Lymphoma reduction in HAART recipients

HIV infection is associated with a high incidence of non-Hodgkin's lymphoma. Since the mid-1990s, when highly active antiretroviral therapy (HAART) became widely used to treat HIV infection, the incidence of AIDS-related illnesses has decreased, leading to increased survival of AIDS patients. The effects of HAART on AIDS-related lymphomas, however, have been controversial. Bensson et al. set out to settle this debate by comparing large data sets of HIV-positive lymphoma patients before and after the use of HAART in a large population. They found that between the early and late 1990s, the number of AIDS-related lymphoma cases decreased by 50%. Importantly, the incidence of primary brain lymphoma dropped almost threefold during these years. The prognosis for AIDS-related lymphoma has also improved, as patients in the late 1990s experienced a median survival time that was threefold longer than that of patients in the pre-HAART era. Bensson et al. associate the reduced risk of lymphoma with the higher number of CD4+ T cells observed in patients treated with HAART.

ORIGINAL RESEARCH PAPER Besson, C. et al. Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood 98, 2339–2344 (2001) [PubMed]

Wave goodbye to radiotherapy?

Are women who receive radiotherapy for cancer in one breast at increased risk of developing cancer in the other breast? Lack of one ATM allele could affect the checkpoint response that allows repair of the damage inflicted by radiotherapy in normal breast cells, so women with ATM mutations might have an increased susceptibility to second cancers.

Fifteen groups worldwide plan to screen 700 women with bilateral breast cancer and 1400 women with unilateral breast cancer for mutations in the ATM gene. This study aims to uncover the role of ATM in women who develop bilateral breast cancer after radiatiotherapy for the initial breast tumour. The groups are using a mutation detection system called WAVE to identify ATM mutations in DNA samples taken from those participating in the trial. The results of this trial could influence the way that many women are treated for breast cancer in the future.

FURTHER READING Janin, N. et al. Breast cancer risk in ataxia telangiectasia (AT) heterozygotes: haplotype study in French AT families. Br. J. Cancer 80, 1042–1045 (1999) [PubMed]

Glioma therapy on the right track

Established tumours nearly always contain necrotic cells, which can account for up to 50% of the tumour volume. A therapy that targets this necrotic core has just been awarded 'fast-track status' by the United States Food and Drug Administration (FDA) for the treatment of the lethal brain tumour glioblastoma multiforme, in response to encouraging preliminary results in a Phase II clinical trial. The fast-track system is designed to speed up the review of drugs that have the potential to address unmet needs for serious diseases; fast-track status does not guarantee approval, but drugs entering the system are typically reviewed within 6 months. The drug — Cotara™ (TNT-1/B) — is an125 iodine-labelled antibody that targets the nucleosomal DNA released by necrotic cells. Once the antibody has found its target, β-radiation from the125 iodine label kills the surrounding tumour cells. As more cells die, the tumour becomes an ever-more effective target for the antibody. A Phase III trial is planned for the end of the year.