Genitourinary Cancers Symposium, Feb. 26-28
The American Society of Clinical Oncology's annual Genitourinary Cancers Symposium was held from Feb. 26 to 28 in Orlando, Fla., and attracted more than 2,000 participants from around the world. The conference highlighted recent advances in the diagnosis, prevention, and management of genitourinary cancers, including prostate, kidney, bladder, and testicular cancers, as well as less common cancers such as those of the penis, ureters, and other urinary organs.
In one study, Mark A. Preston, M.D., of Brigham and Women's Hospital in Boston, and colleagues used two Harvard cohorts, the Nurses' Health Study and Health Professionals Follow-Up Study, in order to study the relationship between obesity and kidney cancer. The investigators identified 575 cases of kidney cancer, of which 149 were fatal. The investigators evaluated body mass index (BMI) using three different methods: (1) BMI at the time of surgery (90 percent of patients underwent surgery for kidney cancer); (2) BMI at baseline when the cohorts started; and (3) cumulative average BMI utilizing BMI levels reported every two years.
"Using this approach, we found an increased risk of kidney cancer tied to increasing cumulative average BMI. Patients with BMI of 25.0 to 29.9 kg/m² had a 38 percent increased risk and patients with BMI of greater than 30 kg/m² had a 55 percent increased risk when compared to a normal BMI of 18.5 to 24.9 kg/m²," Preston said. "However, in contrast to other studies, we found that patients with increased BMI were more likely to develop fatal kidney cancer compared to patients with normal BMI."
Specifically, the investigators found that for patients with a BMI of 25 to 29.9 kg/m², there was 54 percent increased risk of fatal kidney cancer, and for a BMI greater than 30 kg/m², there was a 91 percent increased risk of fatal kidney cancer.
"Measuring patients' average BMI over time better accounts for misclassification and selection bias than simply using BMI at diagnosis where patients with aggressive cancer may have already lost weight," Preston added. "We believe this provides a more accurate understanding of the risk of kidney cancer associated with obesity as well as the risk of death from kidney cancer."
One author disclosed financial ties to the pharmaceutical industry.
In another study, Emmanuel Antonarakis, M.D., of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, and colleagues evaluated whether an androgen receptor abnormality, AR-V7, is associated with primary resistance to taxane chemotherapy. Previous research has demonstrated that an AR-V7 aberration is associated with resistance to hormonal therapy but it is unclear whether this aberration is associated with resistance to taxane chemotherapy.
"We evaluated 37 patients and found that patients with the AR-V7 aberration responded to chemotherapy, which is encouraging. As a result, AR-V7 may not be the main mechanism of resistance," Antonarakis said. "Understanding the implications of AR-V7 aberration as well as the availability of a companion diagnostic will help physicians target treatment more effectively."
Several authors disclosed financial ties to the pharmaceutical industry.
Naomi B. Haas, M.D., of the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, and colleagues discovered that use of adjuvant sorafenib or sunitinibin did not improve disease-free survival in patients with locally-advanced kidney cancer. The investigators found that outcomes were similar to those seen in patients who received placebo.
"These drugs didn't reduce disease recurrence, but on average they did not appear to worsen patient outcomes either," Haas said in a statement. "We are still analyzing the various groups of patients enrolled on this trial, and we hope that analysis of patient specimens collected on this study may provide clues into subsets of patients who might still benefit from these therapies."
Several authors disclosed financial ties to pharmaceutical companies, including Pfizer, which manufactures sunitinib.
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