University of Pittsburgh Cancer Institute (UPCI)

Cancer Prevention and Control

Early Lung CancerCancer Prevention and Control evaluates cancer intervention strategies, including early detection strategies in human populations, and investigates personal and structural barriers to the implementation of otherwise effective and valuable cancer surveillance and prevention programs. Areas of emphasis include chemopreventive interventions, blood-based laboratory biomarkers for early cancer detection, screening flexible sigmoidoscopy, and low-radiation-dose helical chest computed tomography (CT).

Selected Publications

Breast Cancer

  • The double-blind, prospective, National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial (BCPT) showed a 50% reduction in the risk of breast cancer for tamoxifen versus placebo, yet many women at risk of breast cancer do not adhere to the 5-year course. Several factors were studied as predictors of chemoprevention adherence. Alcohol use was associated with reduced full adherence at 1 month. However, college education, age, and per capita household annual income were associated with increased adherence. Current smoking, age, college education, tamoxifen assignment, and breast cancer risk predicted adequate adherence at 36 months. There were no significant associations with obesity or physical activity (Land et.al., Cancer Prev Res (Phila). 4:1393-400, 2011).

Pancreatic Cancer

  • Serum-biomarker based screening for pancreatic cancer could greatly improve survival in appropriately targeted high-risk populations. Eighty-three circulating proteins were analyzed in sera of patients diagnosed with pancreatic ductal adenocarcinoma (PDAC), benign pancreatic conditions, and healthy control individuals. The CA19-9, ICAM-1, OPG panel is found to be selective for PDAC and does not recognize breast, lung, or colon cancer (Brand et.al., Clin Cancer Res 17:805-16, 2011). This PDAC-specific biomarker panels warrants additional clinical validation to determine their role in screening targeted high-risk populations.

Head and Neck Cancer

  • A study was done to identify biomarkers of antitumor activity in patients with locally advanced head and neck cancer treated with therapy containing cetuximab, an epidermal growth factor receptor (EGFR) inhibitor. Baseline serum biomarkers, in particular VEGF and IL-6, were identified as potentially useful prognostic markers of cetuximab-containing therapy (Argiris et.al., Oral Oncol. 47:961-6, 2011). Validation is warranted in future studies specifically designed to detect biomarker associations.

Lung Cancer

  • As CT screening for lung cancer becomes more widespread, volumetric analyses including doubling times (DT), of CT screen detected lung nodules and lung cancers may provide useful information in the follow-up and management of CT detected lung nodules and cancers. UPCI investigators found that volumetric analysis of CT detected lung cancers is particularly useful in adenocarcinoma / bronchioloalveolar carcinoma (AC/BAC). Prevalent cancers have a significantly slower DT than non-prevalent cancers and a higher % of AC/BAC. These results should impact the management of indeterminant lung nodules detected on screening CT scans (Wilson et.al., Am J Respir Crit Care Med. 2012 Jan 1;185(1):85-9). These results should impact the management of indeterminant lung nodules detected on screening CT scans.

Ovarian Cancer

  • MUC1 (CA15-3) and MUC16 (CA125) tumor-associated antigens are upregulated in ovarian cancer and can be detected in patients' sera by standardized tests. Increased serum MUC1 and high anti-MUC1, but not MUC16 and high anti-MUC16 antibody levels, are found as prognostic for poor clinical response and reduced overall survival in platinum-resistant or platinum-refractory ovarian cancer (Budiu et.al., Cancer Immunol Immunother. 60:975-84, 2011).