The M30-monoclonal antibody recognizes a neo-epitope of cytokeratin 18 which is formed after caspase-cleavage during apoptosis. Caspase-cleaved cytokeratin 18 is released from apoptotic cells into circulation. The aim of this study was to evaluate the relationship between M30-antigen level and chemotherapy response in neoadjuvant treatment of breast cancer. Forty-two patients with invasive breast carcinoma received 4 cycles of anthracycline based neoadjuvant chemotherapy. Serum samples were obtained for assessment of M30-antigen levels before the administration of first chemotherapy cycle (baseline), and then after 24 and 48 hours for determination of chemotherapy induced apoptosis. M30-antigen levels at 24 and 48 hours were found to be significantly higher than baseline (p < 0.001, p = 0.003, respectively). M30-antigen levels in responders showed statistically significant increases at 24 and 48 hours (p < 0.001; p = 0.004, respectively), while statistically significant increases were not observed in nonresponders. Percentage change of M30-antigen levels was significantly higher in responders than nonresponders at 24 hours (p = 0.020). In conclusion, our study revealed a significant relationship between increases of M30-antigen levels in serum and overall response to therapy.

The addition of the amifostine to the combination of paclitaxel and carboplatin may prevent or reduce the incidence of neurotoxicity in the treatment of NSCLC. Amifostine does not appear to have a preventive role in neutropenia.

T he review paper entitled "The Essential Medicinal Chemistry of Curcumin", published in the Journal of Medicinal Chemistry, by Nelson et al. 1 is a well-designed paper, presenting a new (and negative) approach to the well-known biologically active compound; curcumin. Although some arguments throughout this paper are completely true, the approach of the authors is unfortunately far from impartial, and many of the conclusions the authors draw from some of their referred papers are especially hard to accept.On page 1621, line 11, the authors mention that the in vivo stability of curcumin is T 1/2 < 5 min and F < 1% by referring to the research papers of Wang et al. 2 and Yang et al. 3 (refs 27 and 28 of the original paper). Interestingly, neither Wang nor Yang et al. directly report these values as the half-life of curcumin, which makes this a very biased supposition of the authors. The paper, published by Wang et al., reports the stability of curcumin in buffer solvents at laboratory conditions and in rat blood circulation. Since it is impossible to directly dissolve curcumin in water, curcumin was dissolved in methanol and then diluted with a buffer, and the amount of curcumin was measured in HPLC at different intervals. It is obvious that curcumin will start precipitating upon dilution with a buffer. Thus, it is doubtful that the sample injected in HPLC or administered to rats includes the supposed amount of curcumin.Yang et al. also do not report the half-life of curcumin below 5 min. This paper reports the elimination period as 28.1 ± 5.6 and 44.5 ± 7.5 min for 500 mg/kg, p.o. and 10 mg/kg, i.v. of curcumin, respectively. It is noteworthy that the half-life results are reported by the studies made in rats, not human studies. A rat weighing 400 g has a total blood volume of approximately 25.6 mL, 4 and the human blood volume is approximately 5.5 L. The half-life measurements of the compound during blood circulation were made without considering the insolubility of curcumin in buffer solutions or the stability measurements in rat blood circulation and therefore do not accurately illustrate the fate of curcumin upon circulation within human blood. More interestingly, the authors acknowledge that the half-life of curcumin with pH 7.4 and 37 °C in human blood is 360−480 min in Supplemental Table 2 of ref 1. However, they report its stability as T 1/2 < 5 min on page 1621, left column line 11.■ IS THE "ALLURE OF THE GOLDEN SPICE" FAKE?On page 1623, left column, line 17, the authors refer to the paper published by Burgos-Moroń et al. entitled "The Dark Side of Curcumin" 5 (also ref 5 of the original paper). The authors did not take into consideration the article published by Kurien et al., which actually is a response paper to Moroń et al. 6 The paper criticizes Moroń et al.'s article not only by referring to related research but also by conducting new investigations to refute their theory. So, we will not further discuss the ideas about "the dark side of curcumin"; however, since the authors have used this expressio...

Adenoid cystic carcinoma (ACC) is an aggressive malignant neoplasm of the secretory glands. Conventional chemotherapy has poor effectiveness against metastatic ACC. Thus, a novel effective therapy is needed against metastatic ACC. A majority of ACCs (up to 94%) express c-kit. Imatinib is monoclonal antibody with specific activity against c-kit but has not been found to be effective in treating patients with ACC in which c-kit is overexpressed and activated. The NF-κB and mTOR pathways have been shown that ubiquitously and concurrently activated, indicating that the inhibition of these pathways may represent a novel treatment approach for patients with ACC. Curcumin has been shown to inhibit NF-κB and NF-κB-related pathways. 43-year-old patient was diagnosed ACC from submandibular salivary gland. After complete resection of tumor adjuvant radiotherapy was initiated. Seven years later multiple lung metastases were detected and ACC was confirmed by re-biopsy. First-line chemotherapy failed. NF-κB and c-kit were overexpressed in the metastatic specimens. Therefore, we treated the patient with metastatic chemoresistant ACC with imatinib 400mg/day and intravenous curcumin 225mg/m(2) twice a week plus oral bioavailable curcumin Arantal(®) 2×84mg/day. At 24 months, we observed near complete anatomic and complete metabolic response. To our knowledge, this is the first report of a patient with a c-kit-positive ACC that is successfully treated with the combination of imatinib and curcumin in an integrative approach.

PurposeThis study aimed to report the practice of managing breast cancer with bone metastasis in Turkey and to determine the adherence to the British Association of Surgical Oncology (BASO) guidelines.MethodsThis multicenter, cross-sectional epidemiological survey was conducted in 38 centers across Turkey. Data from 1,026 breast cancer patients with bone metastases (mean age 54.0 ± 11.9 years) were analyzed.ResultsOver 30 % of patients had a diagnosis of metastatic breast cancer (stage IV) at the time of primary diagnosis. The imaging modalities used for diagnosing bone metastases were bone scintigraphy (57.8 %), radiography (22.8 %), and bone survey (4.4 %). Tumor markers were detected in 94.9 %, and markers of bone metabolism were measured in 90.4 % of patients. A total of 3.5 % of patients underwent surgery for bone metastasis, 26.4 % underwent palliative chemotherapy (most commonly docetaxel + capecitabine), and 56.5 % endured radiotherapy. Most patients (96 %) also received bisphosphonate. Radiography, bone scintigraphy, and CT were the main imaging tools used for postoperative follow-up of bone metastasis. Our results were >95 % in line with the BASO guidelines for the management of bone metastasis, except that interventional procedures, such as biopsy, were applied less frequently in our survey.ConclusionsThe diagnosis and management practices of breast cancer with bone metastasis in Turkey were generally compatible with international guidelines. However, the awareness and knowledge of physicians on the current guidelines should be increased, and equipment for the appropriate interventional procedures should be provided in every clinic to obtain optimal and standard management of bone metastases.