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> Progress Spring, 2001 Index
Diffusion MRI shown to give early signs of cancer's response to treatment
In the first study of its kind, researchers
from the U-M Cancer Center are reporting success in analyzing
diffusion MRI images to distinguish between dead and living
brain tumor cells in both animals and humans. They report
that the imaging technique, which tracks the movement of water
through and between cells, allows them to assess the effect
of therapy on the cancer without relying on measurable changes
in tumor size.
Published in the Dec. 20 issue of the Journal
of the National Cancer Institute, the early finding
has the potential to dramatically change the way physicians
plan and track the effectiveness of the cancer therapies they
prescribe. It could spare patients the physical side effects
of weeks of unsuccessful
treatment, and the psychological effects of then waiting
a month or more for an MRI scan to show if they're responding.
And, it could aid in testing new anti-cancer agents.
"One of the biggest problems in dealing with
many solid cancers is measuring their response to treatment
in a timely way," says corresponding author Brian Ross, Ph.D.
"Diffusion MRI seems to provide a way to gauge that response
faster, and could individualize the clinical management of
each patient." Ross is an associate professor of radiology
and biological chemistry and co-director - with associate
professor of radiation oncology and co-author Alnawaz Rehemtullah,
Ph.D. - of the Health System's Center for Molecular Imaging.
The researchers stress that the technique has
not been, and is not yet ready to be, used in any cancer patient's
actual treatment planning. To learn more about its worth,
they're working with colleagues elsewhere on further studies
of the approach. They're also continuing to test it at U-M,
and are planning a multi-center clinical trial for late 2001.
The research was sponsored in part by the Charles
A. Dana Foundation, the
National Cancer Institute and the U-M
Clinical Research Partnership Fund.
To read more about this study, visit news
releases.
Radioactive compound
used for imaging neuroblastoma may help kill it
A radioactive compound used for the past two
decades to find certain types of cancer is now showing surprising
promise in helping to kill those tumors too, according to
new results from a small trial at the U-M Cancer Center.
All 11 children treated for neuroblastoma
in the drug's first clinical test initially had a positive
response with no significant side effects, lead researcher
Gregory Yanik, M.D., reported at the annual American
Society of Hematology meeting.
The compound, called MIBG, was originally developed
and patented at U-M in the 1970s and is now used around the
world in medical imaging to find and classify certain forms
of cancer - including neuroblastoma, the second most common
solid childhood cancer.
"MIBG can act as a tumor bullet, specifically
targeting the neuroblastoma itself, sparing other parts of
the body from complications or side effects," says Yanik.
"Because of this, we hope that with further research MIBG
will ultimately help treat and perhaps cure many patients
with neuroblastoma."
Yanik, a clinical assistant professor of pediatrics
and a bone marrow transplant specialist, leads the U-M team
that incorporated MIBG into a neuroblastoma treatment regimen,
combining it with chemotherapy and a transplant of the child's
own bone marrow. In the Phase I trial, the therapy produced
partial remission in three children and complete remission
in eight others. All were aged 2 to 14 years and had a history
of advanced, or persistent, neuroblastoma.
The MIBG regimen caused many of the patients'
tumors to shrink or disappear entirely for at least 100 days
- and up to one year -with few side effects. But, Yanik cautions,
"It's still too early to tell if it will be long-lasting."
Some patients have since relapsed and died, while others continue
to be stable. Neuroblastoma accounts for 8 percent of all
childhood cancers, arising in about 500 children each year
in the United States.
To read more about this study, visit news
releases.
Radiation therapy
may be safe for women with breast cancer gene mutations
Results from a U-M Cancer Center study suggest
that women with mutations of the BRCA 1 or 2 gene who had
breast-conserving surgery after cancer diagnosis may get the
same benefit from radiation therapy with no greater incidence
of short- or long-term side effects as women with non-hereditary
cancer. Some doctors have been concerned that in carriers
of the BRCA 1 or 2 mutation, radiation's ability to damage
DNA in normal breast tissue might outweigh its benefit in
killing cancer cells.
"With five years of follow-up data in hand,
we see no increased incidence of skin fibrosis, pain, shortness
of breath or other side effects, which suggest that DNA repair
mechanisms are intact in BRCA
1 or 2 mutation carriers," says U-M radiation oncologist
Lori Pierce, M.D.,
the study's leader. "The fear of harm, based on laboratory
findings that the BRCA gene product is linked to the cells'
own repair system, may have unnecessarily prevented some women
from getting the full range of therapeutic care."
The retrospective study, published in the October Journal
of Clinical Oncology, also found similar high rates
of survival and low rates of cancer recurrence in the affected
breast for 71 women with the BRCA 1 or 2 mutations and 213
without a mutation who had similar diagnoses, surgical procedures
and treatments.
But, Pierce cautions, the cancer recurrence
data are based on only five years of follow-up. Data on how
the women fared after 10 years will be available as early
as spring of 2002.
To learn more about this study, visit news
releases.
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