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Solomon et al have written a valuable primer to guide clinicians in identifying, diagnosing, and treating familial colon cancer syndromes. The authors succinctly describe the essential features of each of the well-defined hereditary colon cancer syndromes, including those associated with colonic adenomas (hereditary nonpolyposis colorectal cancer [HNPCC] and familial adenomatous polyposis [FAP]) and colonic hamartomas (Peutz-Jeghers syndrome, juvenile polyposis, and Cowden syndrome). In addition to the specific features that might trigger recognition of one of these syndromes, we advise health-care providers to consider the possibility of hereditary cancer in cases with the following features:

The effect of a patient’s race or ethnicity on cancer incidence and mortality rates remains a neglected area of cancer research. However, with cancer statistics differing among various populations, research on racial and ethnic groups could provide clues to cancer trends.

The population dynamics of cellular entry, traverse, and exit, through and from each phase of the cell cycle is coordinated throughout the day in the tissue of the human body. This coordination is particularly robust-ie, the daily peaks and valleys are particularly high and low-in tissues with the greatest average daily cellular proliferation. These tissues are also the most severely damaged by cancer treatments, most prominently cytotoxic drugs and ionizing irradiation.

NEW YORK CITY-Weekly irinotecan (Camptosar) and cisplatin (Platinol) can be successfully given as first-line treatment to women with advanced ovarian cancer. The toxicity is manageable, and some patients with suboptimally resected disease achieved an extended disease-free survival, David Spriggs, MD, reported. He is chief of the Developmental Chemotherapy Service at Memorial Sloan-Kettering Cancer Center in New York City.

The Food and Drug Administration (FDA) and the National Cancer Institute (NCI) inaugurated a new program in July that

HOUSTON, Texas-David M. Gershenson, MD, painted a bleak picture of current treatment for advanced ovarian cancer and suggested that new agents such as topoisomerase inhibitors should be studied further in clinical trials. Dr. Gershenson said that although CA-125 and transvaginal ultrasound are used for screening, they have limited efficacy, with the result that over 70% of ovarian cancers have already spread beyond the ovary by the time they are detected.

SAN FRANCISCO-More than four out of 10 cancer patients received chemotherapy during their last year of life, according to a study of Medicare patients in Massachusetts. Even a proportion of patients with tumors considered unresponsive to chemotherapy received treatments within 1 month of their death.

SAN FRANCISCO-Preliminary data from an uncontrolled pilot study suggest that levocarnitine (L-Carnitine, Carnitor) supplementation can reduce fatigue in some patients. Francesco Graziano, MD, found that 87% of patients given levocarnitine 4 g/day po for 7 days reported reduced fatigue. Dr. Graziano is in the medical oncology department at the Hospital of Urbino, Italy.

SAN FRANCISCO-Amifostine (Ethyol) provided cytoprotection and allowed the maximum tolerated dose of melphalan (Alkeran) to be increased to 280 mg/m2 for cancer patients receiving autologous hematopoietic stem cell transplantation in a phase I and II study. Dose-limiting toxicity of melphalan was not able to be clearly determined from the trial, however, and might be higher, according to Gordon L. Phillips II, MD, director of the bone marrow transplantation program of the Greenebaum Cancer Center at the University of Maryland in Baltimore.

The Clinical Trials Referral Resource that appeared in the April issue of ONCOLOGY began a series on health-related quality of life (HRQOL). Part I of this series, which concludes this month, focuses on HRQOL questions in cancer treatment trials. Part II (on investigator-initiated HRQOL research) and part III (on HRQOL research as part of cancer prevention trials) will appear in upcoming issues. Information about these studies can be obtained from the contacts listed for each trial or from Edward L. Trimble, MD, MPH, at the Cancer Therapy Evaluation Program (CTEP), trimble@ctep.nci.nih.gov or (301) 496-1196