THURSDAY, Jan. 26 (HealthDay News) -- A new industry-funded study suggests that a molecular test can provide insight into whether patients are at high risk of a relapse after surgical treatment for a form of lung cancer.

The test, which is currently available, could help doctors decide whether the patients should undergo chemotherapy to prevent the cancer from returning.

There are caveats: The test is expensive, and researchers don't yet know whether patients determined to be at high risk will live longer if they undergo chemotherapy.

Still, "this may be one of the very first examples of where we understood enough about the molecular biology of a cancer to truly personalize the treatment of patients and actually improve the cure rate for that cancer," said study co-author Dr. Michael Mann, an associate professor of surgery at the University of California, San Francisco.

At issue is non-small-cell lung cancer, by far the most common kind of lung cancer. Even if tumors are diagnosed early and removed, the cancer will spread and kill 35 percent to 50 percent of patients.

In these cases, "even when the tumor is small and they got it all, microscopic disease has spread around the body," said Dr. John Minna, co-author of a commentary accompanying the study. He is a cancer researcher and professor of medicine at the University of Texas Southwestern Medical Center in Dallas.

Scientists are trying to find a way to predict what will happen to patients after surgery so they can figure out if chemotherapy treatment is a good idea.

In the new study, researchers gave the molecular test to 433 lung cancer patients in California and 1,006 patients in China. The researchers found that the test helped them to predict the likelihood that patients would survive for five years.

Conceivably, physicians could adjust the treatment of patients after surgery to coincide with the risk of a recurrence of their cancer. For now, though, that's not proven. The research "doesn't tell you that if you had a bad prognosis and you were treated with chemotherapy, then you'd do better," Minna said.

Still, information about the risks faced by a patient could help doctors make choices about treatments, said Minna, who called the test "promising."

Study co-author Mann agreed: "There may be an important conversation that you can have with your oncologist about potential benefit from additional therapy to reduce the likelihood of the cancer coming back."

Mann said the test -- which is currently available -- could cost several thousand dollars. Minna, the commentary co-author, said any cost over a few hundred dollars could be an issue for insurors.

The research was funded by the firm that developed the molecular test, and several of the study authors serve as consultants to the firm.

The study appears in the Jan. 27 online issue of The Lancet.

More information

For more about lung cancer, try the U.S. National Library of Medicine.

WEDNESDAY, Jan. 18 (HealthDay News) -- The recently approved drug vemurafenib (Zelboraf) has been hailed as a breakthrough in the treatment of melanoma, the deadliest form of skin cancer. But roughly one-quarter of patients who take the medication develop a troublesome side effect: secondary skin cancers called squamous cell carcinomas.

Now, a new study by researchers at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, and colleagues identifies the specific genetic mechanism that causes this side effect.

"What we found is that vemurafenib blocks the mutation that makes the melanoma grow, but when patients have skin cells with another mutation that's probably induced from sun exposure, there the drug has the exact opposite effect and causes these squamous cell cancers to grow," said Dr. Antoni Ribas, co-senior author of the study and an associate professor of hematology/oncology at UCLA.

What's more, the findings suggest that combining vemurafenib, a BRAF inhibitor, with a drug called an MEK inhibitor -- which blocks the other mutation -- may not only prevent this side effect, but may also lead to an even more effective melanoma treatment, Ribas said.

"It needs to be demonstrated in clinical trials, but the theory is that if we give these two medications together up front, we will be punching the melanoma where it really hurts twice, and also preventing the growth of secondary skin cancers," Ribas said.

For the study, which appears in the Jan. 19 issue of the New England Journal of Medicine, Ribas and his colleagues analyzed cells from squamous cell lesions in patients treated with vemurafenib to look for specific genetic mutations.

In a set of 21 tumor samples, the researchers found 13 had what's known as an RAS mutation, which predisposes someone to develop squamous cell cancer. In a separate set of 14 samples, eight had RAS mutations.

"Our data suggest that about 60 percent of patients who develop skin squamous cell cancers while treated with a BRAF inhibitor have an RAS mutation," Ribas said.

In experiments in mice with the RAS mutation, the researchers showed that the combination of a BRAF inhibitor and an MEK inhibitor successfully blocked the growth of squamous cell cancers.

This result may need replication in humans, since many findings in animals do not translate into effective treatments for people.

Ribas noted that the findings have implications beyond just melanoma, since RAS mutations are common in lung, pancreatic and colon cancer. "What this data also warns us is that we have to be very careful about using BRAF inhibitors in a setting where we don't know what other mutations may be driving [the cancer]," he said.

In an editorial accompanying the study, a cancer researcher at the Wistar Institute in Philadelphia sounded a similar note. "Patients being given BRAF inhibitors should be tested to determine their RAS status, since the potential for secondary tumor development is of concern," wrote Ashani Weeraratna, an assistant professor in Wistar's Molecular and Cellular Oncogenesis Program.

In an interview, she added, "While cutaneous squamous cell carcinomas are not usually life-threatening, a small portion are. And further, squamous cell carcinomas of other cell types can be very aggressive. So understanding how to solve this problem is critical."

Another skin cancer expert said that although the findings were important and timely, more studies were needed before making broad recommendations. "Patients need to be aware of the risk of development of squamous cell carcinomas, and dermatology exams need to be included as part of the care for these patients," said Dr. Iman Osman, an associate professor of dermatology and oncology at NYU Langone Medical Center in New York City.

"I believe any other recommendation, such as adding a MEK inhibitor from the beginning, or doing biopsies of any squamous cell carcinoma for RAS mutation at the time of starting BRAF inhibition, will require more data," Osman said.

Other researchers who took part in the study included investigators from the Institute of Cancer Research in London and the pharmaceutical companies Roche and Plexxikon.

More information

Visit the U.S. National Cancer Institute to learn about melanoma.

THURSDAY, Dec. 8 (HealthDay News) -- Breast cancer survivors carrying specific genetic mutations, known as BRCA1 or BRCA2, have a 10 percent greater risk for developing cancer in their other breast, and the risk rises further when a woman receives her first diagnosis before age 40, new research suggests.

"Our studies show that certain subgroups of women [with this mutation] who have already had cancers are also at risk for developing a second new cancer in their other breast, much more so than survivors who do not carry the mutation," Alexandra van den Broek, a doctoral candidate at the Netherlands Cancer Institute in Amsterdam, said in a news release from the San Antonio Breast Cancer Symposium.

For the study, the researchers analyzed information on about 5,000 women diagnosed with cancer in one of their breasts. Of these, 4.2 percent were carriers of the BRCA1 or BRCA2 mutation and were followed for about eight years on average. The investigators found that 8.6 percent of these women developed cancer in their other breast.

Overall, the 10-year risk of developing this new cancer among women who did not carry the mutation was 6 percent compared with 17.9 percent for those who did carry the mutation, the study revealed.

The 10-year risk jumped to 26 percent among carriers who were diagnosed with their first breast cancer before the age of 40 years. For women diagnosed between ages 40 and 50, the risk was 11.6 percent.

Women who carried the BRCA mutation and whose first tumor was "triple-negative" had a new-cancer risk of 19 percent within the next 10 years, compared with 11 percent for other women with the BRCA mutation. A triple-negative tumor is one that has none of the three receptors -- estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2) -- that occur in most breast cancers.

"Guidelines for prophylactic measures and screening in the follow-up of patients with breast cancer carrying the BRCA1 or BRCA2 mutation are important to provide patients with the best information and counseling," van den Broek said in the release. "If these results are confirmed, [it will be] possible to personalize the guidelines for these specific subgroups."

The study is slated for presentation Thursday at the 2011 San Antonio Breast Cancer Symposium. Data and conclusions of this study should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more about BRCA1 and BRCA2.

THURSDAY, Jan. 26 (HealthDay News) -- The number of Americans being screened for colon, breast and cervical cancers still fall below national targets, federal health officials said Thursday.

In 2010, 72.4 percent of women were being screened for breast cancer, below the target of 81 percent, for cervical cancer it was 83 percent of women, while the target is 93 percent, and for colon cancer 58.6 percent of Americans were screened, missing the target of 70.5 percent, according to the U.S. Centers for Disease Control and Prevention.

"Not all Americans are getting the recommended screening for breast, cervical and colorectal cancer," said report co-author Mary C. White, branch chief of the CDC's Division of Cancer Prevention and Control. "There continue to be disparities for certain populations."

The screening rates are particularly low among Asians and Hispanics, according to the report in the Jan. 27 issue of Morbidity and Mortality Weekly Report.

Among Asians, the screening rate for breast cancer was 64.1 percent, for cervical cancer it was 75.4 percent, and for colon cancer it was 46.9 percent.

Hispanics were less likely than non-Hispanics to have screening for cervical and colon cancer (78.7 percent and 46.5 percent, respectively), the researchers found.

Screening is important, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

"Screening saves lives," she said. "When you catch a cancer at a smaller size it does affect outcome."

Some people may be confused about screening, because different medical groups have different screening protocols, Bernik said.

"It's hard to get people to do screening in general. People look for any excuse not to get screened. When they see there is a controversy about when to start screening, they look at it as an opportunity to not do the test," she said.

Bernik also admits that screening can result in some over-treatment.

"With screening comes that risk," she said. "Unfortunately, we are not at a point where we can select the patients that are not going to have a problem, so we treat everyone equally. So, there is a little bit of over-treatment but, overall, you are improving survival for many people."

The U.S. Preventive Services Task Force recommends that women aged 50 to 74 get a mammogram every two years to screen for breast cancer.

Women aged 21 to 65, or those who have been sexually active for three years, should have a Pap test to screen for cervical cancer at least every three years, the task force recommends.

For colorectal cancer, men and women aged 50 to 75 should be screened with a yearly fecal occult blood test or sigmoidoscopy every five years, or have a colonoscopy every 10 years.

Other highlights of the report include:

• Breast cancer screening rates remained stable from 2000-2010, varying only about 3 percent.
• Colon cancer screening rates increased from 2000-2010, to more than 58 percent for both men and women.
• Cervical cancer screening rates dipped 3.3 percent from 2000-2010.
• Screening rates for all these cancers was much lower among the uninsured or those who didn't have a regular doctor.

The Affordable Care Act is expected to lower these barriers to access by expanding insurance coverage, the authors said.

"Other efforts are needed, such as developing systems that identify persons eligible for cancer screening tests, actively encouraging the use of screening tests, and monitoring participation to improve screening rates," the authors added.

More information

For more on cancer screening, visit the U.S. Centers for Disease Control and Prevention.