Akt kinases in breast cancer and the results of adjuvant therapy

BACKGROUND: The serine/threonine kinase Akt, or protein kinase B, has recently been a focus of interest because of its activity to inhibit apoptosis. It mediates cell survival by acting as a transducer of signals from growth factor receptors that activate phosphatidylinositol 3-kinase. METHODS: We analysed the expression of the isoforms Akt1 and Akt2 as well as phosphorylated Akt (pAkt) by immunohistochemistry in frozen tumour samples from 280 postmenopausal patients who participated in a randomised trial comparing cyclophosphamide–methotrexate–5-fluorouracil chemotherapy and postoperative radiotherapy. The patients were simultaneously randomised to tamoxifen or to no endocrine treatment. RESULTS: Marked staining was found in 24% of the tumours for Akt1, but in only 4% for Akt2. A low frequency of Akt2-positive cells (1–10%) was observed in another 26% of the tumours. pAkt was significantly associated with both Akt1 and Akt2 expression. Overexpression of erbB2 correlated significantly with pAkt (P = 0.0028). The benefit from tamoxifen was analysed in oestrogen receptor (ER)-positive patients. Patients with a negative status of Akt (no overexpression of Akt1, Akt2 or pAkt) showed significant benefit from tamoxifen. The relative rate of distant recurrence, with versus without tamoxifen, was 0.44 (95% confidence interval [CI], 0.25–0.79) for ER+/Akt1- patients, while it was 0.72 (95% CI, 0.34–1.53) for ER+/Akt1+ patients. The difference in rate ratio did not reach statistical significance. The rate of locoregional recurrence was significantly decreased with radiotherapy versus chemotherapy for Akt-negative patients (rate ratio, 0.23; 95% CI, 0.08–0.67; P = 0.0074), while no benefit was evident for the Akt-positive subgroup (rate ratio, 0.77; 95% CI, 0.31–1.9; P = 0.58). The interaction between Akt and the efficacy of radiotherapy was significant in multivariate analysis (P = 0.042). CONCLUSION: Activation of the Akt pathway is correlated with erbB2 overexpression in breast cancer. The results suggest that Akt may predict the local control benefit from radiotherapy

Hur upplever personer med långvarig smärta sjuksköterskans bemötande?

Bakgrund: Att leva med långvarig smärta påverkar hela människan och dennas vardag. Det är viktigt att personer med långvarig smärta känner sig betrodd av sjuksköterskan och att denna i sin tur besitter kunskap och har förståelse om smärta. Målet med vårdande är att lindra och förebygga lidande, samt att skapa förutsättningar för välbefinnande. Syfte: Syftet med studien är att belysa hur personer med långvarig smärta upplever sjuksköterskans bemötande. Metod: Studien är en kvalitativ litteraturstudie. Artiklar söktes genom tre olika databaser och analyserades sedan med inspiration från Graneheim och Lundmans (2004) metod för innehållsanalys av kvalitativa data. Resultat: Resultatet visade att sjuksköterskans bemötande ofta var otillfredsställande. Det framkom att personer med långvarig smärta kände att de inte blev tagna på allvar och att sjuksköterskan uppvisade brist på förståelse. Att vara i vägen och att uppleva ensamhet i samband med sin smärta är andra exempel på vad som framkom i resultatet. Slutsats: Det är av stor vikt att vårdpersonal tar del av studier, kopplar dessa till det verkliga vårdarbetet och att fortlöpande forskning inom bemötande i samband med smärta sker

Distant recurrence-free survival for oestrogen receptor (ER)-positive patients treated with tamoxifen (TAM) or not (no TAM) in relation to Akt status

<p><b>Copyright information:</b></p><p>Taken from "Akt kinases in breast cancer and the results of adjuvant therapy"</p><p>Breast Cancer Research 2003;5(2):R37-R44.</p><p>Published online 20 Jan 2003</p><p>PMCID:PMC154147.</p><p>Copyright © 2003 Stål et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any non-commercial purpose, provided this notice is preserved along with the article's original URL.</p

Locoregional recurrence-free probability for patients treated with postoperative radiotherapy (RT) or cyclophosphamide–methotrexate–5-fluorouracil (CMF) chemotherapy in relation to Akt status

<p><b>Copyright information:</b></p><p>Taken from "Akt kinases in breast cancer and the results of adjuvant therapy"</p><p>Breast Cancer Research 2003;5(2):R37-R44.</p><p>Published online 20 Jan 2003</p><p>PMCID:PMC154147.</p><p>Copyright © 2003 Stål et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any non-commercial purpose, provided this notice is preserved along with the article's original URL.</p