TON - September 2012 VOL 5, NO 8

What do you get when you combine the terms predisposition and survivor? The term previvor. A previvor is an individual who has not had cancer but is at increased risk due to a gene mutation or family history. He or she is a survivor of a predisposition to cancer.

I arrived in Chicago the day before the start of the 103rd Annual Meeting of the American Associa­tion for Cancer Research (AACR), filled with anticipation. I was feeling very lucky to be selected again to participate in AACR’s Scientist - Survivor Program, whose goal is to build bridges and unity among the leaders of the scientific and cancer survivor and patient advocacy communities worldwide.

The Blood and Marrow Transplant Program was established at Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute in 1991 to provide stem cell transplants to patients with breast cancer. The program fell into a lull when transplant was proven ineffective for breast cancer, but about 10 years later it had a resurgence under the directorship of Michael Lill, MD, who joined the center in 1997. In 2002, the first allogeneic transplants were performed there. Now the program has grown to include 6 medical doctors and 6 nurse coordinators. An expected 140 transplants will be performed in 2012. The largest group of transplant patients is those with multiple myeloma, followed by those with lymphoma and leukemia.

Two studies presented at the 2012 American Society of Clinical On­cology (ASCO) Annual Meet­ing suggested that abiraterone acetate (AA; Zytiga), an androgen biosynthesis inhibitor,¹ has the potential to be used earlier in the course of prostate cancer than its current US Food and Drug Administration (FDA) indication (ie, after failure of chemotherapy in men with metastatic castration-resistant prostate cancer [CRPC]).

In an ideal world, all sick people would have a caregiver who could keep them company and give at least minimal medical care 24/7, or even 8/7. Un­fortunately, because of the way society (at least in the United States) is organized, work demands, financial demands, geographical dispersion of family members, and the nature of medical care make that impossible for many. In my hospital, I see many solitary, lonely patients who most probably have many loved ones who would, if they could, be with their sick relative.

For men with localized prostate cancer detected by prostate-specific antigen (PSA) level, treatment with radical prostatectomy did not significantly reduce mortality compared with observation, according to overall results of the large, randomized, controlled PIVOT trial (Wilt TJ, et al. N Engl J Med. 2012; 367:203-213). All-cause mortality and prostate-specific mortality were similar for the surgery and observation groups over a 12-year follow-up. Results suggest that surgery may be a better option than observation for men with intermediate- and high-risk localized prostate cancer, but low-risk localized prostate cancer can be safely managed with observation.

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) induction therapy followed by maintenance therapy with rituximab was more effective than R-FC (rituximab, fludarabine, and cyclophosphamide) followed by maintenance therapy with interferon alfa in older patients with mantle cell lymphoma, according to a recently published prospective, randomized, double-blind clinical trial (Kluin-Nelemans HC, et al. N Engl J Med. 2012;367:520-531).

The OVA1 blood test had a high chance of correctly identifying whether an ovarian mass was malignant prior to surgery, according to results of the OVA500 clinical trial. In a study of 494 patients, the test had 94% sensitivity in premenopausal women and 91% sensitivity in the early-stage ovarian cancer group, for an overall sensitivity of 96%. The OVA1 blood test had a negative predictive value of 98%.

Although weightlifting reduced the need for lymphedema treatment by 50% compared with standard treatment in breast cancer survivors who participated in the Physical Activity Lymph­edema (PAL) trial, weightlifting is not without its own risks. A retrospective analysis of the PAL trial found that the rate of injury was higher in the weightlifting group compared with controls (Brown JC, et al. Oncologist. 2012; 17:1120-1128).