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By Andrew D Shaw; et al

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A recent study by Huang et al. (17) used nested reverse transcriptase–polymerase chain reaction to analyze mRNA expression of cancer-specific antigens 15 [carcinoembryonic antigen, cytokeratin-19 (CK19)], cytokeratin-20) in peripheral blood from patients with gastrointestinal carcinoma, patients with inflammatory gastrointestinal disease, and healthy volunteers. 2% were positive for at least one marker, while only one blood sample from a healthy control was positive for a marker. A similar approach has been used in several studies examining the correlation between CK19positive peripheral blood cells and outcome in patients with breast cancer.

The clinical estimation of tumor size by palpation may differ from that obtained on imaging studies. For example, it is relatively common to obtain different size estimates by physical examination and mammography in patients with breast cancer (6,7). In such cases, an average of the two values may be used (8). Clinical tumor size is classified as: TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ T1, T2, T3, T4 Increasing size and=or local extent of the primary tumor In cases where there are multiple simultaneous tumors in one organ, the T category is assigned according to the size of the largest tumor, rather than a combination of tumor sizes.

This striking observation, namely, inhibition of growth factor production or receptor signaling could lead to endothelial cell apoptosis, was confirmed using IM-C225 in an orthotopic bladder tumor model using combination therapy with paclitaxel (85). The use of small molecule inhibitors of growth factor receptor signaling (TKI) has been extensively studied in animal tumor models. Using the orthotopic pancreatic model of human cancer in nude mice, Bruns et al. (86) reported that the modest activity of single agent use of either PKI-166 (EGF-R TKI) or gemcitabine was markedly improved by the combination of these agents (reduction in tumor burden of 85%).

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