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WASHINGTON-Sentinel lymph node (SLN) mapping has been used in gastrointestinal cancers to identify patients with occult micrometastases who might benefit from adjuvant chemotherapy. Because rectal lymph drainage is "less predictable" than colon lymph drainage, the technique had been considered less suitable for rectal than for colon cancers, said Sukamal Saha, MD, of the McLaren Regional Medical Center of Michigan State University, Flint.

Colorectal carcinoma is one of the most common malignancies in the western world, and although fluorouracil (5-FU) has been used in its treatment for almost 40 years, new agents with significant activity have been introduced recently. Irinotecan (CPT-11, Camptosar), a topoisomerase I inhibitor, administered at 300 to 350 mg/m2 every 3 weeks is significantly more active than continuous-infusion 5-FU in patients who have experienced disease progression after conventional therapy with 5-FU. In comparison to best supportive care, irinotecan improves survival and preserves quality of life despite treatment-related toxicity. Moreover, the combination of irinotecan and 5-FU has been explored in a number of different schedules. In previously untreated patients, overall response rates are high. Irinotecan can also be combined with mitomycin (mitomycin-C [Mutamycin]), oxaliplatin, or raltitrexed (Tomudex). Oxaliplatin is a new-generation platinum compound that has demonstrated activity against colorectal carcinoma in preclinical trials. It has been evaluated as a single agent against advanced colorectal carcinoma in the salvage setting and also in combination with 5-FU as initial therapy for metastatic disease (where it shows significant activity). The toxicity profile of oxaliplatin (chiefly characterized by neurotoxicity) differs from that of irinotecan (primarily producing diarrhea) and the potential, therefore, exists for combining these agents or for exploiting their possible synergy with 5-FU. The introduction of these two new active agents of different pharmacologic classes promises to enable significant improvements in the treatment of patients with colorectal carcinoma. [ONCOLOGY 15(4):415-434, 2001]

ROCKVILLE, Md-The FDA has approved the marketing of the Optical Biopsy System (SpectraScience, Inc.), a laser-based technique designed to assist physicians in deciding whether certain colon polyps are precancerous and should be removed. The company chose the trademark name Optical Biopsy System after the FDA refused to accept the name "Virtual Biopsy System" for its product.

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

BOSTON-HIV-positive patients often cannot tolerate treatment for anal squamous cell carcinoma and have a worse prognosis than other patients, according to two studies presented at the American Society of Colon and Rectal Surgeons (ASCRS) annual meeting.

NEDLANDS, Australia-If the implications of an Australian study are validated in further prospective studies, microsatellite instability (MSI) could potentially predict those patients with Dukes’ C and possibly Dukes’ B colorectal cancer who will respond best to chemotherapy.

NEW ORLEANS-A prospective study in colorectal cancer patients has found that sentinel lymph node (SLN) mapping correctly predicts the presence or absence of nodal metastases, with a very low incidence of skip metastases (disease in a non-SLN), as it does in melanoma and breast cancer.

NEW YORK-Patients with advanced colorectal cancer have a median survival of only 12 months with single-agent chemotherapy. New drugs and new drug combinations are being tested in an attempt to find more effective treatments for the disease. A panel of researchers discussed trials of raltitrexed (Tomudex) in combination with other drugs at the Chemotherapy Foundation Symposium XVII.