Which cancer clinical trials should be considered for economic evaluation? Selection criteria from the National Cancer Institute of Canada's Working Group on Economic Analysis

Rising health care costs, expensive new health care technologies and increasing patient expectations are placing huge pressures on the publicly funded health care system in Canada. As a result, policy makers need information on the cost and cost-effectiveness of new therapies in addition to their clinical benefits. In response to this need, the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) established a Working Group on Economic Analysis (WGEA) to provide advice on the economic evaluation of new cancer therapies. This article describes the WGEA's recommendations on which trials should be considered for concurrent analysis of economic, as well as related issues, such as the number of patients required for an economic analysis within a prospective clinical trial and the selection of participating centres. The recommendations in this document are meant to be pragmatic, as the WGEA recognizes that both the research funds and human resource capacity for this type of research in Canada are limited. These recommendations are currently guiding priority setting with regard to trials for economic evaluation in NCIC trials. Examples of how these recommendations have been applied to actual trials are presented.     

Lobular capillary hemangioma of the liver

BACKGROUND:Lobular capillary hemangioma(LCH) is a benign vascular tumor that is rare in adults and has never been reported in the liver.This vascular lesion usually presents on the skin or mucous membranes,and predominantly affects children. METHODS:LCH as a large asymptomatic hepatic mass was seen in a 35-year-old female.Imaging and pathologic characteristics of the mass are reviewed,and the relevant literature is also reviewed. RESULTS:A large vascular hepatic lesion was observed in an asymptomatic 35-yea...     

MRI引导下超声聚焦对痛性骨转移瘤的姑息治疗

目的对标准治疗无效或不能进行标准治疗的痛性骨转移瘤病人进行MRI引导下超声聚焦姑息治疗的安全性和初期疗效的评估。材料和方法本研究经病人的知情     

The effects of terbium on the cellular accumulation of cisplatin in MDA-MB-231 human breast tumor cells

 Purpose: Cisplatin (DDP) is an effective antitumor agent limited in its efficacy by the development of tumor cell resistance. The defective accumulation of DDP has been shown to be a prominent feature in many DDP-resistant cell lines. In an effort to circumvent this problem, we examined the cellular accumulation of DDP in the presence of terbium (Tb³⁺). We also examined the effects of verapamil on the cellular accumulation of DDP in order to delineate the specific interaction of Tb³⁺ and DDP. All experiments were performed on DDP-sensitive or DDP-resistant MDA-MB-231 human breast tumor cells. Methods: The cellular accumulation of DDP and verapamil were determined by electrothermal atomic absorption spectrophotometry. Time-resolved luminescence spectroscopy was used to obtain equilibrium binding constants for the Tb³⁺/MDA cell complexes. Results: We found that 100 μM Tb³⁺ increased DDP accumulation in the parent MDA cell line, 5.7-fold resistant MDA/A13 and 10-fold resistant MDA/CH cells by 56.2±7.4, 71.9±9.4 and 50.8±9.4%, respectively (P<0.0001 for all MDA cell types). In contrast, 20 μM verapamil had no significant effect on DDP accumulation in the MDA cell lines. In addition, a positive correlation between the membrane binding of Tb³⁺ and the cellular accumulation of DDP was found to exist in the parent cell line and sublines (r=0.9). Conclusions: In agreement with earlier studies, the plasma membrane of MDA cell lines contain a specific Tb³⁺-binding protein. Our findings suggest that the Tb³⁺-binding protein may be intimately associated with the accumulation of DDP in breast tumor cells. Received: 19 June 1995/Accepted: 25 March 1996     

No evidence of linkage to chromosome 1q42.2-43 in 131 prostate cancer families from the ACTANE consortium. Anglo, Canada, Texas, Australia, Norway, EU Biomed

Genetic linkage studies worldwide have proposed various chromosomal localizations for prostate cancer susceptibility genes. A recent study found evidence for linkage to chromosome 1q42.2-43. The aim of our study was to attempt to confirm these findings by performing linkage analysis in 131 families with multiple prostate cancer cases selected from the ACTANE (Anglo, Canada, Texas, Australia, Norway, EU Biomed) Consortium. Parametric and non-parametric linkage (NPL) analyses were performed. Two-point LOD scores failed to show evidence of linkage at any marker (maximum two-point LOD score = 0. 40 at recombination fraction theta = 0.2 with marker D1S2850). Using a multipoint heterogeneity analysis, the estimated proportion of families linked to this putative locus (alpha) was 0% (95% CI = 0. 00-0.33). Non-parametric linkage analysis also found no evidence of linkage (maximum NPL score = -0.12, P = 0.55). This analysis of 131 ACTANE families does not support the presence of a locus for a prostate cancer susceptibility gene at 1q42.2-43. Although we cannot rule out the existence of such a locus, analysis indicates that less than 16% of families could be linked to this region. These findings may be a reflection of the locus heterogeneity involved in this disease indicating that there are still other major susceptibility loci to be identified.