Angiogenesis modifications related with cetuximab plus irinotecan as anticancer treatment in advanced colorectal cancer patients.

Introduction: Angiogenesis has been correlated with increased invasion and metastases in a variety of human neoplasms. Inadequate inhibition of the growth of tumor microvessels by anticancer agents may result in treatment failure, rated clinically as progressive or stable disease. We designed this trial to investigate the modification of the vascular endothelial growth factor (VEGF) and interferon-c (IFN-c) in advanced colorectal cancer patients during treatment with a weekly combination of cetuximab plus irinotecan. Materials and methods: Forty-five metastatic colorectal cancer patients were prospectively evaluated for circulating levels of VEGF and IFN-c during the treatment with cetuximab (initial dose of 400 mg/m2 , followed by weekly infusions of 250 mg/m2 ) plus weekly irinotecan (90 mg/m2 ). The circulating levels of the cytokines were assessed at the following time points: just before and at 1, 21, 50 and 92 days after the start of cetuximab plus irinotecan treatment. Results: Basal serum VEGF median levels were significantly decreased just at the first day (after the first treatment infusion (P = 0.016). The VEGF persisted at the following time points reaching the highest statistical significance 92 days after the first infusion (P < 0.0001). On the contrary, IFN-c values showed a statistical significant increase one day after the first infusion (P < 0.0001). This effect persisted 21 days after the treatment start (P = 0.001), but was no more evident at the following time points. Moreover, a linear regression model with variance analysis showed a significant negative correlation between VEGF and IFN-c values 1, 21 and 50 days after the treatment beginning (P = 0.002, 0.001 and 0.047, respectively). Conclusions: This study suggests that a cetuximab may induce a modulation of VEGF circulating levels. The reduction of VEGF serum levels is a sudden and long lasting phenomenon. Moreover, in our study we identified a IFN-c increase, even if the specific role of this behavior remains to be investigated

A high positive predictive value algorithm using hospital administrative data identified incident cancer cases

OBJECTIVE: We have developed and validated an algorithm based on Piedmont hospital discharge abstracts for ascertainment of incident cases of breast, colorectal, and lung cancer. STUDY DESIGN AND SETTING: The algorithm training and validation sets were based on data from 2000 and 2001, respectively. The validation was carried out at an individual level by linkage of cases identified by the algorithm with cases in the Piedmont Cancer Registry diagnosed in 2001. RESULTS: The sensitivity of the algorithm was higher for lung cancer (80.8%) than for breast (76.7%) and colorectal (72.4%) cancers. The positive predictive values were 78.7%, 87.9%, and 92.6% for lung, colorectal, and breast cancer, respectively. The high values for colorectal and breast cancers were due to the model's ability to distinguish prevalent from incident cases and to the accuracy of surgery claims for case identification. CONCLUSIONS: Given its moderate sensitivity, this algorithm is not intended to replace cancer registration, but it is a valuable tool to investigate other aspects of cancer surveillance. This method provides a valid study base for timely monitoring cancer practice and related outcomes, geographic and temporal variations, and costs