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Dr. Krasna provides a thoughtful review of thoracoscopy as an emerging technique for the staging of patients with lung and esophageal cancers. In lung cancer, thoracoscopy can be used as a complement to cervical mediastinoscopy in the evaluation of mediastinal and hilar lymph nodes. This is especially true in patients who have left-sided neoplasms with enlarged lymph nodes in the aortico-pulmonary window--a region typically inaccessible to cervical mediastinoscopy.

The incidence of breast cancer has risen steadily over the past several decades. Breast cancer is second only to lung cancer as a cause of cancer deaths among women; 46,000 women died of breast cancer in the United States alone in 1995. Despite efforts to improve the survival of women with metastatic breast cancer with currently available chemotherapeutic agents, results remain disappointing. The primary use of such agents continues to be for palliation, not cure.

FORT LAUDERDALE, Fla--One of the most debated topics of the preliminary practice guidelines prepared by the National Comprehensive Cancer Network (NCCN) has been the level of surveillance after treatment, and this was also the case with the preliminary guideline for small-cell lung cancer (SCLC), presented by George D. Demetri, MD, at the NCCN's first annual conference.

For patients with either limited or extensive small-cell lung cancer (SCLC), dose intensification of VICE chemotherapy affords a significant survival advantage without increasing the danger of sepsis or drug-related death, W.P. Steward, MD, said at the Eighth Annual European Cancer Conference (ECCO-8).

Topotecan HCl, an investigational anticancer drug, has demonstrated significant antitumor activity in previously treated small-cell lung cancer (SCLC) patients, according to European Organization for Research and Treatment of Cancer (EORTC) researchers, who presented phase II trial data at the Eighth European Conference on Clinical Oncology, Cancer Research and Cancer Nursing (ECCO-8) in Paris.

PARIS--Relapse after induction chemotherapy is a virtual inevitability in patients with small-cell lung cancer (SCLC), and response rates to second-line chemotherapy have been generally disappointing. However, new study results presented at the Eighth Annual European Cancer Conference (ECCO-8) suggest that topotecan, an investigational topoisomerase I inhibitor, may improve second-line results.

BETHESDA, Md--The Oncologic Drugs Advisory Committee (ODAC), in a vote of 9 to 4, recommended that Verluma imaging be approved for the initial staging of patients with biopsy-confirmed small-cell lung cancer (SCLC). Verluma is a murine monoclonal antibody (MoAb) Fab fragment, targeted to the NR-LU-10 antigen and linked to technetium-99m.

Topotecan HCl, an investigational anticancer drug, has demonstrated significant antitumor activity in previously treated small-cell lung cancer (SCLC) patients, according to European Organization for Research and Treatment of Cancer (EORTC) researchers, who presented phase II trial data at the Eighth European Conference on Clinical Oncology, Cancer Research and Cancer Nursing (ECCO-8) in Paris.

LUXEMBOURG-Home administration of erythropoietin (epoetin alfa, Epogen, Procrit) safely prevented or delayed the development of chemotherapy-associated anemia and reduced transfusion requirements by as much as 35% in a multicenter study of patients with small-cell lung cancer (SCLC), Nicholas Thatcher, MD, said at the 7th International Symposium of the Multinational Association of Supportive Care in Cancer (MASCC).

The POpulation HEalth Model (POHEM) lung cancer microsimulation model has provided a useful framework for calculating the cost of managing individual cases of lung cancer in Canada by stage, cell type, and treatment modality, as well as the total economic burden of managing all cases of lung cancer diagnosed in Canada. These data allow an estimation of the overall cost effectiveness of lung cancer therapy. The model also provides a framework for evaluating the cost effectiveness of new therapeutic strategies, such as combined modality therapy for stage III disease or new chemotherapy drugs for stage IV disease. By expressing the cost of lung cancer treatment as cost of life-years gained, such analyses allows useful comparisons of the cost effectiveness of these treatments with those of other costly but accepted medical therapies. [ONCOLOGY 9(Suppl):147-153, 1995]

SEATTLE-"Staging of lung cancer by physicians is frequently incomplete and often inaccurate," Scott B. Chelemer, MD, said in an interview at the 1995 International Conference of the American Thoracic Society and American Lung Association. He believes that a computerized lung cancer database that included all clinical, radiographic, and histologic data for every patient could improve staging and possibly outcomes.

WINNIPEG, Canada-Clinical trials have shown that the level of symptom distress at the time of lung cancer diagnosis can predict survival, and now a study performed in an ambulatory setting has confirmed this finding. Patients with higher symptom distress scores are likely to die more quickly than those with lower scores, report University of Manitoba researchers Lesley F. Degner, RN, PhD, and Jeffrey A. Sloan, PhD.

MONTREAL-Patients with advanced non-small-cell lung cancer (NSCLC) who receive chemotherapy report better symptom control and quality of life than those who opt for supportive care alone, William K. Evans, MD, chief executive officer, Ottawa Regional Cancer Centre, On-tario, said at a symposium on lung cancer organized by the 19th International Congress of Chemotherapy.

COLLEGEVILLE, Pa--Rhône-Poulenc Rorer Inc.'s Taxotere (docetaxel) has received approval from the Canadian Health Protection Branch for use as second-line treatment of advanced breast and non-small-cell lung cancer (NSCLC). The new drug submission was based on clinical trials involving more than 800 patients worldwide.

BALTIMORE--A number of factors can suggest whether a focal pulmonary lesion is malignant or benign, but no single test affords a quick answer, and biopsy is usually necessary to make the diagnosis, said Peter White, Jr., MD, assistant professor of medicine at Johns Hopkins University.

ASCO LOS ANGELES--Five studies presented at the American Society of Clinical Oncology (ASCO) meeting raise questions as to whether platinum/taxane combinations are better in non-small-cell lung cancer (NSCLC) than standard platinum/etoposide (VePesid) regimens, and if so, which platinum and which taxane used in combination are best with respect to efficacy, toxicity, and cost?