Gastrointestinal Cancer

A number of advances have been made in the use of adjuvant chemotherapy for resectable rectal cancer. Whereas pelvic radiation therapy has been shown to increase local control in patients with clinically resectable

ASCO-The addition of irinotecan, also known as CPT-11 (Camptosar), to standard first-line therapy significantly increased progression-free survival and antitumor response in patients with metastatic colorectal cancer, according to the preliminary results of a randomized, open-label phase III trial presented at the 35th Annual Meeting of the American Society of Clinical Oncology (ASCO). Irinotecan is currently FDA approved for second-line treatment of metastatic colorectal cancer.

Michael H. Levy, MD: This 38-year-old white male first came to his physician in January of 1993 complaining of epigastric and low back pain. In March of 1993, he was diagnosed with pancreatic cancer that was metastatic to his

WASHINGTON-Baseball star and colon cancer survivor Eric Davis has launched “Score Against Colon Cancer,” a public awareness and screening campaign that will capitalize on the St. Louis Cardinals slugger’s celebrity status and personal experience.

Colorectal cancer is the second leading cause of cancer-related death in the United States. During 1999, approximately

ORLANDO, Fla-Sharp dissection through a plane between the visceral and parietal layers of the pelvic fascia permits a clean removal of the entire rectum and mesorectum, and greatly decreases local recurrence of rectal cancer, Warren E. Enker, MD, reported at the 52nd Annual Cancer Symposium of the Society of Surgical Oncology (SSO). Typically, he said, patients have been treated with blunt dissection, resulting in inadequate mesorectal excision.

Nearly one-fifth of patients who develop colorectal cancer at a young age (40 and younger) have a family history consistent

ATLANTA-Although screening can reduce mortality from colorectal cancer, a CDC study indicates low use of sigmoidoscopy/proctoscopy and the fecal occult blood test (FOBT), particularly within the recommended time intervals. People with health insurance, higher incomes, and more education were more likely to report having had these tests.

Researchers have identified a mechanism that may explain where colorectal tumors arise and at what age the tumors develop in people with hereditary nonpolyposis colorectal cancer (HNPCC). The results of the study, conducted at Ohio State’s Comprehensive Cancer Center, help clarify why some people with the same HNPCC-related genetic mutation develop colorectal tumors at 30 years of age while others develop tumors at age 60. They also help explain why tumors in some patients develop in the distal area of the large intestine rather than in regions closer to the large intestine’s junction with the small intestine, which is more typical.

Aphase III clinical trial conducted by researchers at Lehigh Valley Hospital, Allentown, Pennsylvania, found that the OncoVAX colon cancer vaccine reduced the 5-year recurrence rate of patients with stage II colon cancer patients by 61% and improved their cancer-free survival rate by 50%. The study, published in a recent issue of the Lancet, compared patients who underwent surgery alone to patients who had surgery plus the vaccine.

The article by Drs. Peeters and Haller provides the details of 20 years of investigation into the adjuvant therapy of colorectal cancer. The authors describe pivotal trials through which an international cast of investigators have identified adjuvant

Surgery is the only curative option for patients with colorectal cancer. The goal of other modalities, such as chemotherapy, immunotherapy, and radiotherapy, is to prolong survival and reduce the risk of recurrence.

NEW YORK-A diagnosis of advanced colon cancer may lead some physicians to abandon treatment with curative intent, but John Macdonald, MD, insists that they should be more optimistic and aggressive.

PHOENIX-Conservative, sphincter-sparing surgery followed by chemotherapy plus radiotherapy appears effective in selected patients with early-stage rectal cancer, Anthony Russell, MD, said at the American Society for Therapeutic Radiology and Oncology meeting.

Hormone replacement therapy may reduce the risk of colorectal cancer in women, according to new results of a meta-analysis presented at the North American Menopause Society meeting.

Scientists at Jefferson Medical College believe they’ve uncovered a molecular mechanism by which aspirin interferes with colorectal cancer development in individuals who carry particular gene mutations that make them very likely to get the

Colorectal cancer is one of the most commonly occurring cancers in the United States. In an effort to prevent the occurrence of colorectal cancer, agents identified as reducing risk of the disease are being targeted as potential chemoprevention tools. However, complex associations exist among diet, lifestyle factors, and genetic susceptibility and the eventual development of colon cancer, sometimes making the transition from associations identified in epidemiologic studies to the clinical use of chemoprevention agents difficult. Environmental factors that may serve as chemoprevention agents are addressed in the article by Garay and Engstrom. Does our current knowledge allow us to embrace these agents as tools for chemoprevention?

Remarkable progress has been made in recent years in our understanding of colorectal cancer etiology. The various hypotheses of causality continue to be tested in human observational and intervention studies, as well as experimental models. Drs. Garay and Engstrom provide a comprehensive review of the dietary and chemopreventive factors for colorectal cancer. While their conclusions are noteworthy, those related to dietary factors are debatable.

Colorectal cancer is a major cause of death in the United States, where it accounts for approximately 57,000 deaths per year. Thus, the prevention of this disease would have a significant impact on public health. Chemoprevention is defined as the use of natural or pharmacologic agents to disrupt the process of carcinogenesis. Substances explored as chemopreventive agents in colorectal cancer include: (1) the nonsteroidal anti-inflamma-tory drugs (NSAIDS), which may inhibit the evolution and formation of adenomas by their inhibition of cyclooxygenase and decrease of prostaglandin synthesis; (2) antioxidants, such as vitamin E or C, which may modulate carcinogenic substances; and (3) folate and calcium, which may interfere with tumor cell growth and replication. Dietary intervention can be accomplished by decreasing fat intake and increasing fiber consumption, both of which have been linked to a lower incidence of colon cancer in multiple epidemiologic studies. This field is continuing to evolve. Hopefully, ongoing research efforts will offer a better understanding of the role of these and other substances in chemoprevention. This article summarizes the available data regarding dietary and pharmacologic approaches to colorectal cancer chemoprevention. [ONCOLOGY 1(13):89-98, 1999]

TORONTO-Several studies presented at the Society of Nuclear Medicine’s 45th annual conference support the use of positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (FDG) to evaluate patients with recurrent colorectal cancer.

DALLAS--A team of developmental biologists examining how tumor growth factor (TGF)-beta sends messages into cells has come up with the first animal model for colon cancer that closely mimics the human disease.

TORONTO--New research suggests that tumor marker levels for colorectal cancer do not consistently indicate the presence of malignant tissue. A German study revealed that 10 of 34 patients with colorectal cancer had normal carcinoembryonic antigen (CEA) levels and 16 had normal CA19-9 levels. In addition, a California study found that patients with elevated CEA levels did not necessarily have disease recurrence.

Data presented at the American Society of Clinical Oncology meeting by Professor Eric Van Cutsem, MD, PhD, University Hospital Gasthuisberg, Leuven, Belgium, demonstrate, for the first time, that people with metastatic colorectal cancer who

LOS ANGELES--Raltitrexed (Tomudex), a folate-based specific inhibitor of thymidylate synthase, has been shown in phase III trials to produce response rates similar to those of the Mayo regimen of 5-fluorouracil (5-FU) and leucovorin in patients with advanced colorectal cancer.

LOS ANGELES--Adding oxaliplatin (Eloxatine) to a bimonthly regimen of leucovorin and 5-fluorouracil (5-FU) in colorectal cancer patients "substantially enhanced the regimen’s activity with little increase in toxicity," Aimery de Gramont, MD, Hospital Saint-Antoine, Paris, reported at ASCO. "The study confirms the good activity and excellent tolerability of the bimonthly leucovorin/5-FU schedule," he said.