BACKGROUND.Recently, it was shown that an inflammation‐based prognostic score, the Glasgow Prognostic Score (GPS), provides additional prognostic information in patients with advanced cancer. The objective of the current study was to examine the value of the GPS compared with established scoring systems in predicting cancer‐specific survival in patients with metastatic renal cancer.METHODS.One hundred nineteen patients who underwent immunotherapy for metastatic renal cancer were recruited. The Memorial Sloan‐Kettering Cancer Center (MSKCC) score and the Metastatic Renal Carcinoma Comprehensive Prognostic System (MRCCPS) score were calculated as described previously. Patients who had both an elevated C‐reactive protein level (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a GPS of 2. Patients who had only 1 of those 2 biochemical abnormalities were allocated a GPS of 1. Patients who had neither abnormality were allocated a GPS of 0.RESULTS.On multivariate analysis of significant individual factors, only calcium (hazard ratio [HR], 3.21; 95% confidence interval [95% CI], 1.51–6.83; P = .002), white cell count (HR, 1.66; 95% CI, 1.17–2.35; P = .004), albumin (HR, 2.63; 95% CI, 1.38–5.03; P = .003), and C‐reactive protein (HR, 2.85; 95% CI; 1.49–5.45; P = .002) were associated independently with cancer‐specific survival. On multivariate analysis of the different scoring systems, the MSKCC (HR, 1.88; 95% CI, 1.22–2.88; P = .004), the MRCCPS (HR, 1.42; 95% CI, 0.97–2.09; P = .071), and the GPS (HR, 2.35; 95% CI, 1.51–3.67; P < .001) were associated independently with cancer‐specific survival.CONCLUSIONS.An inflammation‐based prognostic score (GPS) predicted survival independent of established scoring systems in patients with metastatic renal cancer. Cancer 2007. © 2006 American Cancer Society.

Prediction of outcome in patients with metastatic breast cancer remains problematical. The present study evaluated the value of an inflammation-based score (Glasgow Prognostic Score, GPS) in patients with metastatic breast cancer. The GPS was constructed as follows: patients with both an elevated C-reactive protein (410 mg l À1 ) and hypoalbuminaemia (o35 g l À1 ) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. In total, 96 patients were studied. During follow-up 51 patients died of their cancer. On multivariate analysis of the GPS and treatment received, only the GPS (HR 2.26, 95% CI 1.45 -3.52, Po0.001) remained significantly associated with cancer-specific survival. The presence of a systemic inflammatory response (the GPS) appears to be a useful indicator of poor outcome independent of treatment in patients with metastatic breast cancer.

There is a high and rising prevalence of prostate cancer (PRCA) within the male population of the United Kingdom. Although the relative risk of PRCA is higher in male BRCA2 and BRCA1 mutation carriers, the histological characteristics of this malignancy in these groups have not been clearly defined. We present the histopathological findings in the first UK series of BRCA1 and BRCA2 mutation carriers with PRCA. The archived histopathological tissue sections of 20 BRCA1/2 mutation carriers with PRCA were collected from histopathology laboratories in England, Ireland and Scotland. The cases were matched to a control group by age, stage and serum PSA level of PRCA cases diagnosed in the general population. Following histopathological evaluation and re-grading according to current conventional criteria, Gleason scores of PRCA developed by BRCA1/2 mutation carriers were identified to be significantly higher (Gleason scores 8, 9 or 10, P ¼ 0.012) than those in the control group. Since BRCA1/2 mutation carrier status is associated with more aggressive disease, it is a prognostic factor for PRCA outcome. Targeting screening to this population may detect disease at an earlier clinical stage which may therefore be beneficial. British Journal of Cancer (2008) Prostate cancer (PRCA) is the most commonly diagnosed malignancy in men in the United Kingdom. It is thought to be composed of aggressive and indolent varieties. Indolent PRCA may exist for many years without causing symptoms or shortening life expectancy. Aggressive PRCA may cause symptoms difficult to palliate with conventional treatments and is likely to shorten life expectancy. Distinguishing which men are at risk of which types of disease could have far-reaching consequences not only in the treatment and follow-up of patients but also in the surveillance of groups at risk of aggressive PRCA.The morphology of breast cancer found in female BRCA1 and BRCA2 germline mutation carriers has been studied extensively. The histopathological features of breast tumours from patients with BRCA1 and BRCA2 mutations differ from each other and from sporadic breast cancers . BRCA1 and BRCA2 breast cancers are of higher grade (Lakhani, 2001). BRCA1-associated tumours are more likely to be oestrogen, progesterone receptor and Her2 receptor negative, express TP53 protein, and demonstrate medullary/atypical medullary morphology. Lakhani (2001) predicts that a woman diagnosed with high-grade, oestrogen receptor-negative breast cancer before the age of 30 years has a 40-45% chance of harbouring a BRCA1 mutation, compared with a 4-5% chance if these parameters are not met (Lakhani, 2001). Many of the features identified in breast cancer in women who are BRCA1 mutation carriers are associated with a poor prognosis. If similar data were available for men with PRCA who are carriers of these mutations, weighing up the options for radical treatment or active surveillance could be simplified with this added information.Despite studies on the incidence of PRCA in male BRCA1 and BRCA2 mutation...

#15 Background: Exemestane (E) is a steroidal aromatase inactivator, which has been demonstrated to be more effective than tamoxifen (T) in metastatic breast cancer (BC). The role of E in adjuvant therapy has been established after 2 to 3 years of T compared to 5 years of T in the Intergroup Exemestane Study (Lancet 2007; 369: 599-70). One objective of the TEAM study was to evaluate E compared to T as initial adjuvant endocrine therapy.&#x2028; Methods: Using common criteria, eligible postmenopausal patients in 9 countries with invasive ER+ and/or PR+ early BC, were prospectively randomized to either open-label E 25 mg/day or T 20 mg/day. All patients had completed primary therapy of surgery and chemotherapy if indicated. All data were collected and analyzed by the Central Data Center in Leiden, The Netherlands. The trial was initiated in 2001 with a primary endpoint of DFS between T and E. In 2004, based on results of the IES, TEAM was modified such that all patients on T were switched to E at 2.5-3 years. The modified design includes 2 primary endpoints: DFS of T versus E followed up to 2.75 years, and DFS of E for 5 years versus T switched to E treated for a total of 5 years. The present analysis focuses on the first primary endpoint: DFS for T compared to E at 2.75 years with censoring of events after 2.75 years. Log rank test with a 2-sided significance level of 2.98% stratified by country and factors nested in protocols will be utilized.&#x2028; Results: Between January 2001 and January 2006, 9775 women were randomized to T or E of which 9300 will be followed for 2.75 years by October 2008: 99% were ER and/or /PgR+, 50% were node negative, 44% underwent mastectomy, 68% received radiotherapy, and 36% chemotherapy. There have been 693 DFS events (locoregional or distant recurrence, second breast cancers, or death without recurrence) by April 2008 within 2.75 years of randomization. In accordance with the statistical analysis plan, the first planned analysis will be based on 723 events or 9300 patients with at least 2.75 years follow-up. We will present a detailed analysis of the first primary endpoint of DFS between T and E at 2.75 years at the 2008 SABCS. The TEAM study represents the largest of the 3 major trials to compare efficacy of an aromatase inhibitor/inactivator versus tamoxifen as initial endocrine therapy. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 15.

S U M M A R YProduction of paraffin-section material from tissue samples that contain bone requires decalcification. Techniques such as acidic decalcification or EDTA chelation are suitable methods. Acid decalcification is generally quicker than EDTA chelation but studies have suggested that it may result in hydrolysis of DNA. Here we show that limited acid decalcification (less than 24 hr) in 5% formic acid can preserve DNA sufficient for fluorescent in situ hybridization (FISH) or comparative genomic hybridization (CGH) and that prolonged 10% formic acid decalcification results in failure of FISH and only limited retrieval of DNA for CGH studies.