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    <recommendedItem id="20100101_19_271"
                     title="ASCO GI: Diet May Play Role in Colon Cancer Prevention"
                     score="0.002"
                     href="http://www.medpagetoday.com/MeetingCoverage/ASCOGI/tb/18128?impressionId=1265801046892"
                     
      &lt;p&gt;ORLANDO  --  Dietary polyamines may represent a modifiable risk factor for colon cancer, according to a new analysis of data from a prevention trial presented here.&lt;/p&gt;
&lt;p&gt;High intake of polyamine-rich foods increased the risk of large, high-grade, and advanced colonic adenomas by 40% to 65% compared with low intake. High dietary polyamine levels correlated with high polyamine levels in rectal tissue.&lt;/p&gt;
&lt;p&gt;&quot;Our results are consistent with several animal-model studies,&quot; Kavitha P. Raj, MD, of the University of California Irvine, said during a poster presentation at the Gastrointestinal Cancers Symposium.&lt;/p&gt;
&lt;p&gt;&quot;Dietary polyamines may be an important factor in adenoma prevention. Controlling exogenous polyamines may be an adjunctive strategy to chemoprevention with polyamine-inhibitory agents.&quot;&lt;/p&gt;
&lt;p&gt;Increased polyamine synthesis has been linked to colon carcinogenesis in preclinical models and in humans. Ornithine decarboxylase, a key regulatory enzyme involved in polyamine synthesis, is upregulated by several pathways implicated in colon cancer carcinogenesis, including K-ras.&lt;/p&gt;
&lt;p&gt;In a recent prevention study involving patients with sporadic colorectal adenomas, Raj and colleagues found that inhibition of polyamines by DFMO and sulindac reduced adenoma recurrence by 70% compared with placebo. Investigators reviewed data from the study to evaluate dietary polyamines&apos; effect on prevention with DFMO-sulindac therapy and to examine associations between dietary and tissue polyamine concentrations.&lt;/p&gt;
&lt;p&gt;Polyamines occur in a variety of foods, including aged or sharp cheeses, canned or frozen non-green vegetables, citrus fruits such as oranges and tangerines, fermented soy sources containing wheat, packaged or frozen shrimp, and some meats and poultry.&lt;/p&gt;
&lt;p&gt;Study participants completed a dietary questionnaire at enrollment, and investigators used that data to calculate total dietary polyamine content, derived from putrescine, spermine, and spermidine values. Dietary polyamine data were available for 222 of 335 patients enrolled in the interventional trial and for 188 of 267 patients who completed the study.&lt;/p&gt;
&lt;p&gt;Investigators separated study participants into quartiles of dietary polyamine content. Advanced adenomas were defined by size &amp;gt;1 cm, villous histology, high-grade dysplasia, or presence of multiple adenomas.&lt;/p&gt;
&lt;p&gt;Comparing baseline polyamine and polyp characteristics, Raj found that 43% of participants in the highest dietary polyamine quartile had adenomas &amp;gt;1 cm compared with 26.4% of participants in the three lower quartiles (&lt;em&gt;P&lt;/em&gt;=0.01).&lt;/p&gt;
&lt;p&gt;Moreover, 52.7% of the high polyamine group had advanced adenomas, compared with 35.9% of the remaining study participants (&lt;em&gt;P&lt;/em&gt;=0.03). High dietary polyamine content also tended to be associated with more high-grade adenomas (32.7% versus 20.4%), but the difference did not achieve statistical significance (&lt;em&gt;P&lt;/em&gt;=0.06).&lt;/p&gt;
&lt;p&gt;Investigators determined tissue polyamine levels from rectal biopsies of study participants. The high dietary polyamine group had significantly higher tissue spermine  concentrations (&lt;em&gt;P&lt;/em&gt;=0.04) and spermidine (&lt;em&gt;P&lt;/em&gt;=0.02).&lt;/p&gt;
&lt;p&gt;In their analysis of the entire study population, Raj and colleagues found significant interaction among treatment, dietary polyamine, and metachronous adenomas (&lt;em&gt;P&lt;/em&gt;=0.01).&lt;/p&gt;
&lt;p&gt;In the low dietary polyamine group, DFMO-sulindac therapy reduced the risk of recurrence by 80% (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.0001) compared with the placebo group. In contrast, participants in the highest dietary polyamine quartile derived no benefit from treatment, as the risk of recurrence was virtually identical to that of the control group (RR 1.04, 95% CI 0.32 to 3.36).&lt;/p&gt;
&lt;p&gt;In the low dietary polyamine group, separate analyses showed that treatment with DFMO-sulindac reduced the risk of large, high-grade, and advanced adenomas by 90% or more (&lt;em&gt;P&lt;/em&gt;=0.03 to &lt;em&gt;P&lt;/em&gt;=0.005). Too few participants were in the high dietary polyamine group to determine risk estimates.&lt;/p&gt;
&lt;p&gt;&quot;We observed strong interaction between treatment and dietary polyamine intake, which was a key factor in modulating the risk reduction of metachronous adenoma formation by DFMO and sulindac,&quot; said Raj. &quot;There was a 70% risk reduction with DFMO-sulindac in the parent study but an 81% reduction with DFMO-sulindac in the lower dietary polyamine group in this study.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;One or more investigators disclosed relationships with Cancer Prevention Pharmaceuticals.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_226"
                     title="ASCO GI: Blood Test Detects Colorectal Cancer"
                     score="-0.003"
                     href="http://www.medpagetoday.com/MeetingCoverage/ASCOGI/tb/18079?impressionId=1265801046892"
                     
      &lt;p&gt;ORLANDO  --  A novel blood test that measures CD24 protein levels may detect early colorectal cancer and precancerous adenomas, researchers found.&lt;/p&gt;
&lt;p&gt;The investigational assay had 78.4%% sensitivity and 86.8% specificity for distinguishing patients with colorectal adenoma or cancer from healthy controls in a study led by Sarah Kraus, PhD, of Tel Aviv Souraski Medical Center in Israel.&lt;/p&gt;
&lt;p&gt;Further validation for the biomarker would be needed before considering clinical use in surveillance, they cautioned here at the ASCO Gastrointestinal Cancers Symposium.&lt;/p&gt;
&lt;p&gt;But the results were exciting and could represent &quot;a very significant advance,&quot; commented Robert P. Sticca, MD, of the University of North Dakota in Grand Forks.&lt;/p&gt;
&lt;p&gt;&quot;It looks like it may be a very reliable marker for not only the early detection of colon cancer and even precancerous conditions, but also could be used for follow-up for patients who previously had cancer for recurrence,&quot; he said as moderator of a press briefing at which the results were discussed.&lt;/p&gt;
&lt;p&gt;Colorectal cancer screening is effective, with early detection and treatment shown to improve survival.&lt;/p&gt;
&lt;p&gt;However, colorectal cancer is often diagnosed at a late stage with poor prognosis, in part because of &lt;a href=&quot;http://www.medpagetoday.com/Gastroenterology/ColonCancer/10115&quot; mce_href=&quot;http://www.medpagetoday.com/Gastroenterology/ColonCancer/10115&quot; target=&quot;_blank&quot;&gt;poor uptake of colonoscopy&lt;/a&gt;, Kraus said at the press briefing.&lt;/p&gt;
&lt;p&gt;Unfortunately, there are no sufficiently accurate blood-based screening tests, he noted, although there have been &lt;a href=&quot;http://www.medpagetoday.com/MeetingCoverage/ECCO-ESMO/16057&quot; mce_href=&quot;http://www.medpagetoday.com/MeetingCoverage/ECCO-ESMO/16057&quot; target=&quot;_blank&quot;&gt;attempts&lt;/a&gt; to develop them.&lt;/p&gt;
&lt;p&gt;Her group had previously found that the CD24 protein  --  expressed on the cell surface, where it plays a role in cell adhesion and metastasis  --  was associated with development of colorectal cancer in a gene expression study.&lt;/p&gt;
&lt;p&gt;So, with two independent cohorts, they tested whether CD24 could be a good biomarker for colorectal cancer.&lt;/p&gt;
&lt;p&gt;The first cohort included 63 patients with colorectal cancer, 19 with adenoma, and 68 controls with a clean bill of health on colonoscopy. Of these 150 individuals, 143 were externally evaluated by a blinded investigator.&lt;/p&gt;
&lt;p&gt;CD24 expression was nearly six-fold higher among adenoma and colorectal cancer cases than among controls, a significant difference. Levels were similar between the cancer and adenoma groups.&lt;/p&gt;
&lt;p&gt;The second cohort included 73 subjects: 38 normal controls, 24 with colorectal adenoma, and 11 with colorectal cancer.&lt;/p&gt;
&lt;p&gt;The test could distinguish colorectal cancer cases from controls with &quot;relatively high&quot; sensitivity and specificity (92.3% and 83.8%, respectively), Kraus said.&lt;/p&gt;
&lt;p&gt;Its performance in detecting adenoma versus normal colonoscopy results was lower, 75.0% sensitivity and 89.2% specificity.&lt;/p&gt;
&lt;p&gt;Kraus said her group is now testing this CD24 approach in a larger sample and developing an enzyme-linked immunosorbent assay (ELISA) that could be more widely used.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The researchers reported no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_5_194"
                     title="AACR: Colon Cancer Prevention Continues after Stopping Celecoxib (Celebrex)"
                     score="-0.006"
                     href="