Oncology NEWS International Vol 7 No 7

Calling the National Cancer Institute

July 01, 1998

WASHINGTON--Up to one-third of callers to the National Cancer Institute’s hot line for cancer information(1-800-4-CANCER) get a busy signal or hang up because of the long wait for someone to pick up, according to a report by the inspector general of the Department of Health and Human Services.

Six Cycles of AT Found Safe in Advanced Breast Cancer

July 01, 1998

MILAN, Italy--Concern about the cardiotoxicity reported in early studies of AT--doxorubicin (Adriamycin)/paclitaxel (Taxol)--in advanced breast cancer was somewhat eased by a retrospective analysis of all previous AT studies.

New Drug Promising in Advanced Pancreatic Cancer

July 01, 1998

LOS ANGELES--A second-generation topo-isomerase I inhibitor, RFS 2000, has led to significantly improved survival in patients with advanced pancreatic carcinoma, according to interim results of an ongoing phase II study presented at an ASCO poster session.

Herceptin/Chemo Effective in Metastatic Breast Cancer

July 01, 1998

LOS ANGELES--A monoclonal antibody directed at the HER2 receptor greatly enhances the effect of chemotherapy for women whose breast cancer overexpresses the HER2 gene. This encouraging finding comes as experts are beginning to suspect that increasing dose intensity of conventional chemotherapy may have "gone about as far as it can go," said Dennis Slamon, MD, PhD, chief, Division of Hematology-Oncology, UCLA School of Medicine.

Virtual Reality Exhibit Simulates Cancer Fatigue

July 01, 1998

LOS ANGELES--Visitors to the Exhibitor’s Hall at this year’s ASCO meeting had the opportunity to walk in the shoes of a patient with cancer-related fatigue at Ortho-Biotech’s In My Steps virtual reality experience, developed in cooperation with cancer patients and the Fatigue Coalition.

New Director of AIDS Research

July 01, 1998

BETHESDA, Md--NIH director Harold Varmus, MD, has named Neal Nathanson, MD, to serve as the new director of NIH’s Office of AIDS Research (OAR). Dr. Nathanson, a leader in viral pathogenesis, comes to the NIH from the University of Pennsylvania Medical Center, where he was Vice Dean for Research and Research Training. He is an active member of the NIH AIDS Vaccine Research Committee, chaired by Dr. David Baltimore.

Update on Trials of Thrombopoietin for Platelet Recovery

July 01, 1998

SAN DIEGO--Since thrombopoie-tin (TPO), the ligand for the Mpl receptor, was cloned by four separate laboratories in 1994, researchers have been exploring, with animal models and in clinical settings, how it can be used to benefit patients. Kenneth Kaushansky, MD, a prominent researcher in the field, summarized some of the results of the studies to date, at the Sixth International Symposium on Recent Advances in Hematopoietic Stem Cell Transplantation, sponsored by the University of California, San Diego.

Amifostine Reduces Xerostomia After RT for Head and Neck Cancer

July 01, 1998

DURHAM, NC--Use of amifostine (Ethyol) significantly reduces the incidence of chronic as well as acute xerostomia and associated symptoms in patients undergoing radiotherapy for the treatment of head and neck cancer, David Brizel, MD, associate professor of radiation oncology, Duke University Medical Center, said at the ASCO meeting.

National Survey Documents Gap in Quality of HIV/AIDS Care

July 01, 1998

WASHINGTON--One in four Americans starting treatment for HIV infection does not receive care that meets the most up-to-date and recognized standards, according to the results of the first National HIV/AIDS Treatment Survey.

Stomach Cancer Susceptibility Gene Found in the Maori

July 01, 1998

NEW ORLEANS--A mutation in the gene for E-cadherin may partly explain the high rate of stomach cancer among the Maori, the indigenous people of New Zealand, Parry Guilford, PhD, a research fellow in the Cancer Genetics Laboratory, University of Otago, Dunedin, New Zealand, reported at the 89th annual meeting of the American Association for Cancer Research.

Study Shows 6-Month Chemo Regimen Should Be New Colon Cancer Standard

July 01, 1998

PHILADELPHIA--"Six months of 5-fluorouracil (5-FU) and leucovorin should be the new standard adjuvant therapy for patients with node-positive, high-risk colon cancer," Daniel Haller, MD, said at the annual ASCO meeting.

Nurses Urged to Be Alert for Depression in Cancer Patients

July 01, 1998

HOUSTON--About 50% of patients function well when dealing with the diagnosis of cancer, but the other 50% need assistance adapting to the trauma brought on by the disease and its treatment, Debra Sivesind, RN, said at M.D. Anderson Cancer Center’s 2nd Annual Nursing Conference.

Androgen Ablation Added to RT Improves Outcome in Locally Advanced Prostate Cancer

July 01, 1998

ANN ARBOR, Michigan--The addition of androgen ablation to radiation therapy led to significant improvement in the rate of local failure, distant failure, and disease-free survival, but not overall survival, in men with large-volume, low-grade, locally advanced prostate cancer.

NCI Director Reviews Advances and Future Plans for NCI

July 01, 1998

BETHESDA, Md--In an effort to increase participation in clinical trials, the National Cancer Institute is developing a marketing campaign aimed at selling patients on the importance of taking part in experimental treatments. "This effort represents a new and an important activity by NCI," director Richard D. Klausner told the National Cancer Advisory Board (NCAB). "The marketing initiative is aimed at developing approaches to getting the word out about the value and the opportunities of clinical trials," he said.

Survival Benefit Seen With Multimodality Therapy in NSCLC

July 01, 1998

CHICAGO--A role is emerging for multimodality therapy in the treatment of both resectable and unresectable stage III non-small-cell lung cancer (NSCLC). When given as an adjunct to radiotherapy or surgery, chemotherapy can downstage local disease and control systemic disease spread by eliminating micro-metastases or delaying the development of metastases, Ann Mauer, MD, a senior fellow in oncology at the University of Chicago, said at the International Conference of the American Thoracic Society and American Lung Association.

Patient Info on Preventive Tamoxifen May Be ‘Too Complex’

July 01, 1998

BETHESDA, Md--National Cancer Institute officials have committed themselves to providing information to women and their physicians to help women make an informed decision whether to take tamoxifen (Nolvadex) to prevent breast cancer. But some members of the NCI’s own advisory board have questioned whether the information provided to date is too complex for most women to grasp.

Pain Best Addressed Through Comprehensive Approach

July 01, 1998

NEW YORK--American and European epidemiologic surveys indicate that as many as 90% of patients with end-stage cancer have pain severe enough to warrant treatment with opioid drugs. Other surveys indicate that this pain is widely undertreated. A survey of roughly 1,100 oncologists in the Eastern Cooperative Oncology Group (ECOG) showed that poor assessment of pain is perhaps the most common cause of inadequate treatment.

HHS Enlists Senior Citizens As Medicare Fraud Busters

July 01, 1998

WASHINGTON--The Department of Health and Human Services (HHS) has announced a new program to reward citizens who alert Medicare to acts of fraud and abuse. The Incentive Program for Fraud and Abuse Information, starting in January 1999, will pay 10% of a recovered overpayment up to a maximum of $1,000.

Quality of Life in NSCLC May Be Difficult to Measure

July 01, 1998

CHICAGO--Monitoring instruments that evaluate the symptoms and psychosocial problems of patients with non-small-cell lung cancer (NSCLC) may not provide clear answers regarding the quality of patients’ lives because they are difficult to analyze and they measure aspects of quality that are not affected by chemotherapy, said Richard Gralla, MD, chief of immunology and oncology and director of the Ochsner Cancer Center, New Orleans.

Maryland Will Require Insurers To Pay for Trials

July 01, 1998

BALTIMORE, Md--The Maryland legislation has passed an historic bill requiring insurers, including managed care companies, to pay the patient care costs for patients enrolled in clinical trials. The law takes effect January 1999.

Updated International Trial Supports Cisplatin/Paclitaxel as Front-Line Treatment of Advanced Ovarian Cancer

July 01, 1998

LOS ANGELES--The use of cisplatin (Platinol)/paclitaxel (Taxol) for first-line treatment of advanced ovarian cancer gained additional support from the final survival analysis of a major international study presented at an ASCO scientific session.

Anti-HER2 Antibody Proves Active as a Single Agent in Metastatic Breast Cancer

July 01, 1998

CHICAGO--A monoclonal antibody expected to be approved by the FDA before year’s end is as potent as taxane therapy in certain virulent refractory breast cancers, according to research presented at an integrated symposium at the 34th Annual Meeting of the American Society of Clinical Oncology.

Gemcitabine/Cisplatin Superior to Cisplatin Alone in Advanced NSCLC

July 01, 1998

INDIANAPOLIS--Patients with advanced non-small cell lung cancer (NSCLC) have higher response rates, longer time to progression, and better overall survival with gemcitabine (Gemzar) plus cisplatin (Platinol) than with cis-platin alone, according to data from a multicenter, randomized, phase III study presented at the annual ASCO meeting.

FDA Proposes Rules for Disseminating Data on Off-Label Uses

July 01, 1998

ROCKVILLE, Md--The Food and Drug Administration (FDA) has proposed rules that would give manufacturers greater flexibility in disseminating information about the safety, effectiveness, or benefits of "off label" uses of drugs, biologics, and medical devices. The new regulations will implement provisions of the FDA Modernization Act of 1997, enacted last year.

FDA Reviews Modernization Act, Drug Approval Acceleration

July 01, 1998

WASHINGTON--The mission of the FDA has historically been to respond to public needs and to protect public health, and the 1997 Modernization Act "will not divert the agency from this agenda," Michael Friedman, MD, the FDA’s lead deputy commissioner, said at a consumer forum sponsored by the FDA’s Office of Consumer Affairs.

ELVIS Favors Vinorelbine for Elderly With NSCLC

July 01, 1998

NAPLES, Italy--Platinum-based chemotherapy is often avoided in elderly lung cancer patients due to concerns about tolerability. Since about one-third of patients with non-small cell lung cancer (NSCLC) are over age 70 at diagnosis, this presents a significant problem.

Good Response Rate With Combination Preop Therapy for Advanced Esophageal Cancer

July 01, 1998

NASHVILLE--Combined neoadjuvant therapy with paclitaxel (Taxol), carboplatin (Paraplatin), fluorouracil (5-FU), and irradiation, followed by surgery, resulted in complete pathologic responses in almost half of a group of patients with advanced esophageal cancer.

Raloxifene Significantly Reduces the Risk of Breast Cancer in MORE Trial

July 01, 1998

SAN FRANCISCO--Raloxifene (Evista), an estrogen-receptor modulator used to treat osteoporosis, also has a protective effect against breast cancer, according to a 2-year randomized study and an overview analysis reported at ASCO. These findings require some caution in interpretation, since they were mainly observed in women with osteoporosis, a population that has a lower breast cancer risk than the general population.

Program Backs PBSC Protocols in Community

July 01, 1998

SAN DIEGO--Not wishing to be a self-contained island of clinical research in a region with a wealth of private cancer specialists, the Fred Hutchinson Cancer Research Center established a community outreach program to involve more oncologists in clinical trials, a program that now includes autologous transplants of peripheral blood stem cells (PBSCs), Leona Holmberg, MD, an associate in the clinical division at Hutch-inson, said at a conference sponsored by the University of California, San Diego.

First-Line Carboplatin/Docetaxel Safe, Effective for Advanced Ovarian Cancer

July 01, 1998

GLASGOW--Docetaxel (Taxotere) used in combination with carboplatin (Paraplatin) appears to be an active and well-tolerated first-line treatment for advanced ovarian cancer, producing minimal neurotoxicity. Only 5% of patients experienced neuropathy, said lead investigator Paul Vasey, MD.

Combination More Effective Than High-Dose Cisplatin in NSCLC

July 01, 1998

HAMBURG, Germany--Increasing cisplatin dose intensity was less effective than combining standard cisplatin (Platinol) with paclitaxel (Taxol) in a multicenter multinational study of advanced non-small cell lung cancer (NSCLC) reported at ASCO.

Adjuvant Paclitaxel Increases Survival in Early, N+ Breast Cancer

July 01, 1998

SAN FRANCISCO--Interim results of a major intergroup study of paclitaxel (Taxol) as adjuvant treatment of node-positive breast cancer "will change the standard of care for node-positive breast cancer patients," I. Craig Henderson, MD, of the University of California, San Francisco, said at ASCO.

Psychologist Debunks Eight Myths About Breast Cancer

July 01, 1998

NEW YORK--There is a soap opera scenario surrounding breast cancer survivors that goes something like this: "Breast cancer ruins the woman’s life. Her husband leaves her for another woman. She loses her job. She considers suicide but bravely goes on, knowing no man will ever want her. Looking in the mirror is her worst nightmare."

3D Conformal RT Equal to Surgery for Early Stage Prostate Cancer

July 01, 1998

ANN ARBOR, Michigan--The typical candidate for radical prostatectomy does at least as well with three-dimensional (3D) conformal radiation therapy for early-stage prostate cancer, results of a University of Michigan study suggest. Findings in 172 consecutively treated patients showed a 95% actuarial survival 8 years after radiation therapy and an 85% rate of freedom from biochemical failure.

New Hospital Opens at Roswell Park Cancer Institute Complex

July 01, 1998

BUFFALO, NY--The cornerstone of a $241.1 million dollar major modernization project was unveiled at Roswell Park Cancer Institute. The new Diagnostic and Treatment Center and patient tower (Figure 1) feature state-of-the-art diagnostic imaging, radiotherapy, surgery, postanesthesia care, and intensive care units. The 5-year renovation of the 25-acre campus coincides with the Institute’s centennial anniversary.

Senate Fails to Bring McCain Tobacco Control Bill to a Vote

July 01, 1998

WASHINGTON--National tobacco legislation may be decidedly down, but it is not definitely dead. Following the two votes in the Senate that defeated the comprehensive tobacco bill sponsored by Sen. John McCain(R-Ariz), Republicans and Democrats alike vowed to continue efforts to pass some form of legislation. But politicians throughout Congress are in such discord on details that many doubt any tobacco legislation will clear Congress and win the President’s signature in 1998.

Tattooing Before Preop Chemo Aids Surgeons

July 01, 1998

ORLANDO--Preoperative chemotherapy in breast cancer patients can leave a surgeon in the dark as to the specific amount of normal tissue to remove if the chemotherapy eliminates the tumor or renders it no longer palpable. A simple tattoo outlining the original tumor site can be a great aid in helping surgeons determine the type of surgery to be performed after the therapy.

PDT Improves QOL in Lung Cancer Patients Who Have Endobronchial Obstruction

July 01, 1998

LOUISVILLE, Kentucky--Photodynamic therapy (PDT) offers a simple and effective alternative to conventional techniques for palliative debridement of endobronchial obstructions in lung cancer patients, data from two clinical trials suggest.

Cardiotoxicity with Combination Doxorubicin/Paclitaxel (AT) Is Reversible, Rare With 6 Cycles

July 01, 1998

MILAN, Italy--The cardiotoxicity seen in preliminary studies of bolus doxorubicin (Adriamycin) plus 3-hour paclitaxel (Taxol) (AT) proved to be reversible and mostly confined to patients who received more than 6 cycles of therapy, according to follow-up data presented at the ASCO meeting.

Suramin Helps Prostate Cancer Pain

July 01, 1998

LOS ANGELES--Combined therapy with suramin and hydrocortisone significantly improved palliation over placebo plus hydrocortisone in hormone-refractory prostate cancer. The palliative improvement emerged within 6 weeks, and the difference between the regimens increased to the end of therapy, Eric Small, MD, reported at the ASCO integrated symposium on prostate cancer.

MoAb Inhibits Stomach Cancer Growth

July 01, 1998

NEW ORLEANS--A monoclonal antibody isolated from a patient with stomach cancer appeared to cause specific cell death in tumors when infused into patients with stomach cancer prior to surgery, H. Peter Vollmers, PhD, said at the American Association for Cancer Research meeting. To look for an antibody that might target stomach cancer, the researchers removed B cells from the spleen of a patient with a diffuse adenocarcino-ma of the stomach and then isolated antibodies, said Dr. Vollmers, professor of experimental pathology, University of Würzburg, Germany.

Taxanes Increase Breast Cancer Survival

July 01, 1998

LOS ANGELES--Taxane therapy lengthens survival in breast cancer patients, both in the metastatic and adjuvant settings, according to the results of two phase III trials presented at the 34th Annual Meeting of the American Society of Clinical Oncology (ASCO).

Disregard of Guidelines Blamed for Low Breast Conservation Rates

July 01, 1998

ASCO--Fewer than half of women with early-stage breast cancer are treated with breast-conserving lumpectomy, even though up to 75% are eligible. Almost one-quarter of those who have lumpectomy are not given radiotherapy to improve local control.

Immunotherapy Post-transplant For Metastatic Breast Cancer Studied

July 01, 1998

BUFFALO, NY--Studies have shown that only 15% to 20% of patients with metastatic breast cancer have a long-term disease-free survival following administration of high-dose chemotherapy with autologous bone marrow or stem cell support. "We have therefore decided to explore immunotherapy for this patient population," said Meir Wetzler, MD, of the Division of Medicine, Roswell Park Cancer Institute.

SWOG Self-Exam Finds Elderly Underaccrued in Clinical Trials

July 01, 1998

LOS ANGELES--The Southwest Oncology Group (SWOG) is generally doing fine at enrolling women and African-Americans into clinical trials but is not doing so well at enrolling elderly patients, SWOG investigators reported at the ASCO annual meeting. SWOG biostatistician Joseph Unger found that the elderly were under-represented in almost every type of cancer clinical trial.

Bladder Cancer Agent Fails to Pass Muster With ODAC

July 01, 1998

WASHINGTON--Citing inadequate data to prove efficacy, ODAC (Oncologic Drugs Advisory Committee) voted unanimously against recommending that the FDA approve the new drug application for Anthra Pharmaceuticals’ valrubicin (Valstar).

Older Women Have More Chemo-Induced Neutropenia But Few Clinical Consequences

July 01, 1998

BALTIMORE--Adjuvant chemotherapy regimens for breast cancer are often reduced for patients over age 65 due to concerns about toxicity. These reductions may not be necessary in most cases. Elizabeth Claire Dees, MD, and her colleagues at the Johns Hopkins Oncology Center found that although older women had more neutropenia, this seldom resulted in clinical complications.

Traveling Exhibit of Cancer Educational Material

July 01, 1998

MADISON, Wisconsin--The Am-erican Association for Cancer Education (AACE) and the European Association for Cancer Education have joined with the WHO International Network for Cancer Education (INCE) to put together a traveling exhibit of cancer educational materials for display at cancer congresses around the world.

Andean Mummies Reveal H pylori Is an Ancient Enemy

July 01, 1998

NEW ORLEANS--Analysis of stools of centuries-old mummies shows that some were infected with Helicobacter pylori, indicating that this bacterium, which colonizes the stomach and can cause ulcers and stomach cancer, has long plagued humans.

Twice-Daily Intensive RT Improves SCLC Survival Rates

July 01, 1998

LOS ANGELES--Twice-daily chest irradiation concurrent with cycle 1 chemotherapy substantially improves survival and reduces the rate of local failure in limited stage small-cell lung cancer (SCLC), compared with a less intensive once-daily schedule, a large intergroup trial has shown.

HSV-TK Gene Therapy Promising in Prostate Cancer

July 01, 1998

LOS ANGELES--Preliminary results with a gene-therapy approach to recurrent prostate cancer suggest antitumor activity in at least some patients. Three of 18 patients have had decreases in PSA levels of more than 50%. The effects have persisted for 45 to 290 days, including one patient who became biopsy negative for a brief period of time.

Curcumin Inhibits Colon Cancer Progression in Rat Model

July 01, 1998

NEW ORLEANS--Curcumin and sulindac sulfone both can inhibit colon carcinogenesis in a rat model during the initiation and post-initiation stages. But a study from the American Association for Cancer Research meeting suggests that during the promotion and progression stages, only curcumin inhibits tumor development.

CAF Produces Small But Significant Survival Advantage Over CMF in High-Risk Node-Negative Breast Cancer

July 01, 1998

SAN ANTONIO--The first results of a large Intergroup study show that adjuvant chemotherapy with CAF is superior to CMF in high-risk node-negative patients, Laura Hutchins, MD, of the University of Arkansas, reported at the ASCO plenary session for SWOG. The study also suggests that S phase fraction can be used to stratify patients into risk groups.

Ice, Water Advised to Help the Elderly Cope With CMF Toxicity

July 01, 1998

AVIANO, Italy--Elderly women with node-positive breast cancer are more vulnerable to chemotherapy-related toxicity. Physicians should be prepared to help older patients prevent or manage these problems and should not be too quick to reduce scheduled dosages, Diana Crivellari, MD, said at her ASCO poster presentation for the International Breast Cancer Study Group (IBCSG) Trial VII.

Adenoviral-p53 Gene Therapy Promising in NSCLC

July 01, 1998

HOUSTON--Adenoviral-p53 gene therapy with Introgen Therapeutics’ INGN 201 was well tolerated and showed evidence of clinical activity both alone and with cisplatin (Platinol) in patients with advanced non-small-cell lung cancer (NSCLC) who had failed conventional therapy. Stephen Swisher, MD, of the M. D. Anderson Cancer Center, presented the completed phase I/II trial results at an ASCO poster session.

CPT-11 Recommended as Standard in 5-FU Resistant Colorectal Cancer

July 01, 1998

LOS ANGELES--Irinotecan (Camptosar), also known as CPT-11, should be standard therapy for patients whose metastatic colorectal cancer has become resistant to fluorouracil (5-FU), David Cunningham, MD, said at the plenary session of the American Society of Clinical Oncology (ASCO) annual meeting. Dr. Cunningham is head of the Gastrointestinal Cancer Unit, Royal Marsden Hospital, London, UK.

Disease Management Avoids Fragmented Patient Care

July 01, 1998

PASADENA, California--The health care system in the United States has been developed along the lines of medical specialization, which can lead to the fragmentation of patient care. Specialties are created by artificial divisions such as organ systems (cardiology, neurology); age (pediatrics, geriatrics); sex (urology, gynecology); disease (oncology); and function (surgery, obstetrics).

National Toxicology Program Requests Data on 11 Chemicals

July 01, 1998

RESEARCH TRIANGLE PARK, NC--The National Toxicology Program has requested public input on 11 chemicals recommended for absorption, toxicity, or carcinogenicity studies. It seeks information from completed or ongoing studies, and information on planned studies, as well as current production data, human exposure information, use patterns, and environmental occurrences.

Carboplatin/Paclitaxel Appears To Be as Effective as Cisplatin/Paclitaxel in Ovarian Cancer

July 01, 1998

LOS ANGELES--Interim analysis of a major German-Austrian trial comparing cisplatin (Platinol)/paclitaxel (Taxol) with carboplatin (Paraplatin)/paclitaxel as first-line treatment in ovarian cancer found significantly less toxicity with carboplatin/paclitaxel, with no apparent loss of efficacy.

Prophylactic Tamoxifen Cuts Breast Cancer Risk by 45% in High-Risk Patients

July 01, 1998

PITTSBURGH--Five years of prophylactic tamoxifen (Nolvadex) cut the risk of breast cancer almost in half in women at high risk for the disease. D. Lawrence Wickerham, MD, associate chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP), gave the first formal presentation of the results of the Breast Cancer Prevention Trial (BCPT) at the ASCO plenary session.

Three-Drug Combination May Improve Response Rates in NSCLC Patients

July 01, 1998

NASHVILLE--Adding gemcitabine (Gemzar) to the widely used combination of paclitaxel (Taxol) and carboplatin (Paraplatin) may increase the response rate in advanced non-small-cell lung cancer (NSCLC), compared with the two-drug combination, a phase I/II study has shown.

Performing Economic Evaluations Alongside of Cancer Clinical Trials

July 01, 1998

Health care providers and financing organizations have become more aware of the resource constraints on the provision of medical services, thus increasing the importance of economic evaluations within the health care industry.[1,2] This has carried over to the evaluation of new, therapeutic strategies for cancer, which have traditionally been evaluated exclusively for safety and clinical efficacy.

Weekly High-Dose Paclitaxel Produces High Response Rates in Advanced Breast Cancer

July 01, 1998

PROVIDENCE, RI--Weekly high-dose paclitaxel (Taxol) produces response rates similar to those seen with combination chemotherapy in patients with advanced breast cancer and merits further study, William M. Sikov, MD, said at an ASCO poster session.

Biologic Markers May Help Predict Recurrence of NSCLC

July 01, 1998

CHICAGO--Molecular biologic markers may be able to identify patients with early-stage non-small-cell lung cancer (NSCLC) who are at the highest risk for metastasis and therefore may benefit from aggressive therapy.