Oncology NEWS International Vol 6 No 2

NCI Launches Trial of High-Dose Chemo for Advanced Ovarian Cancer

February 01, 1997

BETHESDA, Md--Hoping to resolve one of cancer care's ongoing controversies, the National Cancer Institute is launching the first large national study of high-dose chemotherapy for advanced ovarian cancer, to be conducted at dozens of medical centers affiliated with the Gynecologic Oncology Group and other cooperative groups supported by NCI.

Brachytherapy to Tumor Bed After Lumpectomy a Possible Alternative to External Beam Therapy

February 01, 1997

ROYAL OAK, Mich-Interstitial implants that deliver radiation therapy to the tumor bed alone after lumpectomy have been well tolerated with no significant acute or late toxicity in the first 50 patients in a Michigan study. In addition, with three years' median follow-up, no patients have recurred locally or distantly.

Breast Conservation Is Contraindicated in Less Than 25% of Early-Stage Patients

February 01, 1997

CHICAGO-Medical contraindications to breast-preserving cancer surgery occur in a minority of patients with early-stage breast cancer when accepted clinical guidelines are appropriately applied, results from a series of more than 400 patients suggest.

'More May Be Less' in Metastatic Cervical Cancer

February 01, 1997

VIENNA--A new study from the EORTC Gynecologic Cancer Cooperative Group (GCCG) has challenged the assumption that aggressive combination chemotherapy is worthwhile in chemotherapy-naïve women with metastatic squamous cell cancer of the cervix.

At 10 Years, DCIS Patients' Risk of Breast Cancer Death Is Very Low

February 01, 1997

SAN FRANCISCO-A new analysis based on SEER data shows a very low probability of fatal breast cancer among women with DCIS for up to 10 years after diagnosis and treatment. Further, the data suggest that women with DCIS are, overall, healthier than the general population, Virginia L. Ernster, PhD, reported at a poster session of the San Antonio Breast Cancer Symposium.

Tumor Cells in Marrow May Better Predict Metastases Than Axillary Node Dissection

February 01, 1997

HEIDELBERG, Germany-Evaluation of bone marrow for breast cancer cells proved superior to axillary lymph node dissection in predicting subsequent metastases in a German study of more than 1,000 patients, Ingo J. Diel, MD, said at a general session of the San Antonio Breast Cancer Symposium.

Survey Finds 122 New Anti-HIV Medicines Currently Being Tested

February 01, 1997

WASHINGTON--A new survey of pharmaceutical and biotechnology companies by the Pharmaceutical Research and Manufacturers of America (PhRMA) has identified 122 drugs and vaccines in testing to prevent HIV infection or to treat AIDS and AIDS-related diseases. These drugs are in addition to the 42 medications already approved and on the market in the United States.

Delaying Radiotherapy to Allow Adjuvant Chemotherapy Not Shown to Increase Ipsilateral Recurrence Risk

February 01, 1997

PITTSBURGH-Although not designed specifically to answer the question, NSABP B-15 and B-16 provide no evidence that delay in radiation therapy, to allow administration of adjuvant chemotherapy, increases the risk of ipsilateral breast cancer recurrence in node-positive patients undergoing breast-conserving surgery. E.P. Mamounas, MD, presented the updated results of these two trials at a general session of the San Antonio meeting. Dr. Mamounas is with the NSABP at the University of Pittsburgh, and is also medical director of the Mount Sinai Center for Breast Health, Beachwood, Ohio.

President Clinton Unveils National AIDS Policy

February 01, 1997

WASHINGTON--President Clin-ton calls his new national AIDS strategy an important milestone in the history of efforts to end the pandemic that has killed more than 343,000 Americans since 1981. "In the 15 years of this epidemic, we have never had such a unified strategy," the President said. "These goals will guide our work in the coming term and, more specifically, in the coming year."

Mammotomy May Reduce Biopsy Sampling Errors

February 01, 1997

CHICAGO--A percutaneous breast biopsy method that uses a thin rotating blade to snip off tissue and a vacuum element to withdraw pathological samples is proving to be three times more accurate and two times faster than core needle biopsy, said Roger J. Jackman, MD, of the Department of Diagnostic Radiology, Palo Alto Medical Clinic, Calif, at the annual meeting of the Radiological Society of North America (RSNA).

Ultrasound Advances May Expand Role in Treatment Planning

February 01, 1997

CHICAGO--Although ultrasound has been the primary imaging technique used in the assessment of the prostate gland for potential malignancy, it has been secondary to PSA assays and the digital rectal examination as a screening technique because "the cost-benefit ratio is too low to warrant its use," Matthew D. Rifkin, MD, said at the annual meeting of the Radiological Society of North America. New technological refinements of sonographic equipment, however, may allow a bigger role for ultrasound in prostate cancer in the future, said Dr. Rifkin, chair of the Department of Radiology, Albany Medical College, NY.

NIH Consensus Development Statement Sparks Rancor

February 01, 1997

BETHESDA, Md--The NIH Consensus Development Conference was unanimous in its decision not to recommend routine screening mammography for women aged 40 to 49, saying that the evidence to date does not show that any possible benefits outweigh potential risks.

Breast Cancer Patients May Overestimate the Benefits of Adjuvant Chemotherapy

February 01, 1997

SAN ANTONIO-Most breast cancer patients vastly overestimate the benefits of adjuvant chemotherapy, believing that it reduces their risk of recurrence by as much as 77%, Laura Siminoff, PhD, reported at a general session of the San Antonio Breast Cancer Symposium.

Letrozole Superior to Progestin as Second-Line Postmenopausal Advanced Breast Cancer Therapy

February 01, 1997

VIENNA--The fourth-generation aromatase inhibitor letrozole has become the first drug of its class to outperform megestrol acetate as a second-line hormonal therapy for postmenopausal women with metastatic breast cancer who relapsed or progressed during tamoxifen (Nolvadex) therapy.

Toremifene Studied as Palliation for Renal Cell Cancer

February 01, 1997

ST. PETERSBURG, Russia--High doses of the investigational antiestrogen toremifene (Fareston) proved safe and effective as palliative therapy in patients with advanced renal cell carcinoma, say Dr. Michael Gershanovich and colleagues, of the Professor N. N. Petrov Research Institute of Oncology, St. Petersburg, and Orion Corporation, Turku, Finland.

High-Dose Contact RT Feasible in KS on the Hard Palate

February 01, 1997

CHICAGO--In feasibility testing, a custom-designed high-dose-rate contact radiation therapy technique destroyed Kaposi's sarcoma on the hard palate in less time than conventional external beam radiotherapy and with less severe side effects.

New Indication for Procrit in Elective Surgeries

February 01, 1997

RARITAN, NJ--Procrit (Epoetin alfa) has received marketing clearance by the FDA for use in reducing the need for allogeneic blood transfusions in anemic patients scheduled to undergo elective noncardiac, nonvascular surgery. Patients should be at high risk for perioperative transfusion with significant, anticipated blood loss. Procrit is not indicated for anemic patients who are willing to donate autologous blood.

Researchers Debate Need for Radiotherapy After Excision In Subset of DCIS Patients

February 01, 1997

SAN ANTONIO-Is adjuvant radiotherapy necessary for all breast cancer patients undergoing breast-conserving therapy? Prospective, randomized studies from the NSABP indicate that it is, Norman Wolmark, MD, said in a minisymposium held in conjunction with the San Antonio Breast Cancer meeting.

Estrogen Use May Decrease Risk of Breast Cancer Death, Large ACS Study Suggests

February 01, 1997

ATLANTA-A study of more than 400,000 postmenopausal women has found no increased risk of fatal breast cancer with use of estrogen replacement therapy (ERT). In fact, women who reported ever having used estrogen actually had a 16% decreased risk of dying of breast cancer, Dawn Willis, PhD, MPH, reported for the American Cancer Society (ACS) at a general session of the San Antonio Breast Cancer Symposium.

Radioactive Seeds Used to Help Prevent Local Recurrence of Non-Small-Cell Lung Cancer

February 01, 1997

CHICAGO--Implantation of iodine-125 seeds along the edges of a limited surgical resection can enhance local control of stage I non-small-cell lung carcinoma (NSCLC) in patients who cannot have more extensive surgery, Jack McGrath, MD, said at the Radiological Society of North America meeting.

Trials Show Efficacy of Toremifene in Advanced Breast Cancer

February 01, 1997

PALM SPRINGS, Calif--Three major randomized trials comparing the antiestrogens toremifene (Fareston) and tamoxifen (Nolvadex) in patients with advanced breast cancer showed no significant differences in efficacy or side effects profiles, Richard Gams, MD, of Ohio State University, said at the symposium.

Study Indicates Need for Lower PSAD Cutoff

February 01, 1997

CHICAGO--According to the clinical literature, men with a prostate-specific antigen density (PSAD) level less than 0.15 ng/mL do not need ultrasound-guided biopsy because the PSAD is considered normal or reflects only a benign process.

PET Shows Promise in Screening for Axillary Node Metastases

February 01, 1997

CHICAGO--Positron emission tomography (PET) has excellent potential as a screening test for spotting axillary lymph node metastases in women with newly diagnosed, early-stage breast cancer, thereby sparing many women from unnecessary lymph node dissection, Lee Adler, MD, of Case Western Reserve University, said at the Radiological Society of North America meeting.

Intraoperative Radiation Allows Lumpectomy Patients to Skip Boost

February 01, 1997

TOLEDO, Ohio-Researchers at the Medical College of Ohio have treated a series of breast-conservation patients with intraoperative electron beam radiation to the tumor bed, in conjunction with a course of 45 to 50 Gy of external beam radiation.

Paclitaxel as Weekly One Hour Infusion Is Active in Metastatic Breast Cancer

February 01, 1997

NEW YORK-Paclitaxel (Taxol) given as a weekly one-hour infusion has significant activity in metastatic breast cancer and is well tolerated at a dose of 100 mg/m²/wk or less, researchers from Memorial Sloan-Kettering Cancer Center reported at a poster session of the San Antonio Breast Cancer Symposium.

States Consider Model Managed Care Consumer Protection Bill

February 01, 1997

WASHINGTON--State legislators from nine states announced they will introduce the Managed Care Consumer Protection Act when their respective legislatures convene this year. Legislators in others states may also introduce the "model" bill, drafted by a bipartisan group of state legislators. The drafting panel said it sought to avoid piecemeal attempts to resolve conflicts between consumers and managed care plans by drafting a comprehensive, uniform bill.

Sequential Dose-Dense Regimen Is Well Tolerated, May Improve Survival in Advanced Breast Cancer

February 01, 1997

SAN ANTONIO-At almost three years' median follow-up, disease-free survival is 81% among a group of 42 women with resected breast cancer and four or more positive nodes who received dose-dense sequential chemotherapy using doxorubicin, paclitaxel (Taxol), and cyclophosphamide, Clifford A. Hudis, MD, said in his poster presentation.

Stem Cells Simplify Transplant in Pediatric Solid Tumors

February 01, 1997

SEATTLE--Studies are underway using high-dose chemotherapy followed by autologous hematopoietic stem cell transplant for the treatment of neuroblastoma, Ewing's sarcoma, and other solid tumors in children, Julie Park, MD, of Children's Hospital and Medical Center, Seattle, said at the Association of Pediatric Oncology Nurses meeting.

Pact With NCI Expands Veterans' Access to Trials

February 01, 1997

BETHESDA, Md--In a move designed to increase the pool of patients available for clinical trials, the National Cancer Institute has forged an agreement with the Department of Veterans Affairs that will increase the ability of veterans to enroll in phase I, II, and III studies.

Paclitaxel/5-FU Promising in Metastatic Breast Cancer

February 01, 1997

ROME, Italy-The combination of paclitaxel (Taxol), fluorouracil (5-FU), and leucovorin, with G-CSF support, in pretreated patients with advanced breast cancer had a good toxicity profile and an encouraging response rate in a study from the Regina Elena Cancer Institute, Rome.

Milan Reports 18-Year Results of ABVD in Hodgkin's Disease

February 01, 1997

VIENNA--The first Hodgkin's disease study updates to come out of the Milan Cancer Institute since 1989 have now confirmed that the therapeutic advantages of regimens containing ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) are sustained for nearly two decades.

Breast Palpation at Time of Breast Implant Excision May Find Cancer

February 01, 1997

DALLAS--Breast implant excision or exchange offers a unique cancer screening opportunity in breasts frequently difficult to check manually or radiologically, William Shaw, MD, said at the American Society of Plastic and Reconstructive Surgeons annual meeting.

Paclitaxel Is Dose Escalated in Combination Regimen

February 01, 1997

DUARTE, Calif-Researchers at the City of Hope National Medical Center are in the process of updating their high-dose chemotherapy regimens for high-risk breast cancer patients to include paclitaxel (Taxol), George Somlo, MD, said in a poster presentation at the San Antonio Breast Cancer Symposium.

New Series to Explore Cancer Genetic Issues

February 01, 1997

The familial aggregation of cancer has piqued the curiosity of physicians for more than two millennia. Most explanations for this aggregation were based upon environmental hypotheses, such as diet, solar radiation, habit patterns, and cultural practices, as well as occupational exposures. On rare occasions, ancients and now, more frequently, contemporaries have suggested that genetics might provide an important causal explanation for familial cancer.

Stable Disease May Be a Valid Criterion for Continuing Hormonal Treatment in Metastatic Breast Cancer Patients

February 01, 1997

NOTTINGHAM, UK-Stable disease appears to be a clinically relevant category for judging the effectiveness of hormonal therapy in metastatic breast cancer, John Robertson, MD, said in his poster presentation of a study from the Department of Surgery, City Hospital, Nottingham.

Expanded Role for Bisphosphonates in Metastatic Breast Cancer

February 01, 1997

SAN ANTONIO--Bisphosphon-ates are indicated in patients with established bone metastases from breast cancer or myeloma, to reduce skeletal complications, Alexander H.G. Paterson, MD, said at a minisymposium held in conjunction with the San Antonio Breast Cancer Symposium.

FDA Proposes Selection Process for Patient Reps

February 01, 1997

ROCKVILLE, Md--The FDA has proposed a formal process for selecting patient representatives to serve on its cancer-related advisory boards--the Onco-logic Drugs Advisory Committee, the Biological Response Modifiers Advisory Committee, and the Medical Imaging Drugs Advisory Committee.

Oral Vinorelbine Is Promising in Advanced Breast Cancer Patients

February 01, 1997

BOULOGNE, France-An oral formulation of vinorelbine (Navelbine) demonstrated encouraging antitumor activity and proved to be well tolerated in a phase I study of patients with advanced breast cancer, French physicians reported in a poster presentation.

Reid Sleeve Improves Chronic Lymphedema

February 01, 1997

ST. LOUIS-In a study of 31 breast cancer patients with chronic lymphedema who had failed other treatment methods, 27 showed significant improvement with use of the Reid Sleeve, a custom-designed pattern of soft polymer ridges that apply varying degrees of pressure, Diane Radford, MD, of Washington University, said in a poster presentation.

Expanding Uses of Taxol Therapy in Breast Cancer

February 01, 1997

SAN ANTONIO-Although paclitaxel (Taxol) is still being evaluated as a single agent in advanced breast cancer, to determine optimal dosing and schedule, it is also being studied for use in combination with other cytotoxic agents, as adjuvant therapy in early-stage disease, and as part of high-dose chemotherapy regimens used with stem cell transplant.

New Website Gateway to Vast Array of Cancer Resources

February 01, 1997

HUNTINGTON, NY--Imagine a website designed exclusively for cancer professionals. It would, of course, offer free access to Medline via a state-of-the-art search tool, as well as access to the National Cancer Institute's PDQ database and CancerLit.

Topotecan Promising Alternative in Advanced Ovarian Cancer: Dutch Trial

February 01, 1997

VIENNA--For women with advanced epithelial ovarian cancer who fail one platinum-based regimen, topotecan (Hycamtin) may represent a promising alternative to paclitaxel (Taxol), reported W. W. ten Bokkel Huinink, MD, of the Netherlands Cancer Institute.

Computer Program Helps Resolve Ethical Decisions About Genetic Testing

February 01, 1997

DALLAS-A new interactive computer program, The Ethics Companion, is currently under development to help physicians think through ethical dilemmas in genetic testing for breast cancer, Gail Tomlinson, MD, PhD, of the University of Texas Southwestern Medical Center, said at a poster paper at the San Antonio meeting.

No Link Found Between LCIS and Local Recurrence

February 01, 1997

BOSTON-Neither the presence nor the extent of lobular carcinoma in situ (LCIS) is related to risk of local recurrence in patients with invasive breast cancer treated with conservative surgery and radiotherapy, a retrospective study from the Joint Center for Radiation Therapy has shown.

Tape/Workbook Helps Breast Cancer Patients Decide on Therapy

February 01, 1997

SAN ANTONIO--A new decision aid, developed by a group of Canadian researchers, uses an audiotape and a workbook to help women with early-stage breast cancer decide between mas-tectomy and breast-conserving surgery with radiation therapy.

Ultrasound Spots Cancers Overlooked by Mammography

February 01, 1997

CHICAGO--Although mammography is the best screening tool for breast cancer, it misses carcinoma in 15% or more of women with dense breasts. Supplemental, bilateral, high-resolution ultrasound can find these malignancies, Thomas M. Kolb, MD, a New York City radiologist who specializes in breast cancer detection, reported at the Radiological Society of North America meeting.

Racial Variation in Prostate Cancer Care Explored

February 01, 1997

In the United States, racial variations have been documented in the incidence, mortality, and clinical management of cancers of the breast, colon, lung, and prostate.[1-4] In conjunction with similar findings from nonmalignant diseases, such as cardiovascular and cerebrovascular disease, these data suggest that racial variations in medical care are widespread.[5-8] However, few empirical studies explain why these racial variations exist at all.