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| From OncoLog,
November 2007, Vol. 52, No. 11 |
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Study Examines Diet, Breast Cancer Recurrence Risk
Researchers have discovered that a diet very high in fruits, vegetables, and fiber and extremely low in fat neither reduces the risk of breast cancer recurrence in women nor increases the chance for survival any more than the nationally recommended five servings a day of fruits and vegetables.
The Women’s Healthy Eating Living (WHEL) Study, whose results were published in the July 18 issue of the Journal of the American Medical Association, enrolled more than 3,000 women previously treated for early-stage breast cancer. The comparison group (1,551 women) followed a standard “five-a-day” healthy diet, was given written material regarding a healthy lifestyle, was offered four cooking classes during the first year, and received bimonthly newsletters. In contrast, the intervention group (1,537 women) adopted a diet low in fat, high in fiber, and with twice the daily servings of fruits and vegetables; these women were intensively monitored with frequent phone counseling sessions, were offered 12 cooking classes during the first year, and received monthly newsletters.
No statistically significant difference emerged in either the breast cancer recurrence or death rates in the two groups. During the study, 518 of the women—256 (16.7%) from the intervention group and 262 (16.9%) from the comparison group—had a recurrence of their breast cancer, or developed a second primary tumor. A total of 315 women, 155 (10.1%) from the intervention group and 160 (10.3%) from the comparison group, died during the study.
M. D. Anderson Cancer Center enrolled 380 breast cancer survivors. Lovell Jones, Ph.D., professor in the Department of Health Disparities and the study’s principal investigator at M. D. Anderson, said the study’s results were extremely surprising.
“The WHEL’s findings are pivotal because we always assumed that we were not eating enough fruits and vegetables and the more we ate, the more protected we would be against cancer,” Dr. Jones said.
However, he cautioned, “With these findings, it is imperative that we not discount the importance of a healthy diet and its role in cancer prevention. It is important to remember that our control group was eating the recommended guidelines for fruits and vegetables.”
Differing interim results have been seen in another trial, the Women’s Intervention Nutrition Study, which concluded that reducing dietary fat intake was marginally associated with longer relapse-free survival of breast cancer patients. However, the WHEL Study was not designed as a comparison investigation.
Dr. Jones explained that the WHEL Study also did not address whether a low-fat diet high in fiber, fruits, and vegetables would alter the risk of primary breast cancer; it did not take into account what participants were eating prior to their enrollment into the study, healthy or not; and the outcome of the study could have been impacted by the improvement of breast cancer therapy over the past decade.
Except with women of color, Dr. Jones said, “We made more strides in the treatment of breast cancer in the last 10 years than we had in the 25 years before that. It is very possible that we are seeing the impact of better therapy on both sides of our study.”
Pancreatic Cancer Gene Therapy Shows Promise in Preclinical Study
A liposome-delivered gene therapy developed at M. D. Anderson has been shown to selectively kill pancreatic cancer cells in mice while leaving healthy tissue unharmed. Researchers say the results show promise for more effective treatment of pancreatic cancer—which has a five-year overall survival rate of less than 4%, making it one of the deadliest forms of the disease.
The new therapy, named VISABikDD, uses a gene-based targeting agent, or promoter, that is known to be active in pancreatic cancer but not healthy tissue. The promoter was made more active with the addition of a regulatory gene sequence and a two-step transcriptional amplification system.
Finally, researchers added an engineered version of the Bik gene (known as BikDD) to the promoter and packaged everything in a liposome for intravenous delivery to the cancer.
According to laboratory findings, the gene activity was minimal or absent from healthy cells and even cell lines from other cancers. However, in pancreatic cancer, the BikDD gene forced cell death in all lines tested, resulting in prolonged survival, tumor shrinkage or eradication, and inhibition of metastasis. And, because the selectivity of the therapy was so strong, virtually no toxicity occurred. The findings were reported recently in the journal Cancer Cell.
“This looks like a promising approach to gene therapy for pancreatic cancer, and we are working to bring it to a clinical trial,” said co-author James Abbruzzese, M.D., professor in and chair of the Department of Gastrointestinal Medical Oncology. A phase I trial could be ready to open in less than two years.
Senior author Mien-Chie Hung, Ph.D., professor in and chair of the Department of Molecular and Cellular Oncology, is leading a team that continues to research ways to tailor the gene expression vehicle so that it can target other cancers or even other diseases. For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
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