“A new procedure developed by surgeons at The University of Texas MD Anderson Cancer Center improves the accuracy of axillary staging and pathologic evaluation in clinically node-positive breast cancer, and reduces the need for a more invasive procedure with debilitating complications.
“The research, published in the Journal of Clinical Oncology, has changed treatment guidelines at the institution for a select group of breast cancer patients with lymph node metastasis, who will now receive Targeted Axillary Dissection (TAD).
“The TAD procedure involves removing sentinel lymph nodes, as well as additional cancerous lymph nodes found during diagnosis. At the time of diagnosis, those select nodes are clipped for identification during later surgery.”
“The FDA has announced a de novo clearance for a minimally invasive high-intensity focused ultrasound (HIFU) prostate tissue ablation device called Sonablate 450. This clearance marks the first time HIFU technology will be used in the United States.
“ ‘It is anticipated that ablative urological surgeons in the US will quickly master and adapt this technology for their patients,’ said Herbert Lepor, MD, professor and Martin Spatz Chairman, Department of Urology, New York University School of Medicine, in a statement. ‘HIFU offers the opportunity for the precise delivery of ablative energy to the prostate. Thus, it can be adapted to whole gland or focal gland ablation.’
“Sonablate 450 is used on patients with low-to-high-risk prostate cancer with a PSA lower than 10 ng/mL who have progressed on external beam radiation therapy. The device utilizes a fully integrated probe with dual ablation transducer and focuses ultrasound energy at a targeted location in the prostate gland called the focal point, which is heated to nearly 195 degrees Fahrenheit (90 degrees Celsius). The tissue targeted at the focal point is destroyed, but tissue surrounding the targeted area remains unharmed.”
“A new type of blood test is starting to transform cancer treatment, sparing some patients the surgical and needle biopsies long needed to guide their care.
“The tests, called liquid biopsies, capture cancer cells or DNA that tumors shed into the blood, instead of taking tissue from the tumor itself. A lot is still unknown about the value of these tests, but many doctors think they are a big advance that could make personalized medicine possible for far more people.
“They give the first noninvasive way to repeatedly sample a cancer so doctors can profile its genes, target drugs to mutations, tell quickly whether treatment is working, and adjust it as the cancer evolves.
“Two years ago, these tests were rarely used except in research. Now, several are sold, more than a dozen are in development, and some doctors are using them in routine care.”
O'Connell MP, Marchbank K, Webster MR, Valiga AA, et al. Cancer Discovery. Oct 8, 2013.
“An emerging concept in melanoma biology is that of dynamic, adaptive phenotype switching, where cells switch from a highly proliferative, poorly invasive phenotype to a highly invasive, less proliferative one. This switch may hold significant implications not just for metastasis, but also for therapy resistance. We demonstrate that phenotype switching and subsequent resistance can be guided by changes in expression of receptors involved in the non-canonical Wnt5A signaling pathway, ROR1 and ROR2. ROR1 and ROR2 are inversely expressed in melanomas and negatively regulate each other. Further, hypoxia initiates a shift of ROR1-positive melanomas to a more invasive, ROR2-positive phenotype. Notably, this receptor switch induces a 10-fold decrease in sensitivity to BRAF inhibitors. In melanoma patients treated with the BRAF inhibitor, Vemurafenib, Wnt5A expression correlates with clinical response and therapy resistance. These data highlight the fact that mechanisms that guide metastatic progression may be linked to those that mediate therapy resistance.”