Patient with Metastatic Breast Cancer Achieves Stable Disease for 5 Years on Graviola and Xeloda after Progressing on Multiple Lines of Therapy

Breast cancer (BC) is the most common malignancy in women and is second to lung cancer in terms of cancer mortality. Treatment of BC remains a challenge as current therapies are limited by toxicity and drug resistance. Graviola (Annona muricata) is a tree that grows in the tropics of North and South America. Traditionally, the leaves and stems from the graviola tree have been used for a wide range of human diseases including cancer.?In vitro?and?in vivo?studies demonstrate anticancer activity in BC however clinical studies are lacking. We present the first case demonstrating clinical benefit without side effects using graviola in a patient with BC whose disease was refractory to multiple lines of chemotherapy including anthracyclines and taxanes.

Evaluation of Tobacco Use and Her-2 Receptor Expression in Breast Cancer in an Ethnically Diverse Inner-City Population

Background: Tobacco is linked to most cancers however despite overwhelming biological plausibility and decades of epidemiological studies, no association has been established between tobacco and breast cancer. Although estrogen receptor status has been looked at as a variable there has been no evaluation of the role of Her-2 and smoking in breast cancer. Methods: Review of records from patients treated at the University of Miami/Jackson Memorial Hospital from 1998-2012. The incidence of smoking and Her-2 expression in1255 women was evaluated. Data was analyzed by age, race, ethnic group, menopausal status, tumor stage, and ER/PR/Her-2 receptor status. Results: 1255 charts were analyzed with 1094 having full information. Overall rate of Her-2 expression 18.1%. The rate of Her-2 expression was 21.4% in smokers and 17.0% in non-smokers (p = 0.10). The rate of Her-2 expression was 10.8% in Caucasian smokers and 9.8% in Caucasian non-smokers (p = 0.88);24.5% in smokers of African descent and 17.3% in non-smokers of African descent (p = 0.24);22.9% in Latino smokers and 17.4% in Latino non-smokers (p = 0.10). The rate of Her-2/ER expression was 9.4% in smokers and 7.9% in non-smokers (p = 0.42);5.4% in Caucasian smokers and 4.9% in Caucasian non-smokers (p = 0.916);12.2% in smokers of African descent and 5.9% in non-smokers of African descent (p = 0.11);9.5% in Latin smokers and 8.8% in Latin non-smokers (p = 0.77). Conclusions: We found non-statistically significant positive associations in all analyses between Her-2 expression with or without ER expression and tobacco exposure when analyzed by ethnicity.

A pilot study of radiologic measures of abdominal adiposity:weighty contributors to early pancreatic carcinogenesis worth evaluating?

Objective:Intra-abdominal fat is a risk factor for pancreatic cancer(PC),but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms(IPMNs).Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology.Methods:In a cohort of 34 surgically-resected,pathologically-confirmed IPMNs(17 benign;17 malignant) with preoperative abdominal computed tomography(CT) images,we calculated body mass index(BMI) and four radiologic measures of obesity:total abdominal fat(TAF) area,visceral fat area(VFA),subcutaneous fat area(SFA),and visceral to subcutaneous fat ratio(V/S).Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics.Results:Mean BMI for individuals with malignant IPMNs(28.9 kg/m^2) was higher than mean BMI for those with benign IPMNs(25.8 kg/m^2)(P=0.045).Mean VFA was higher for patients with malignant IPMNs(199.3 cm^2) compared to benign IPMNs(120.4cm^2),P=0.092.V/S was significantly higher(P=0.013) for patients with malignant versus benign IPMNs(1.25 vs.0.69 cm^2),especially among females.The accuracy,sensitivity,specificity,and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%,71%,76%,75%,and 72%,respectively.Conclusions:Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology,acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI.Further investigation of gender-specific associations in larger,prospective IPMN cohorts is warranted to validate and expand upon these observations.