Zoledronic acid significantly improves pain scores and quality of life in breast cancer patients with bone metastases: a randomised, crossover study of community vs hospital bisphosphonate administration Patients with bone metastases from breast cancer often experience substantial skeletal complications -including debilitating bone pain -which negatively affect quality of life. Zoledronic acid (4 mg) has been demonstrated to reduce significantly the risk of skeletal complications in these patients and is administered via a short, 15-min infusion every 3 weeks, allowing the possibility for home administration. This study compared the efficacy and safety of zoledronic acid administered in the community setting vs the hospital setting in breast cancer patients with X1 bone metastasis receiving hormonal therapy. After a lead-in phase of three infusions of 4 mg zoledronic acid in the hospital setting, 101 patients were randomized to receive three open-label infusions in the community or hospital setting, followed by three infusions in the opposite venue (a total of nine infusions). The Brief Pain Inventory (BPI) and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) were used to assess potential benefits of zoledronic acid therapy. At study end, analysis of the BPI showed significant reductions in worst pain (P ¼ 0.008) and average pain in the last 7 days (P ¼ 0.039), and interference with general activity (P ¼ 0.012). In each case, there were significantly greater improvements in pain scores after treatment in the community setting compared with the hospital crossover setting for worst pain (P ¼ 0.021), average pain (P ¼ 0.003), and interference with general activity (P ¼ 0.001). Overall global health status showed a significant median improvement of 8.3% (P ¼ 0.013) at study end. Physical, emotional, and social functioning also showed significant overall improvement (P ¼ 0.013, 0.005, and 0.043, respectively). Furthermore, physical, role, and social functioning showed significantly greater improvements after treatment in the community setting compared with the hospital crossover setting (P ¼ 0.018, 0.001, and 0.026, respectively). There was no difference between hospital and community administration in renal or other toxicity, with zoledronic acid being well tolerated in both treatment settings. These data confirm the safety and quality-of-life benefits of zoledronic acid in breast cancer patients with bone metastases, particularly when administered in the community setting.

No abstract

Background: The EphB2 gene was recently implicated as a prostate cancer (PC) tumour suppressor gene, with somatic inactivating mutations occurring in ,10% of sporadic tumours. We evaluated the contribution of EphB2 to inherited PC susceptibility in African Americans (AA) by screening the gene for germline polymorphisms. Methods: Direct sequencing of the coding region of EphB2 was performed on 72 probands from the African American Hereditary Prostate Cancer Study (AAHPC). A case-control association analysis was then carried out using the AAHPC probands and an additional 183 cases of sporadic PC compared with 329 healthy AA male controls. In addition, we performed an ancestry adjusted association study where we adjusted for individual ancestry among all subjects, in order to rule out a spurious association due to population stratification. Results: Ten coding sequence variants were identified, including the K1019X (3055ART) nonsense mutation which was present in 15.3% of the AAHPC probands but only 1.7% of 231 European American (EA) control samples. We observed that the 3055ART mutation significantly increased risk for prostate cancer over twofold (Fisher's two sided test, p = 0.003). The T allele was significantly more common among AAHPC probands (15.3%) than among healthy AA male controls (5.2%) (odds ratio 3.31; 95% confidence interval 1.5 to 7.4; p = 0.008). The ancestry adjusted analyses confirmed the association. Conclusions: Our data show that the K1019X mutation in the EphB2 gene differs in frequency between AA and EA, is associated with increased risk for PC in AA men with a positive family history, and may be an important genetic risk factor for prostate cancer in AA.

While a number of investigations of the health of taxi cab drivers have been conducted in Europe, Asia, and Africa, virtually none have been conducted in the United States. We undertook a survey of taxi cab operators in the Chicago area to understand better their health status and health promotion practices. The survey was completed by a convenience sample of 751 Chicago taxi drivers. Taxi drivers had low rates of insurance coverage, fruit and vegetable consumption, and physical activity compared with the general Chicago population. Participation in cancer screening tests was also lower for this group. A high proportion of taxi drivers are immigrants. They tend to be highly educated and report a readiness to engage in more health-promoting behaviors. Further research is needed to develop a targeted intervention for this population.

An effective post-discharge follow-up programme significantly increased the SSI rate. From the authors' experience and a literature survey, possible ways to achieve high follow-up rates were suggested. It was also recommended that professional and regulating bodies in Australia be encouraged to standardize methodology and set minimum follow-up rates for post-discharge SSI surveillance. Increasing use of computerized hospital database systems for automated data gathering and processing should make this more practicable.