tbuckley/cabot-search huggingface dataset:
Efficacy and toxicity of cetuximab (C225) plus mFOLOFX6 in patients (pts) with nonoptimally resectable, colorectal metastases (MCRC) confined to the liver
Authors: S. R. Alberts, J. H. Donohue, M. R. Mahoney, G. D. Nelson, P. O. Schwarzenberger, J. W. Kugler, R. F. Morton, P. J. Flynn
Journal: Journal of Clinical Oncology (2008)

15006 Background: Bismuth et al pioneered treatment of pts with non-optimally resectable liver limited MCRC with Oxaliplatin/5fluorouracil (OXAL/5FU) regimens to allow resection (Sem Oncol 1998). We previously reported results on the response in 42 eligible pts from an NCCTG trial designed to confirm Bismuth’s findings with FOLFOX4 (J Clin Oncol 2005). Here, we report results of the addition of C225, in this setting. Methods: Pts with liver only MCRC deemed not optimally resectable by a liver surgeon received biweekly OXAL 85 mg/m2 d1, with leucovorin 200 mg/m2, 5FU 400 mg/m2 bolus IV, then 46-hr IV 5FU 2,400 mg/m2 on d1–2 (mFOLFOX6), plus 250 mg/m2 C225 d1&8, with C225 at 400 mg/m2, cycle 1, d1. Responding pts were reassessed for resectability. Surgical outcomes were grouped as complete (S-CR), partial (S-PR), or not resected (S- NR). The interim analysis required 6 S-CRs to complete accrual. Results: 29 eligible pts enrolled. Neutropenia was most common (39% Gr 3, 13% Gr 4). One pt died cycle 6 of treatment induced sepsis. 20 pts had tumor reduction by pre-operative imaging. 11 (38%, 45% of responders) underwent surgery (7 S-CR, 3 S-PR, 1 S-NR) after a median of 5 months (3–7); however, only 5 S-CRs were observed in the interim analysis cohort. With a median post-surgical follow-up of 11 months (0–24), 4 recurrences occurred in S-CR/PR pts (44% of all resected pts). Median TTP in 16/29 pts is 9.6 months (95% CI 7–16), predominantly liver (4/11 surgical, 7/18 non-surgical). 8 pts have died, with median follow- up of 15 months (5–29). Conclusions: C225+mFOLFOX6 provided a 69% pre-operative response rate. Despite this, the study failed to pass the interim analysis endpoint of ≥ 24% surgical complete resectability. Continued refinement of this and other treatment strategies are needed. Supported by NIH Grant CA25224–18, Sanofi-Synthelabo, and Bristol-Myers Squibb. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration ImClone Bristol-Myers Squibb
Three-weekly docetaxel (T) plus capecitabine (X) in 1<sup>st</sup> and 2<sup>nd</sup> line metastatic esophageal cancer (MEC): Final Results of the phase II DACAPO Trial
Authors: S. Lorenzen, J. Duyster, C. Lersch, S. Delius, B. Lang, M. Hennig, R. Bredenkamp, C. Peschel, F. Lordick
Journal: Journal of Clinical Oncology (2005)

4142 Background: Both X and T have single agent activity in upper gastrointestinal tumors, and have together demonstrated preclinical synergy and a survival benefit in breast cancer. Phase II trials of XT have shown response rates of 40–53% and good tolerability in 1st-line metastatic gastric cancer (ASCO 04, abstracts 4051 and 4057). This trial assessed the efficacy and feasibility of XT combination in patients (pts) with MEC. Methods: Pts received T 75mg/m2 day 1 plus oral X 1000mg/m2 twice a day d1–14 every 3 weeks. The primary endpoint was response according to RECIST. Toxicity was reported according to NCI.CTCAE v3.0. Median follow up is 16.5 (7.9–21.4) months. Results: From 02/03 until 04/04 we included 24 pts in one center: 21 men, 3 women; median age 61.5 years, range 49–72; 17 had squamous cell and 7 adenocarcinomas. All pts had metastatic disease. 16 pts were treated in 1st-line, 8 in 2nd-line. Pts received a median of 4 (0–6) cycles. Dose reductions of one or both agents (to <80% of initial doses) were reported in 41% of pts. 2/24 (8.3%) pts died within 60 days after inclusion: one rapid tumor progression with upper gastrointestinal bleeding, one esophageal stent dislocation with subsequent mediastinitis. Severe adverse events (grade 3/4) reported were: neutropenia 10 (42%), febrile neutropenia 2 (8%), diarrhea 3 (13%), sensory neuropathy 3 (13%), fatigue 2 (8%), hand-foot syndrome 7 (29%). Grade1/2 sensory neuropathy was reported in 7 pts (29%) and hand-foot syndrome in 7 pts (29%). Intent-to-treat efficacy analysis showed a 46% response rate including 1 CR, 17% SD, 29% PD and 8% NE. Of the 11 responses, 9/16 (56%) were in 1st-line pts and 2/8 (25%) in 2nd-line therapy. Median survival is 16.0 months (95%CI 7.9–24.2). Median time to progression is 6.2 months (95%CI 4.6–7.8). Conclusions: Docetaxel plus capecitabine has a manageable toxicity profile and very promising activity in MEC, at least comparable to other doublet regimens. The combination merits further investigation. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis Aventis, Roche
A randomized study of ganetespib, a heat shock protein 90 inhibitor, in combination with docetaxel versus docetaxel alone for second-line therapy of lung adenocarcinoma (GALAXY-1).
Authors: Suresh S. Ramalingam, Glenwood D. Goss, Zoran Gojko Andric, Igor Bondarenko, Bojan Zaric, Timur Ceric, Elena Vladimir Poddubskaya, Tudor-Eliade Ciuleanu, James F. Spicer, Enriqueta Felip, Vera Hirsh, Christian Manegold, Rafael Rosell, Fadlo Raja Khuri, Vojislav M. Vukovic, Florentina Teofilovici, Iman El-Hariry, Wei Guo, Safi R. Bahcall, Dean Fennell
Journal: Journal of Clinical Oncology (2013)

CRA8007 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Monday, June, 3, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
Sugar tax and screening: listen to the evidence
Authors: Fiona Godlee
Journal: BMJ (2016)

“Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” So wrote Adam Smith in his 1776 Inquiry into the Nature and Causes of the Wealth of Nations . So what will today’s UK government decide? Will its obesity strategy, due to be published later this month, include a sugar tax? Last year the prime minister, David Cameron, ruled this out. It would be nice to think that the latest, much anticipated evidence …
Parsing Pathologic Complete Response in Patients Receiving Neoadjuvant Chemotherapy for Breast Cancer
Authors: Monica Morrow
Journal: JAMA Oncology (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
The macrocyclic lactone protein kinase C activator, bryostatin 1, either alone, or in conjunction with recombinant murine granulocyte- macrophage colony-stimulating factor, protects Balb/c and C3H/HeN mice from the lethal in vivo effects of ionizing radiation
Authors: S Grant, R Traylor, GR Pettit, PS Lin
Journal: Blood (1994)
Predictors of tumor shrinkage after anthracycline-based preoperative chemotherapy
Authors: P. Ermacora, P. Driol, S. Russo, C. Andreetta, F. E. Pisa, B. Alessi, A. M. Minisini, M. Mansutti, G. Fasola, F. Puglisi
Journal: Journal of Clinical Oncology (2009)

e11531 Background: Anthracyclines are currently included in several chemotherapy (CT) regimens for the treatment of breast cancer (BC). However, increasing evidence suggests that benefit from these agents is limited to some subgroups of patients (pts). Aim of this study was to identify potential predictors of tumor shrinkage (TS) in a retrospective series of pts receiving preoperative anthracycline-based CT for operable BC. Methods: The study population consisted of 94 pts with large (&gt;2 cm), any N, operable BC treated with preoperative anthracycline-based CT. Association between clinico-biological factors and clinico-radiological TS (by caliper and MRI) was assessed. TS was calculated as the difference between the maximum tumor diameter at baseline and the maximum tumor diameter after preoperative CT/ the maximum tumor diameter at baseline x 100. Immunohistochemical analyses for biological variables (ER, PgR, HER2, MIB1, topoisomerase II alpha) were performed on pretreatment biopsies. Results: In univariate analysis, the following variables were associated with clinical TS: high MIB-1 [Odd ratio (OR) 2.6, p = 0.03], type of taxane (docetaxel vs paclitaxel: OR 0.3, p = 0.01) and number of cycles of CT (&gt; 4 vs ≤ 4: OR 9.2, p &lt; 0.0001). In multivariate analysis, number of cycles of CT was the only independent predictor of clinical TS (OR = 9.2, p = 0.05). In univariate analysis, the following variables were associated with MRI TS: high MIB-1 (OR 2.4, p = 0.06), tumor size (≥ 40 mm vs &lt; 40 mm: OR 5.6, p 0 0.01), taxane CT (yes vs no: OR 4.3, p = 0.02) and number of cycles of CT (&gt; 4 vs ≤ 4: OR 4.4, p = 0.002). In multivariate analysis, high MIB-1 was the only independent predictor of MRI TS (OR = 3.7, p = 0.03). Conclusions: High MIB-1 expression and number of cycles of chemotherapy significantly predicted tumor shrinkage in patients treated with preoperative anthracycline-based chemotherapy. Further studies are warranted to better identify patients who derive benefit from anthracyclines. No significant financial relationships to disclose.
Older age limits the use of adjuvant chemotherapy according to all negative risk factors in early breast cancer patients
Authors: U. Basso, A. Brunello, C. Pogliani, F. Lumachi, L. M. Pasetto, A. Tosoni, A. A. Brandes, S. Monfardini
Journal: Journal of Clinical Oncology (2004)

8159 Background: Adjuvant chemotherapy of elderly women is currently perceived as one of the priorities in breast cancer (BC) research and prospective trials are still lacking. We performed a retrospective analysis of the actual use of adjuvant cytotoxic treatment according to each negative prognostic factor at our Institution. Methods: Charts of 384 women ≥ 70 yrs with BC referred from 2000 to July 2003 were reviewed for tumor stage and treatment, and compared with an equal cohort of younger, randomly selected post-menopausal patients (pts) (control group). Results: 232 elderly pts with histologic diagnosis of early BC were eligible, mean age 75 yrs, range 70–97 (vs 61 yrs, range 50–69). Fifty-four percent of pts underwent conservative surgery (vs 68.7%); nodal dissection was performed in 85% (vs 92.2%), sentinel node biopsy in 4.7% (vs 5.9%). Tumor size was pT2-T3 in 43% of pts, grading was G3 in 26.7%, hormonal status was positive in 79%, lymphnodes were positive in 35%. Of 161 elderly pts presenting one or more risk factors (pT2-T3, N+, G3 or ER-), 50.3% (vs 6.7%) were not proposed adjuvant chemotherapy. Were considered unfit for adjuvant chemotherapy 50% of women with pT2-pT3 (vs 11.7%), 39.5% with nodal involvement (vs 4.3%), 38.7% with G3 (vs 1.4%) and 22.5% of ER- (vs 0%). Thirteen pts (16%) of those proposed for chemotherapy refused (vs 7.3%), while 19 women starting treatment (27.9%) were not able to complete the planned number of cycles (vs 13.2%). Toxicity in pts receiving CMF (and not anthracyclines) is outlined in table. Conclusions: Age or age-associated conditions strongly limited the choice for adjuvant chemotherapy in elderly BC pts according to all prognostic factors, with ER- status probably being the most impelling factor for its use. Toxicity of CMF regimen frequently imposed treatment interruption, therefore alternative regimens should be assessed in this age class. No significant financial relationships to disclose.
Abstract 11542: Prognostic Significance of Insulin Treatment and Glucose Control Status on Clinical Cardiovascular Outcomes in Diabetic Patients Who Underwent Elective PCI Using Drug-Eluting Stents
Authors: Ayako Kunimura, Tadayuki Uetani, Takashi Kataoka, Masataka Takeshita, Kazuhiro Harada, Satoshi Okumura, Norihiro Shinoda, Ken Harada, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Masahiro Nanki, Tatsuaki Matsubara, Hideki Ishii, Tetsuya Amano, Toyoaki Murohara
Journal: Circulation (2014)

Background: The aim of this study was to evaluate prognostic impact of insulin treatment and glucose control status on cardiovascular outcomes in diabetic patients after elective coronary intervention using drug-eluting stents (DES). Methods: A total of 198 consecutive diabetic patients undergoing elective percutaneous coronary intervention (PCI) with DES in Chubu Rosai Hospital from October 2005 to March 2008 were enrolled. The median HbA1c value of the patients was 7.5%. Patients were divided into four groups based on the presence or absence of insulin treatment and the HbA1c value at baseline (&lt;7.5% or ≧7.5%). The endpoint of this study was major adverse cardiac event (MACE) defined as the composite of cardiovascular death, non-fatal myocardial infarction and any revascularization. Results: During the median follow-up of 1454 days, total 87 events occurred. MACE occurred more frequently in insulin-treated group with HbA1c&lt;7.5% (78.9%) than in the other groups (log-rank p &lt; 0.0001). The incidence of cardiac death or non-fatal myocardial infarction (p=0.022) and any revascularization (p=0.025) were significantly increased in insulin-treated group with HbA1c&lt;7.5% than the other groups. In cox analysis, after adjustment for conventional risk factors (age, sex, body mass index, smoking status, hypertention, dyslipidemia) and duration of diabetes, fasting blood glucose, hemodialysis, the hazard ratio for MACE relative to non-insulin-treated group with HbA1c&lt;7.5% was 2.91 (95% confidence interval 1.09 - 7.81, p = 0.034) in insulin-treated group with HbA1c&lt;7.5%. Compared with insulin-treated group with HbA1c≧7.5%, the hazard ratio was 3.83 (95% confidence interval 1.01 - 14.54, p = 0.049) in insulin-treated group with HbA1c&lt;7.5%. Conclusion: Insulin treatment with lower HbA1c value was proven to be an independent predictor of MACE in diabetic patients after PCI using DES.
Development of HER2 expressing adenoviral vectors for cancer immunotherapy
Authors: Gabriel T. Chong, Xiao Y. Yang, Takuya Osada, Matthew McKinney, Zachary Hartman, Delila Serra, H. Kim Lyerly, Michael A. Morse, Andrea Amalfitano, Timothy M. Clay
Journal: Cancer Research (2005)

Proc Amer Assoc Cancer Res, Volume 46, 2005

6037 

Cancer vaccines targeting tumor antigens such as HER2/ neu have been demonstrated to activate low level antigen-specific immune responses in vivo . We and others have observed that the most potent platform for immunization involves modifying dendritic cells (DC) with viral vectors. In this study, we propose to modify DC with adenoviral vectors encoding the tumor antigen HER2/ neu , which is often overexpressed in aggressive breast cancers. Murine bone marrow was extracted from the long bones of 8-week-old C57BL/6 mice and cultured for ten days in IL-4 (10 ng/mL) and GM-CSF (10 ng/mL) to differentiate DC. After 10 days, adherent DC were infected with the Ad[E1-]HER2 vector at a multiplicity of infection (MOI) ranging from 0 to 4000 particles per cell. Following 48 hour infection, DC were stained (HER2, CD11c, CD80) and analyzed on flow cytometry for HER2 expression. The Ad[E1-]HER2 vector reproducibly achieved transduction efficiencies of up to 65% in these mouse bone marrow derived GM-CSF and IL-4 cultured DC at the higher MOI. The next step is to examine the effectiveness of these vectors in a recently developed human HER2-transgenic mouse model (Piechocki et al. , 2003) by treatment of established tumors using a human HER2 expressing mouse mammary tumor line (4T1-huHER2: Chong et al. , unpublished). It is hoped that information gleaned from the mouse model system will be useful in designing human clinical trials with Ad-vector modified DC. Reference: Piechocki MP, Ho YS, Pilon S, Wei WZ. Human ErbB-2 (Her-2) Transgenic Mice: A Model System for Testing Her-2 Based Vaccines. J Immunol. 2003;171(11):5787-94. Gabriel Chong is a Howard Hughes Medical Institute Medical Student Research Training Fellow.
Abstract 17119: Clinical Usefulness of Coronary Computed Tomographic Angiography in Asymptomatic Patients with Type 2 Diabetic Mellitus
Authors: Gyung-Min Park, Young-Rak Cho, Hyun Woo Park, Uk Jo, Shin-Eui Yoon, Seung Mo Kang, Jung-Min Ahn, Jong-Young Lee, Won-Jang Kim, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Circulation (2012)

Background: Little is known regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic type 2 diabetic mellitus. To address these issues, we evaluated the clinical usefu...
An open-label phase II study of sorafenib and dacarbazine as first-line therapy in patients with advanced melanoma
Authors: T. Eisen, R. Marais, A. Affolter, P. Lorigan, C. Ottensmeier, C. Robert, P. Corrie, C. Chevreau, F. Erlandsson, M. Gore
Journal: Journal of Clinical Oncology (2007)

8529 Background: Sorafenib (SOR) exerts anti-tumor and anti-angiogenic effects via inhibition of VEGFR-1,-2,-3, PDGFR-a, -β and Raf. In a phase I, study SOR + dacarbazine (DTIC) as first-line therapy for advanced melanoma patients (pts) was well-tolerated and had activity. Methods: In this multicenter, phase II, open-label, uncontrolled, 2-stage study, eligibility criteria included: measurable disease by RECIST, ECOG performance status 0 or 1, no prior chemotherapy. Prior immunotherapy was allowed. Planned sample size was 82 pts based on a Simon 2-stage optimal design. Pts were treated with oral SOR 400 mg bid daily combined with repeated 21-day cycles of iv DTIC 1,000 mg/m 2 given on day 1 of each cycle until occurrence of progressive disease or intolerable toxicity. The primary endpoint was overall tumor response rate using RECIST. Secondary endpoints included progression-free survival (PFS), overall survival (OS), safety and toxicity. Results: 30 and 53 pts were treated in Stages I and II, respectively. Baseline characteristics were as follows: median age 56 yrs; 60% male, 34% ECOG 1, 80% AJCC Stage IV M1c; 31% elevated LDH. Eight (10%) pts had partial responses, 34 (41%) had stable disease, 32 (39%) had progressive disease and 9 (11%) were not evaluable. The median PFS was 14 wks (95% CI 12, 19; 28% censored). PFS rates at 3 &amp; 6 mos were 56% (45%, 67%; 13% censored) and 33% (22%, 45%; 24% censored), respectively. Median OS was 41 wks (28, 59, 63% censored). Grade 3/4 drug-related adverse events included: neutrophils 33%, platelets 22%, hand-foot skin reaction 8%, fatigue 7% and abdominal pain 6%. 1 patient had febrile neutropenia. To correlate treatment response with mutational status, melanoma samples from 20 pts were analyzed for mutations in B-RAF (exon 15) and PI3Kinase (exons 9 &amp; 20). 3 of 20 samples had V600E mutations in B- RAF; no PI3Kinase alterations were detected. Conclusions: Addition of SOR to DTIC was well-tolerated and resulted in encouraging PFS and OS rates in this poor prognostic cohort of patients. The data are promising as compared with published results of DTIC alone in metastatic melanoma (RR 7.5%, PFS 6 wks; Bedikian et al. 2006). A recently completed randomized Phase II trial will provide additional information on the efficacy of this combination regimen. [Table: see text]
Improved Treatment of Breast Cancer with Anti-HER2 Therapy Requires Interleukin-21 Signaling in CD8+ T Cells
Authors: Deepak Mittal, Franco Caramia, Stefan Michiels, Heikki Joensuu, Pirkko-Liisa Kellokumpu-Lehtinen, Christos Sotiriou, Sherene Loi, Mark J. Smyth
Journal: Cancer Research (2016)

The HER2/ErbB2 monoclonal antibody (mAb) trastuzumab is combined with chemotherapy as a standard-of-care for newly diagnosed HER2(+) breast cancer patients, but some patients treated with this combination therapy experience early relapse. Our analysis of data from a clinical trial evaluating the efficacy of chemotherapy plus/minus trastuzumab suggested that the magnitude of trastuzumab benefit on distant disease-free survival was higher for increasing expression of the IL21 receptor (IL21R). Therefore, we investigated a possible role for IL21 signaling in promoting HER2 mAb therapeutic efficacy. We found that IL21R-deficient mice and wild-type mice treated with a neutralizing anti-IL21 mAb were less susceptible to trastuzumab-like anti-ErbB2 therapy. Furthermore, IL21R expression on CD8(+) T cells, but not on natural killer cells, was required for optimal anti-ErbB2 mAb efficacy, and IL21 expression was enhanced in tumor-infiltrating CD4(+) T lymphocytes after anti-ErbB2 therapy. Finally, we found that administering recombinant IL21 in combination with anti-ErbB2 therapy was therapeutic against primary tumors and experimental metastases in mice. Collectively, our findings suggest that elevating IL21 signaling may enhance trastuzumab efficacy, thus constituting a novel candidate strategy to overcome trastuzumab resistance and improve patient survival. Cancer
Cerebrospinal fluid vasopressin as a marker of central nervous system metastases from small-cell bronchogenic carcinoma.
Authors: A G Pedersen, M Hammer, M Hansen, P S Sørensen
Journal: Journal of Clinical Oncology (1985)

Vasopressin (ADH) was measured in CSF and plasma in 75 evaluable patients with known or suspected CNS metastases from small-cell bronchogenic carcinoma (SCBC), and in 66 control patients having neither malignant disease nor organic CNS disease. The presence of CNS metastases was confirmed or excluded on the basis of computed tomographic scans, neurologic examination, and autopsy. Twenty-four of the 75 patients had no CNS metastases. Ten of the 51 patients with CNS metastases had leptomeningeal carcinomatosis (MC). CSF-ADH was significantly increased in patients with MC (P less than .05), but not in patients having exclusively parenchymatous CNS metastases. Taking 2 pg/mL (95th percentile of control patients) as the upper limit of normal, 15 SCBC patients had elevated CSF-ADH, including 12 patients with CNS metastases and six patients with MC. The CSF-ADH to plasma ADH ratio was significantly increased in patients with CNS metastases (P less than .05). Patients without CNS metastases had a ratio less than or equal to 0.8 whereas the ratio was greater than 0.8, in 21 of the 51 patients with CNS metastases. The positive and negative predictive values with 95% confidence limits were 84% to 100% and 31% to 59%, respectively. Patients with inappropriate secretion of ADH (SIADH) constituted a significantly greater proportion of patients with elevated CSF-ADH than of patients with normal CSF-ADH levels (P less than .05). In addition, patients with SIADH constituted a significantly greater proportion of patients with MC than of patients with parenchymatous metastases (P less than .05). The diagnostic application of these findings is limited because of the large number of false-negative results, but it may prove to be of value in conjunction with the measurement of other tumor markers.