provided a preference (eight dropped out and two had no preference); 18 (32%) preferred gabapentin and 38 (68%) preferred venlafaxine (P = .01).

Breast cancer survivors prefer venlafaxine over gabapentin for treating hot flashes.

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Placebo-Controlled Trial to Determine the Effectiveness of a Urea/Lactic Acid–Based Topical Keratolytic Agent for Prevention of Capecitabine-Induced Hand-Foot Syndrome: North Central Cancer Treatment Group Study N05C5

Sherry L. Wolf et al. JCO, early release

This trial was conducted on the basis of preliminary data that a urea/lactic acid–based topical keratolytic agent (ULABTKA) may prevent HFS. Patients were randomly assigned to a ULABTKA versus a placebo cream, which was applied to the hands and feet twice per day for 21 days after the start of capecitabine. Patients completed an HFS diary (HFSD) daily.

The percentage of patients with moderate/severe HFS symptoms was not different between groups, being 13.6% in the ULABTKA arm and 10.2% in the placebo arm (P = .768 by Fisher's exact test).

This data does not support the efficacy of a ULABTKA cream for preventing HFS symptoms in patients receiving capecitabine.

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