HDT as consolidation therapy for relapsed ESFT seems to be associated with improved OS, even after adjusting for RFI and response to second-line treatment.

Purpose: The double-strand break (DSB) is the major DNA lesion leading to chromosomal aberrations and faithful repair is crucial for maintaining genomic instability. Very little is known about the expression of DNA DSB repair proteins in colorectal cancer. To address this issue, we examined the expression pattern of DSB repair key proteins ATM, BRCA1, BRCA2, Ku70, and Ku80 and their putative role in patients survival in a large series of colorectal cancer. Experimental Design: 342 sporadic colorectal cancer were subjected to immunohistochemistry by using specific antibodies for the various proteins investigated. Staining results were compared with clinicopathologic data, patient survival, as well as expression of mismatch repair proteins MLH1 and MSH2. Results: The expression pattern of both ATM and BRCA1 predicted survival in all colorectal cancer patients as well as in the small subgroup of patients that received adjuvant therapy. Low expression of ATM and BRCA1 was associated with loss of MLH1 or MSH2 expression. Conclusions: This is the first study to show a relationship between the expression of DNA DSB repair proteins ATM and BRCA1 and survival in colorectal cancer patients. Studies in tumors from large randomized trials are now necessary to validate our pilot data and establish the clinical usefulness of the immunohistochemical assay in predicting response to a particular adjuvant therapy regimen. Furthermore, our results indicate a possible link between expression of DNA mismatch repair and DNA DSB repair proteins in sporadic colorectal cancer, which warrants further investigation. Genetic instability has been proposed to be a driving force in colorectal carcinogenesis (1). Two major types of genetic instability have been described in colorectal cancer: chromosomal instability and microsatellite instability (2). Up to 15% of colorectal cancer show a high frequency of microsatellite instability which is caused by a defect of the DNA mismatch repair pathway (3). The vast majority of colorectal cancer, however, shows chromosomal instability, which is characterized by gains and losses of whole chromosomes or large chromosomal regions.Whereas a large number of genes that trigger chromosomal instability have been identified in yeast in the past (reviewed in ref. 4), the underlying mechanisms leading to chromosomal instability in colorectal cancer remain to be characterized. The DNA double-strand break (DSB) is regarded as the most critical of all DNA lesions (5, 6) and it has been shown that defects in the cellular response to DSBs can lead to genetic alteration, chromosomal instability, and ultimately malignant transformation (7).In mammalian cells, DSBs can be repaired by two distinct pathways: homologous recombination and nonhomologous end joining (8). DSB repair by nonhomologous end joining involves the formation of a Ku70/Ku80 protein heterodimer and recruitment of DNA-dependent protein kinase C to the site of DNA damage (9). DSB repair by homologous recombination is mediated by a large number of...