European Journal of Cancer: Highlights of Issue 37:05

Treatment of advanced/metastatic CRC patients with capecitabine compared with 5-FU/LV reduces medical resource use

In this issue, Twelves and colleagues have assessed in a randomised phase III study the medical resource use associated with the first-line treatment of 602 advanced/metastatic colorectal (CRC) patients with capecitabine compared with the Mayo regimen of 5-fluorouracil and leucovorin (5-FU/LV). Clinical efficacy and safety were improved with capecitabine and, as might be expected for an orally-administered drug compared with an intravenous regimen, the number of hospital visits for drug administration was lower for the former. The requirement for expensive drugs to manage adverse effects was also less with capecitabine. Although more home, day care, office and telephone consultations were required for capecitabine, the results suggest that this drug is the preferred fluoro-based regimen for the treatment of these patients.

Treatment decisions for patients with CML are becoming increasingly complex

Chronic myeloid leukaemia (CML) was generally regarded as fatal until the 1980s. However, since then, advances have been made and in this issue Mughal and Goldman discuss and review the increasingly complex options available for the treatment of this disease. Molecular targeted therapies are being intensively studied and the authors focus on one such example, STI 571. This is an inhibitor that is designed to target the ABL-associated tyrosine kinase activity and is of great current interest as preliminary studies suggest that it shows a considerable improvement over more standard therapies such as interferon-alpha (IFN-a).

Diversity in B-catenin signalling pathways

The debate on the role of B-catenin signalling in breast cancer goes on with two letters to the Editor. Rahn and Hugh commenting on a previous publication by Jonsson and coworkers (EJC 2000 36 242-248) provide confirmation of the absence of the B-catenin protein from the nucleus in 71 cases of breast tumours, despite the detection of nuclear protein using the same antibody in colon and ovarian carcinomas. These authors propose that the lack of expression suggests that B-catenin does not play a major role in breast cancer tumorigenesis. In their response, Jonsson and colleagues discuss several reasons for the absence of the protein in the nucleus such as removal from the nucleus by an active APC protein. It is likely the debate will continue.

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