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NEW ORLEANS-Colorectal cancer cells are shed into the stool, providing a potential means for early detection using noninvasive approaches. A multi-center research effort has evaluated a set of three genetic markers that may indeed constitute a reliable genetic mutation analysis of stool, signifying cancer

BETHESDA, Md-Evidence of a relationship between diet and the origins of colorectal cancer is tantalizing but shadowy, two longtime researchers said at the Colorectal Cancer Prevention and Treatment conference, co-sponsored by the Cancer Research Foundation of America and the American Digestive Health Foundation.

CHARLESTON, South Carolina-Irinotecan/gemcitabine combinations have looked sufficiently promising for pancreatic cancer in phase II trials that researchers are proceeding with randomized phase II and phase III studies, Caio Max S. Rocha Lima, MD, told those attending the Vanderbilt University Symposium. Dr. Rocha Lima is assistant professor of medicine in the Hematology Oncology Division at the Medical University of South Carolina in Charleston.

NEW YORK-The biologic response modifier virulizin, which has in vitro and preclinical activity in a variety of cancers, has exhibited possible activity in pancreatic cancer in phase I and II clinical trials, said Michael P. Thirlwell, MD, director, Department of Oncology, McGill University, Montreal.

NEW YORK-Irofulven, the first of the acylfulvenes, a new class of cytotoxic agents, is being studied in a number of solid tumors, including a phase III trial in advanced pancreatic cancer, said Raymond Taetle, MD, clinical professor of medicine and pathology, University of Arizona, Arizona Cancer Center, Tucson.

In their article, Drs. Wagman and Minsky provide an excellent overview of the current status of local treatment strategies for early rectal cancer. They have rightly pointed out that while minimal surgery is an attractive option, it must be balanced against the highly curable outcomes of radical surgical resection. Expanded experience with stapling devices has extended the level at which safe and satisfactory anastomoses can be accomplished in the distal rectum. The promise of enhanced preservation of rectal, urinary, and sexual functions makes local treatment strategies an attractive option. The most important aspect of disease management using this approach remains the process of patient selection.

The article by Drs. Khayat and Gil-Delgado outlines the exciting new developments in the treatment of advanced colorectal cancer with irinotecan (CPT-11 [Camptosar]) and oxaliplatin. Although the development of these drugs provides an alternative to fluorouracil (5-FU) in the treatment of this common tumor, it is still unclear how to optimally integrate these promising compounds into therapy for colorectal cancer.

Since its development in 1957, fluorouracil (5-FU) has been the central component in the treatment of colorectal cancer. Over the past several decades, innumerable permutations of fluorouracil biomodulation have been studied. Indeed, rarely has a drug been so well understood in terms of its mechanisms and metabolism, and rarely has such an understanding been so extensively exploited in clinical strategies. But despite these efforts, overall progress in the management of advanced colorectal cancer has been modest.

NEW YORK-Although no complete responses occurred in patients with advanced pancreatic cancer in a study of DX-8951F (exatecan mesylate, Daiichi Pharmaceuticals), those who were treatment-naïve survived longer than usual, and stable disease was observed in 39%, Eileen M. O’Reilly, MD, reported at the Chemotherapy Foundation Symposium XVIII.

Capecitabine (Xeloda) is the first orally available fluoropyrimidine approved for use in patients with cancer. It was initially approved for use in metastatic breast cancer, but significant data also support its use in the management

NEW YORK-An irinotecan (Camptosar) plus gemcitabine (Gemzar) combination known as IrinoGem was associated with low toxicity, median survival of 6 months, and a 1-year survival rate of 27%, according to results from a phase II study presented at the Chemotherapy Foundation Symposium XVIII.

BOSTON-Neoadjuvant therapy for adenocarcinoma of the rectum is well tolerated and can produce substantial downstaging and high curative resection rates, according to a retrospective study presented at the American Society of Colon and Rectal Surgeons (ASCRS) annual meeting. The manuscript of the study has been accepted for publication in Diseases of the Colon and Rectum.

NEW YORK-The combination of oxaliplatin (investigational) and irinotecan (Camptosar) as front-line treatment for colorectal cancer is feasible and potentially synergistic, preliminary data from an M.D. Anderson Cancer Center phase I/II trial suggests.