Challenges to effective cancer control in China, India, and Russia.

Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.

Tau expression correlated with breast cancer sensitivity to taxanes-based neoadjuvant chemotherapy.

The purpose of this study was to investigate the correlation between tau expression in primary breast cancer and sensitivity to taxanes during neoadjuvant chemotherapy in patients with breast cancer. We used immunohistochemistry to examine tau expression in breast cancer biopsies from 113 primary breast cancer patients and evaluated the correlation between tau expression and taxane sensitivity. Twenty-eight (24.78 %, 28/113) patients were positive for tau expression. After taxanes-based neoadjuvant chemotherapy, 40 patients achieved pathological complete response (pCR) (35.4 %). Among the 40 patients with pCR, five (12.5 %) were positive for tau expression. In univariate analysis, estrogen receptor (ER), progesterone receptor, human epidermal growth factor receptor 2 (HER2), and tau were found to be significantly predictive of a pCR (P = 0.001, 0.030, 0.002, and 0.025, respectively). Tau, ER, and HER2 status were significant for pCR on multivariate analysis (P = 0.025, 0.005, and 0.043, respectively). Tau expression was positively related to ER (P = 0.007) and progestin receptor (P = 0.008). In conclusion, tau protein expression correlated with breast cancer sensitivity to taxanes-based neoadjuvant chemotherapy; patients negative for tau expression were more likely to achieve pCR.

Comparative study of the impact of 3- versus 8-month neoadjuvant hormonal therapy on outcome of laparoscopic radical prostatectomy.

PURPOSE: To comparatively evaluate the effect of 3- versus 8-month neoadjuvant hormonal therapy (NHT) on laparoscopic radical prostatectomy (LRP) operative and postoperative parameters. METHODS: We evaluated 55 patients with clinically localized prostate cancer treated by 3-month (25 patients, group-1), 8-month NHT (19 patients, group-2) and non-neoadjuvant therapy (11 patients, group-3) before LRP. Serum PSA levels and prostate volume were measured and evaluated monthly before operation. The operative and postoperative parameters were recorded and compared in the three different groups. RESULTS: Transrectal ultrasound determined that prostate volume decreased 39.6% in group 1 and 35.4% in group 2 after 3-month NHT and a further 34.4% in group 2 after 8-month NHT. The mean prostate volume was significantly smaller after 8-month than 3-month NHT in group 2 (P < 0.05). Mean serum PSA decreased 97.8% in group 1 and 98.1% in group 2 after 3-month NHT. A further 72.9% PSA decrease was determined after 8-month NHT in group 2. There were no significant differences in the three groups with respect to mean operative time, mean blood loss, transfusion rate, operative difficulty, catheterization time, hospital time and complication rate (P > 0.05, respectively). Positive margin rate was significantly lower in the 3- or 8-month NHT group than in the non-adjuvant group (P < 0.05, respectively). However, there was no significant difference between the 3- and 8-month groups with respect to positive margin rate (P > 0.05). CONCLUSIONS: The prolonged NHT (8-month) did not affect the operative or postoperative parameters. The LRP can be safely performed in patients after prolonged NHT. Prospective randomized studies are required to determine whether prolonged NHT reduces the risk of biochemical recurrence after LRP.

Two-dose-level confirmatory study of the pharmacokinetics and tolerability of everolimus in Chinese patients with advanced solid tumors.

BACKGROUND: This phase I, randomized, multicenter, open-label study investigated the pharmacokinetics, safety, and efficacy of the oral mammalian target of rapamycin inhibitor everolimus in Chinese patients with advanced solid tumors. METHODS: A total of 24 patients with advanced breast cancer (n = 6), gastric cancer (n = 6), non-small cell lung cancer (n = 6), or renal cell carcinoma (n = 6) who were refractory to/unsuitable for standard therapy were randomized 1:1 to oral everolimus 5 or 10 mg/day. Primary end points were pharmacokinetic parameters and safety and tolerability. Pharmacokinetic 24-h profiles were measured on day 15; trough level was measured on days 2, 8, 15, 16, and 22. Tolerability was assessed continuously. This final analysis was performed after all patients had received 6 months of study drug or had discontinued. RESULTS: Everolimus was absorbed rapidly; median Tmax was 3 h (range, 1-4) and 2 h (range, 0.9-6) in the 5 and 10 mg/day groups, respectively. Pharmacokinetic parameters increased dose proportionally from the 5 and 10 mg/day doses. Steady-state levels were achieved by day 8 or earlier. The most common adverse events suspected to be related to everolimus therapy were increased blood glucose (16.7% and 41.7%) and fatigue (16.7% and 33.3%) in the everolimus 5 and 10 mg/day dose cohorts, respectively. Best tumor response was stable disease in 10 (83%) and 6 (50%) patients in the 5 and 10 mg/day groups, respectively. CONCLUSIONS: Everolimus 5 or 10 mg/day was well tolerated in Chinese patients with advanced solid tumors. The observed safety and pharmacokinetic profile of everolimus from this study were consistent with previous studies. TRIAL REGISTRATION: Chinese Health Authorities 2008L09346.