Oncology NEWS International Vol 9 No 2

Neoadjuvant Docetaxel Increases Response Rate in Large Breast Tumors

February 02, 2000

ABERDEEN, Scotland-Primary, or neoadjuvant, chemotherapy with docetaxel (Taxotere) substantially increases the response rate in breast cancer patients who have received initial treatment with a chemotherapy combination, results of a phase III Scottish study demonstrate.

Faslodex, a Pure Antiestrogen, Shows Antitumor Activity

February 02, 2000

NOTTINGHAM, England-A new long-acting nonagonist antiestrogen, fulvestrant (Faslodex), significantly reduced estrogen and proges-terone receptor (ER/PR) content in breast tumors prior to surgery, compared with tamoxifen (Nolvadex) and placebo, according to a multicenter study presented at the San Antonio Breast Cancer Symposium.

Consider Node Dissection, Adjuvant Therapy in Elderly Breast Cancer Patients

February 02, 2000

BALTIMORE-Axillary lymph node status and hormone receptor status are significant prognostic factors in elderly breast cancer patients, warranting more careful consideration of lymph node dissection and adjuvant therapy, according to a review of 277 cases presented at the San Antonio Breast Cancer Symposium.

Tumor-Associated Proteases Predict Outcome in Node-Negative Patients

February 02, 2000

HAMBURG, germany-Elevated levels of two related tumor-associated proteases correlated with an increased risk of recurrence after definitive surgical treatment for node-negative breast cancer, German investigators reported at the San Antonio Breast Cancer Symposium.

Herceptin Plus Vinorelbine a Promising Combination in Advanced Breast Cancer

February 02, 2000

BOSTON-The combination of weekly trastuzumab (Herceptin) and vinorelbine (Navelbine) gave promising results in a phase II study of metastatic breast cancer. After a median of 21 weekly courses of therapy, the combination has produced a 71% overall response rate (all partial responses) in 34 evaluable patients. The regimen has been well tolerated, and no patient has experienced symptomatic congestive heart failure.

Adjuvant Therapy Improves Relapse-Free Survival With Small, Node-Negative Tumors

February 02, 2000

PITTSBURGH-Adjuvant therapy in patients with small, node-negative breast tumors has been controversial due to the lack of randomized studies. To explore this question, University of Pittsburgh researchers reviewed data on patients with tumors of 1 cm or less from five large clinical trials of adjuvant therapy that enrolled women with various-sized tumors.

Small Risk of Breast Cancer Death After Invasive Recurrence in DCIS Patients

February 02, 2000

LOS ANGELES-A study of 839 patients presented at the San Antonio Breast Cancer Symposium has found that women with ductal carcinoma in situ (DCIS) run a very small risk of death from invasive recurrence regardless of type of surgery.

Paclitaxel/Herceptin Effective in Metastatic Breast Cancer

February 02, 2000

HOUSTON-A weekly regimen of paclitaxel (Taxol) and trastuzumab (Herceptin) produced evidence of enhanced antitumor activity in patients with metastatic breast cancer and HER-2 overexpression, according to preliminary results from an ongoing phase II trial.

Conservative Surgery Alone Not Sufficient to Prevent Recurrence

February 02, 2000

BOSTON-Even in a highly selected group of patients with stage I breast cancer, there is a substantial and long-term risk of local recurrence following treatment with conservative surgery without radiotherapy or systemic therapy, May Lim, MD, reported at a general session of the San Antonio Breast Cancer Symposium.

Surgical Margin Width Is a Reasonable Surrogate for Van Nuys Prognostic Index

February 02, 2000

LOS ANGELES-Surgical margin width offers a reasonable prognostic surrogate for the more complicated multiparameter Van Nuys Prognostic Index to predict breast cancer recurrence after treatment for ductal carcinoma in situ (DCIS), but the index still provides superior accuracy, Melvin J. Silverstein, MD, of the University of Southern California, said at the San Antonio Breast Cancer Symposium.

Anastrozole as Effective as Tamoxifen as First-Line Therapy of Advanced Breast Cancer

February 02, 2000

EDMONTON, Canada-In what Jean-Marc Nabholtz, MD, calls “the first trials challenging tamoxifen as the primary drug of choice in postmenopausal women with advanced breast cancer,” anastrozole (Arimidex, a nonsteroidal aromatase inhibitor) proved as effective as tamoxifen (Nolvadex). Dr. Nabholtz, of the University of Alberta, Edmonton, Canada, reported the results at the San Antonio Breast Cancer Symposium.

Sentinel Node Biopsy: Reasons for Failure

February 02, 2000

GREENVILLE, NC-Patient age and surgeon experience appear to play the biggest role in failure of sentinel lymph node biopsy for detection of breast cancer, according to a large multicenter clinical trial presented at the San Antonio Symposium.

AT Superior to FAC in Metastatic Breast Cancer

February 02, 2000

WARSAW, Poland-Results of a multicenter randomized European trial demonstrated the superiority of paclitaxel (Taxol) and doxorubicin (Adriamycin) (AT) over standard FAC chemotherapy as first-line treatment for metastatic breast cancer.

New SERM Promising in Advanced Breast Cancer

February 02, 2000

BARCELONA-Preliminary results of a trial of a new selective estrogen-receptor modulator (SERM), known as LY353381, show a 32% response rate in patients with previously untreated locally advanced or metastatic breast cancer, José Baselga, MD, of Vall d’Hebron University Hospital, Barcelona, Spain, said at the San Antonio Breast Cancer Symposium.

Adjuvant Goserelin Improves Disease-Free Survival in Premenopausal Breast Cancer

February 02, 2000

SAN ANTONIO-“Younger, premenopausal estrogen-receptor (ER)-positive breast cancer patients should be aware that there is an alternative to adjuvant chemotherapy,” Michael Baum, MD, professor of surgery, University College, London, said at the San Antonio Symposium.

Docetaxel + Gemcitabine Effective for Patients With Advanced Breast Cancer

February 02, 2000

COLUMBUS, Ohio-A phase II study presented at the San Antonio symposium has shown that weekly gemcitabine (Gemzar) combined with monthly docetaxel (Taxotere) is an effective second-line therapy for metastatic breast cancer.

Weekly High-Dose Neoadjuvant Paclitaxel Appears Promising

February 02, 2000

PROVIDENCE, RI-Weekly, high-dose neoadjuvant chemother-apy with paclitaxel (Taxol) resulted in an 87% clinical response rate in a small pilot study aimed at assessing the feasibility and tolerability of the regimen in patients with stage IIB-IIIB breast cancer.

Rituximab Shows Activity Against CLL

February 01, 2000

HOUSTON-The treatment of relapsed or refractory non-Hodgkin’s lymphoma has clearly been improved by the monoclonal antibody, rituximab (Rituxan). Because of encouraging results in this setting, rituximab is being studied in previously treated patients with chronic lymphocytic leukemia (CLL), where it is showing significant activity as well, according to a presentation at ASH by M. D. Anderson investigators.

STI 571 Effective Against Some CML/ALL

February 01, 2000

PORTLAND, Oregon-A rationally designed drug now known as STI 571 is both effective and well tolerated in treating certain leukemia patients that have not responded to other therapies. The results of two phase I clinical trials using STI 571 for chronic myelogenous leukemia (CML) and acute lymphoblastic leukemia (ALL) were reported by Brian Druker, MD, of the Oregon Health Sciences University in Portland, at the ASH meeting. The trials were conducted in collaboration with M.D. Anderson Cancer Center in Houston, Novartis Pharmaceuticals in East Hanover, New Jersey, and the University of California at Los Angeles.

AHCPR Becomes AHRQ, But Call It ARC

February 01, 2000

ROCKVILLE, Md—An old agency has a new name. On orders from Congress, the Agency for Health Care Policy and Research (AHCPR) is now the Agency for Healthcare Research and Quality (AHRQ), pronounced “arc.”

Hepatitis B Vaccine Helps Prevent Liver Cancer

February 01, 2000

PHILADELPHIA—SmithKline Beecham has announced that labeling for Engerix-B (hepatitis B vaccine recombinant) now includes a statement recognizing the hepatitis B vaccine as “the first anti-cancer vaccine because it can prevent primary liver cancer. A clear link has been demonstrated between chronic hepatitis B infection and the occurrence of hepatocellular carcinoma.”

US Plans to Add $100 Million to International AIDS Effort

February 01, 2000

WASHINGTON-President Clinton will ask Congress to appropriate an additional $100 million to battle AIDS outside the United States in his budget request for fiscal year 2001. This would raise to $325 million the amount of funding pledged by the United States that year to help foreign nations prevent and treat the disease.

Rituximab Retreatment of NHL Produces Long Responses

February 01, 2000

ROCKVILLE, Md-The monoclonal antibody rituximab (Rituxan), which is directed against the CD20 antigen expressed in most B-cell malignancies, can be given repeatedly to patients with non-Hodgkin’s lymphoma (NHL) and may produce longer responses with retreatment. This unusual increase in response duration is in contrast to the ever-diminishing efficacy seen with repeated rounds of chemotherapy, researchers reported at the 41st annual meeting of the American Society of Hematology (ASH).

IOM Addresses Medicare Screening, Clinical Coverage Issues

February 01, 2000

WASHINGTON-Insufficient evidence exists to support or reject the inclusion of routine skin cancer screenings in Medicare coverage, according to a new report by the Institute of Medicine (IOM). A second IOM report urges the Health Care Financing Administration (HCFA) to end uncertainties about whether it will cover routine care for patients taking part in clinical trials by stating that it will.

Cancer Benefits to Look for in a Health Plan

February 01, 2000

WASHINGTON-The American Federation of Clinical Oncologic Societies (AFCOS) has developed a 15-item list of basic standards for consumers to consider in selecting a health insurance plan. The aim is to ensure that patients will obtain high-quality cancer care, should they need it. AFCOS, a coalition of nine professional medical societies, released the list at a Capitol Hill briefing sponsored by Rep. Sue Kelly (R-NY) and Rep. Anna Eshoo (D-CA).

Choosing AML Consolidation Therapy After Remission

February 01, 2000

NEW YORK-Acute myelogenous leukemia (AML) is an aggressive disease. But improved diagnosis with cytogenetic examinations and other special studies have made it possible to select the most effective induction therapy, Frederick R. Appelbaum, MD, told patients at a teleconference sponsored by Cancer Care Inc. and the Leukemia Society of America.

New Cancer Atlas Charts Variations in US Cancer Mortality

February 01, 2000

The National Cancer Institute has compressed 45 years of cancer mortality data into a single atlas. The new publication contains 254 color-coded maps showing variations in cancer deaths over two time periods, across various

Fluoxetine Reduces Hot Flashes in Breast Cancer Survivors

February 01, 2000

ROCHESTER, Minn-Preliminary results from an ongoing Mayo Clinic study show that fluoxetine (Prozac) reduced the incidence of hot flashes in breast cancer survivors by more than 50%, Charles L. Loprinzi, MD, said at the San Antonio Breast Cancer Symposium.

Tositumomab Effective for Untreated and Relapsed, Low-Grade and Follicular NHL

February 01, 2000

NEW ORLEANS-The monoclonal antibody tositumomab (Bexxar) showed promising efficacy in low-grade and follicular non-Hodgkin’s lymphoma in several preliminary studies reported during poster presentations at the ASH meeting.

In Memoriam: Gerald P. Murphy, MD, DSc, of RPCI

February 01, 2000

BUFFALO, New York-Gerald P. Murphy, MD, DSc, seventh director of Roswell Park Cancer Institute (RPCI), died suddenly, January 21, 2000, in Tel Aviv, Israel, while attending an International Union Against Cancer meeting in his role as secretary-general. Dr. Murphy was 65. He began his career at RPCI in 1967 when he was appointed associate director for clinical affairs and chief of the Departments of Urology and Experimental Surgery. He served as director of RPCI from 1970 to 1985.

Improved Survival with Transplants of Peripheral Blood Stem Cells

February 01, 2000

SEATTLE-A phase III study of 168 patients with hematologic malignancies found that those receiving peripheral blood stem cells (PBSC) had fewer relapses, fewer deaths, and faster engraftment than those receiving bone marrow, without a greater risk of acute graft-vs-host disease (GVHD). Both the PBSC and bone marrow transplants were from HLA identical sibling donors. William Bensinger, MD, a researcher in the Clinical Research Division at the Fred Hutchinson Cancer Research Center reported the study at the ASH meeting.

NCI Research Grants Will Increase in Fiscal Year 2000

February 01, 2000

BETHESDA, Md-The National Cancer Institute (NCI) plans to increase both the number of research grants it awards in fiscal year 2000 and the size of the average grant, but it also expects to fund a smaller percentage of grant requests because of the increasing number of proposals it is receiving.

Getting Past the Fear: Doctors, Survivors Talk About Cancer

February 01, 2000

NEW YORK-Three years after being diagnosed with testicular cancer, Lance Armstrong bicycled 2,455 miles to win the Tour de France in 1999. St. Louis Cardinals baseball player Eric Davis was diagnosed with colon cancer in 1997, returned to the field 5 weeks after surgery, and hit a game-deciding home run in the playoffs. The crowd gave him a 5-minute standing ovation.

Positive SLNs Likely Have Little Clinical Impact in DCIS

February 01, 2000

NEW YORK-In patients with ductal carcinoma in situ (DCIS), the identification of positive sentinel lymph nodes (SLNs) is unlikely to be clinically significant, David Brenin, MD, of Columbia-Presbyterian Medical Center, said at the San Antonio Breast Cancer Symposium.

Rep. Lazio Looks at the Cancer Issues Before Congress in 2000

February 01, 2000

WASHINGTON-Rep. Rick Lazio (R-NY) is a vocal advocate within Congress for cancer research and cancer patients. The fourth-term representative from Long Island is founder of the House Cancer Awareness Working Group. He has been a leader in efforts to increase the National Cancer Institute (NCI) budget and has sponsored or co-sponsored major pieces of cancer legislation.

Van Nevel Retires as NCI Communications Chief

February 01, 2000

BETHESDA, Md-J. Paul Van Nevel ended a 26-year career at the National Cancer Institute on Dec. 31, when he retired as associate director for cancer communications. He immediately began a new career as a communications consultant, with NCI as a client.

Early Data Support Use of Monoclonal Antibody Ibritumomab Tiuxetan in Refractory NHL

February 01, 2000

NEW ORLEANS-The radioactive monoclonal antibody ibritumomab tiuxetan (Zevalin, IDEC-Y2B8) may be a useful therapy in patients with rituximab-refractory follicular non-Hodgkin’s lymphoma (NHL). In addition, Y2B8 can be used safely in patients with mild thrombocytopenia, researchers reported at the ASH meeting.

Individually Tailored FEC for Metastatic Cancer

February 01, 2000

SAN ANTONIO-Treatment with FEC (fluorouracil, epirubicine, cyclophosphamide) to a dose optimized for each patient produced an overall response rate of 82% in a group of 39 Swedish patients with metastatic breast cancer, Dr. H. Lindman and colleagues, of Uppsala University and the Karolinska Institute, reported at the 22nd Annual San Antonio Breast Cancer Symposium.

All-trans Retinoic Acid Could Make APL Most Curable Acute Myeloid Leukemia

February 01, 2000

CHICAGO-Using all-trans retinoic acid (ATRA) to both induce remission and for maintenance makes acute promyelocytic leukemia (APL) potentially the most curable subtype of adult acute myeloid leukemia, said Martin S. Tallman, MD, at the American Society of Hematology meeting.

Durable Complete Remissions Possible ‘Prelude to Cure’ in Multiple Myeloma

February 01, 2000

LITTLE ROCK-Durable complete remissions “as a prelude to cure” can be obtained in more than half of good-risk multiple myeloma patients who are optimally treated. This conclusion was based on findings from 1,000 consecutive multiple myeloma patients enrolled from 1988 to 1998 in tandem melphalan-based high-dose therapy (HDT) trials with autologous hematopoetic stem cell support. The study was conducted by Bart Barlogie, MD, and colleagues from the Myeloma and Transplantation Research Center, University of Arkansas for Medicine Sciences, and reported at the ASH meeting.

Look for Depression in Prostate Cancer Patients With ED

February 01, 2000

Mood disorders may play a role in erectile dysfunction (ED) in prostate cancer patients, according to a report at the Pan American Congress of Psychosocial & Behavioral Oncology. Of 10 prostate cancer patients referred for erectile dysfunction and/or a suspected mood disorder, 7 were diagnosed as having depression and 3 were found to have preexisting relationship problems.

Epratuzumab Active in Indolent Lymphomas

February 01, 2000

NEW ORLEANS-Epratuzumab (LymphoCide), a monoclonal antibody directed against the CD22 antigen, was safe and produced some objective tumor responses in indolent non-Hodgkin’s lymphoma (NHL) in a Phase I/II study. Data from the study were reported in a poster presentation at the ASH meeting by John P. Leonard, MD, of Weill Medical College of Cornell University and New York Presbyterian Hospital, New York. He said that the data suggested that the antibody is a potential new therapy for NHL that may be effective in cases where rituximab (Rituxan) is not.

In Prostate Cancer, Sexual Function Correlates With QOL

February 01, 2000

NEW YORK-Erectile dysfunction is a significant factor in decreasing the quality of life (QOL) of prostate cancer patients, according to a report at the Pan American Congress of Psychosocial & Behavioral Oncology.

Idiotype Protein Vaccine Improves Survival in Post-Transplant Multiple Myeloma

February 01, 2000

LITTLE ROCK-High-dose chemotherapy with bone-marrow transplant produces complete remissions in about 40% of multiple myeloma patients, but current maintenance therapy is not able to maintain this response. New preliminary data, however, show that multiple myeloma patients who receive a purified immunoglobulin idiotype protein as a vaccine after high-dose chemotherapy and transplant are likely to have improved event-free survival. Nikhil C. Munshi, MD, of the University of Arkansas for Medical Sciences reported these preliminary results at the ASH meeting.

RT/Two-Drug Chemo Ups NSCLC Survival

February 01, 2000

NEW YORK-An improved 2-year survival rate was achieved in stage III non-small-cell lung cancer (NSCLC) patients with a combination of paclitaxel (Taxol) and carboplatin (Paraplatin) given concurrently with radiation therapy, according to a report at the Chemotherapy Foundation Symposium XVII.

Cisplatin Gel Injections Show Response in Primary Liver Cancer

February 01, 2000

A phase II open-label multicenter trial of an injectable cisplatin-based gel preparation may improve treatment of primary liver cancer (hepatocellular carcinoma). Philip J. Johnson, MD, chairman, Department of Clinical Oncology,

Cladribine Can Produce Response Rate of 80% and Higher in Mantle Cell Lymphomas

February 01, 2000

NEW ORLEANS-2-Chlorodeoxyadenosine (cladribine, 2-CdA [Leustatin]) can produce response rates of 80% and higher in patients with mantle cell lymphoma (MCL), according to two studies presented at the ASH meeting. One study examined 2-CdA as monotherapy, and the other studied it combined with mitoxantrone (Novantrone).

Promising Results in First Randomized Trial of a Colon Cancer Vaccine

February 01, 2000

CHICAGO-Using a patient’s own tumor cells to produce immunity against further cancer growth may improve survival in some patients, researchers have found in the first randomized multicenter test of immunotherapy in colon cancer. The 7-year, 412-patient trial, conducted by the Eastern Cooperative Oncology Group, shows the promise of adjuvant active specific immunotherapy in stage II/ III colon cancer, said lead author Jules E. Harris, MD, of Rush-Presbyterian-St. Luke’s Medical Center.

No Increase in Bladder Symptoms With RT

February 01, 2000

SAN ANTONIO—A new study has shown that prostate cancer patients treated with 3D conformal radiation therapy may not differ from the normal population in bladder quality-of-life issues. “The bladder findings were very interesting,” said Alexandra Hanlon, PhD. “We’ve never had a baseline before for urinary incontinence; that is, we haven’t known the incidence in the normal population. We showed in this study that urinary incontinence is no more common in prostate cancer patients who have had 3D conformal radiation therapy than in the normal population.”

Hydromorphone Injector Pen for Rescue Dose Delivery

February 01, 2000

VIENNA, Austria-Even cancer patients whose pain is well controlled with regular daily opioids sometimes need rescue doses for breakthrough pain. For inpatients, this is often done with injected doses. Hakan Samuelsson, MD, has tested an injector pen that patients can use for self-administration of rescue doses. A pilot study suggests that this approach may be a useful option for most patients who need rescue opioid doses, he reported at the 9th World Congress on Pain.

‘Sentinel Node Biopsy Unnecessary for Most DCIS Patients’

February 01, 2000

NEW YORK–A favorable long-term prognosis makes sentinel lymph node biopsy unnecessary for the vast majority of patients with ductal carcinoma in situ (DCIS), New York investigators have concluded from a 15-year follow-up of more than 300 patients.

Monoclonal Antibodies Show Some Progress Against Hairy Cell Leukemia

February 01, 2000

NEW ORLEANS-Hairy cell leukemia (HCL) has the highest reported surface expression of CD20 of leukemias studied to date, according to research reviewed at the ASH meeting. In a symposium presentation, Deborah A. Thomas, MD, and colleagues from the M.D. Anderson Cancer Center in Houston, reported that the anti-CD20 monoclonal antibody rituximab (Rituxan) is active against HCL. Response appears to correlate with a decrease in serum interleukin-2 (IL-2) receptor levels. In a poster presentation, Robert J. Kreitman, MD, and colleagues from the National Cancer Institute reported that recombinant immunotoxins containing truncated Pseudomonas exotoxin and targeting either CD25 or CD22 can induce some major responses in patients with refractory HCL.

Delay Breast Reconstruction Until After Radiotherapy

February 01, 2000

NEW ORLEANS-Patients undergoing staged breast reconstruction with saline-filled implants and subsequent radiation therapy experienced more complications and required more replacement procedures than patients who underwent reconstruction without radiation therapy, according to a retrospective study presented at the 68th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons (now the American Society of Plastic Surgeons).

Oral Inhalation System Delivers Morphine Doses

February 01, 2000

VIENNA, Austria-A new oral inhalation system for morphine is almost as efficient as IV dosing, Aradigm Corp and SmithKline Beecham researchers reported at the 9th World Congress on Pain. B. A. Otulana, MD, said that the dose-corrected bioavailability of morphine with the new device was 75% of that with intravenous morphine, a major increase over the 5% bioavailability achieved with other nebulizers. This approach might provide a useful, noninvasive alternative to parenteral morphine administration.

Tumor Regression Can Continue After Rituximab Therapy for Low-grade NHL Is Completed

February 01, 2000

SAN DIEGO-Patients with relapsed or refractory low-grade or follicular non-Hodgkin’s lymphoma (NHL) may respond to rituximab (Rituxan) up to 4 months after completion of therapy. Salvage therapy should therefore be delayed at least until that time for patients with stable disease after rituximab treatment, Antonio J. Grillo-Lopez, MD, of IDEC Pharmaceutical Corp., advised in a poster presentation at the ASH meeting.

Raltitrexed in Combination Used in Advanced Colon Cancer

February 01, 2000

NEW YORK-Patients with advanced colorectal cancer have a median survival of only 12 months with single-agent chemotherapy. New drugs and new drug combinations are being tested in an attempt to find more effective treatments for the disease. A panel of researchers discussed trials of raltitrexed (Tomudex) in combination with other drugs at the Chemotherapy Foundation Symposium XVII.

AACTG Funding Renewed for Another 5 Years

February 01, 2000

BETHESDA, Md-The Adult AIDS Clinical Trials Group (AACTG) will continue its research activities for another 5 years under a new grant from the National Institute of Allergy and Infectious Diseases. NIAID will provide the group $80 million in the first year of renewed funding.

Caregivers Also Need to Be Care Receivers

February 01, 2000

Just deciding to go out for an evening can be a big decision for someone taking care of a sick family member. The caregiver can feel guilty or may not have anyone to take care of the sick relative, or may simply feel too depressed to go

Rituximab May Be Effective in Purging in Vivo Autografts for Indolent Lymphoma

February 01, 2000

BALTIMORE-The monoclonal antibody rituximab (Rituxan) may be effective in purging in vivo autografts for indolent lymphoma, and post-transplant may serve as adjuvant immunotherapy, according to research presented at the ASH meeting.

Agent in Phase II Testing to Prevent Drug Resistance

February 01, 2000

HERSHEY, Pennsylvania-A phase II study is about to begin testing a novel approach to enhancing the effectiveness of chemotherapy, one that uses a new agent to deactivate a critical DNA repair mechanism in malignant cells. Shutting down this repair system appears to increase the killing power of currently available drugs that work by disrupting DNA.

Scar-Free Breast Reconstruction: New Technique

February 01, 2000

NEW ORLEANS—A new technique for breast reconstruction, used after a new method of skin-sparing mastectomy, offers patients a scar-free result, according to the surgeon who developed the method, Gino Rigotti, MD, head of the Plastic Surgery Department, Verona General Hospital, Italy.

Amifostine May Prevent Esophagitis in Lung Cancer Patients

February 01, 2000

NEW YORK-Esophagitis was less frequent and less severe in patients with locally advanced non-small-cell lung cancer (NSCLC) treated with standard chemotherapy and thoracic radiation when amifostine (Ethyol) was added to the regimen, according to a report at the Chemotherapy Foundation Symposium XVII.

Umbilical Cord Blood Transplantation May Be Option for Adults with Hematologic Malignancies

February 01, 2000

DURHAM, North Carolina-Umbilical cord blood transplantation may be a viable option for adult patients with hematologic malignancies who do not have suitably matched donors as a source of stem cells, according to reports presented at the ASH meeting.

Rituximab/CHOP Yields High Initial Response in Mantle Cell Lymphoma

February 01, 2000

BOSTON-Adding rituximab (Rituxan) to cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) induction therapy may provide a cleaner source of autologous stem cells for use following high-dose therapy in mantle cell lymphoma, Orion Howard, MD, reported at the ASH meeting.

New Monoclonal Antibody Studied in Stage III Colon Cancer

February 01, 2000

NEW YORK-A monoclonal antibody (MoAb) is being studied as monotherapy and in combination with standard fluorouracil (5-FU) in two large phase III trials of stage III colon cancer. The drug is edrecolomab (Panorex), a murine IgG2a MoAb that recognizes the 17-1A antigen, which is preferentially expressed on adenocarcinomas.

CLL Responds to Monoclonal Antibodies Against Both CD20 and CF52 Antigens

February 01, 2000

NEW ORLEANS-Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) may benefit from treatment with monoclonal antibody treatments directed against the CD20 and/or CD52 antigens, according to data presented at the ASH meeting. Increasing dosing frequency of rituximab (Rituxan) to three times per week produced responses in half of CLL/SLL patients treated in a phase I/II trial reported by John C. Byrd, MD, of the Hematology-Oncology Service at Walter Reed Army Medical Center, Washington, DC. In a separate study at M.D. Anderson Cancer Center in Houston, one-third of patients with CLL refractory to fludarabine (Fludara) responded to the anti-CD52 monoclonal antibody Campath-1H.

For High-Grade NHL, High-Dose Chemotherapy With Stem Cell Transplant Beats CHOP

February 01, 2000

NANTES, France-High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) leads to better event-free survival and freedom from progression in people with intermediate and high-grade non-Hodgkin’s lymphomas (NHL) than does the standard therapy. That was conclusion of a randomized trial comparing autologous PBSCT with CHOP (cyclophosphamide, doxorubicin, Oncovin, prednisone) and reported by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes, at the ASH meeting.

Combination Rituximab/CHOP Therapy Produces Prolonged Results in NHL

February 01, 2000

NEW ORLEANS-Combining rituximab (Rituxan) with the conventional CHOP regimen can produce prolonged disease-free survival in low-grade lymphomas and can increase complete response (CR) rates to over 60% in patients with intermediate-grade or high-grade non-Hodgkin’s lymphoma (NHL). These results from two separate studies were reported at poster presentations at the American Society of Hematology (ASH) meeting.

New Machine Combines CT, PET Scans Into a Single Image

February 01, 2000

NEW YORK-A new prototype machine is producing images that combine CT and scintillation-camera-based PET scans into a single image. In a presentation at the Chemotherapy Foundation Symposium XVII, Hak Choy, MD, professor of radiation oncology, Vanderbilt University, showed images of lung cancer produced by the new device-the GE Millennium VG-code-named “Hawkeye”.

Cytoreductive Surgery May Improve Survival in Ovarian Cancer

February 01, 2000

BUFFALO, NY-Survival in patients with ovarian cancer by stage is similar to that of other cancers, William Hoskins, MD, said at the Surgical Oncology Symposium, hosted by Roswell Park Cancer Institute. “However, the vast majority of women are diagnosed with advanced disease, and there are no screening methods available to change this truth. Until screening methods improve, the surgical treatment offered these women is critical to their survival,” said Dr. Hoskins, chief, Gynecology Service, Memorial Sloan-Kettering Cancer Center.

Rituximab Retreatment Produces Longer Responses Than Initial Use in NHL

February 01, 2000

ROCKVILLE, Maryland—The monoclonal antibody rituximab (Rituxan), which is directed against the CD20 antigen expressed in most B-cell malignancies, can be given repeatedly to patients with non-Hodgkin’s lymphoma (NHL) and may produce longer responses with retreatment. This unusual increase in response duration is in contrast to the ever-diminishing efficacy seen with repeated rounds of chemotherapy, researchers reported at the ASH meeting. The increase may indicate that some novel anti-tumor immune response is acting in addition to classic antibody-dependent, cell-mediated cytotoxicity (ADCC) in patients who respond to rituximab.

Idiotype Vaccination With Dendritic Cells Induces Response in Multiple Myeloma Patients

February 01, 2000

STANFORD, California-Idiotype (Id) vaccination using dendritic cells induced Id-specific T-cell responses in multiple myeloma and was associated with a decrease in the myeloma protein level, according to Stanford University researchers, who reported their results at the ASH meeting.

New Antibody-targeted Chemotherapy Induces Remission in Some AML Patients

February 01, 2000

SEATTLE-A new chemotherapy agent called CMA-676 that specifically targets tumor cells led to remissions in 34% of patients with acute myeloid leukemia (AML) in relapse and was well tolerated. Eric Sievers, MD, of the Fred Hutchinson Cancer Research Center reported the results of the phase II trial at the ASH meeting.

Rituximab Proves Useful Against Post-Transplant Lymphoproliferative Disease and Is Less Toxic

February 01, 2000

NANTES, France-The anti-CD20 monoclonal antibody rituximab (Rituxan) produced a 69% overall response rate in patients with B-cell post-transplant lymphoproliferative disease (PTLD), according to a retrospective analysis presented at the ASH meeting by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes. The analysis also showed that rituximab is effective in both solid organ and bone marrow transplant recipients (see Table 1).

Dendritic Cell–Based Vaccine Induces Immune Response in Multiple Myeloma

February 01, 2000

NEW ORLEANS-Vaccinating multiple myeloma patients with their own idiotype-loaded dendritic cells appears to be a safe way of stimulating immune responses against the cancers, according to two poster presentations at the ASH meeting.

Adding Radioactivity to an Anti-CD20 Antibody Increases the Response Rate Compared to CD20 Alone

February 01, 2000

ROCHESTER, Minnesota-Adding a radioactive antibody aimed at the CD20 antigen to rituximab (Rituxan), a chimeric anti-CD-20 antibody, raised overall response rates to 80% and complete response rates to 21% in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL). Preliminary data from this multicenter trial was reported at the ASH meeting by Thomas E. Witzig, MD, of the Mayo Clinic.

Phase I/II Trials Suggest Role for Gemcitabine in Colon Cancer

February 01, 2000

NEW YORK-Gemcitabine (Gem-zar), approved for the treatment of advanced pancreatic cancer, may have value as a modulator of standard chemotherapy in advanced colorectal cancer, Stefan Madajewicz, MD, said at the Chemotherapy Foundation Symposium XVII. Dr. Madajewicz, professor of medicine and chief of neoplastic diseases, Division of Medical Oncology, SUNY Health Center, Stony Brook, NY, reported on phase I/II trials of gemcitabine in colorectal cancer used in combination with fluorouracil (5-FU) and folinic acid.

PSA Doubling Time Predicts Distant Metastasis

February 01, 2000

SAN ANTONIO-In a retrospective study of prostate cancer patients with a rising PSA after external beam radiation therapy, pretreatment factors appeared to have little independent influence on the development of metastatic disease. However, two post-treatment factors, PSA doubling time and time to onset of a rising PSA, were found to be major determinants of metastatic relapse, Lewis G. Smith III, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

Rituximab Active in Multiple Myeloma

February 01, 2000

BOSTON-Multiple myeloma remains one of the more intractable problems in oncology. Although about 60% of patients respond to current standard treatment with melphalan and prednisone, median survival is only 2 to 3 years, and toxicity is significant. Nearly all multiple myeloma patients treated with melphalan/prednisone ultimately die of progressive disease. About 25% of patients survive for 5 years or longer, but 10-year survival is less than 5%. High-dose chemotherapy followed by stem-cell transplantation produces higher remission rates but no cures.

IFN-g Increases Rituximab Binding to Multiple Myeloma Plasma Cells

February 01, 2000

BOSTON-Interferon-gamma (IFN-g) triggers expression of CD20 on otherwise non-expressing multiple myeloma cells and may set them up for destruction by anti- CD20 monoclonal antibodies such as rituximab (Rituxan), Steven P. Treon, MD, PhD, of Dana-Farber Cancer Institute reported at the ASH meeting. Rituximab is an appealing therapeutic agent because of its relative lack of toxicity, but other studies have shown that in multiple myeloma, it is effective primarily in patients with CD20+ cells.

New Nonmyeloablative Approach Can Extend Benefits of Stem Cell Transplant

February 01, 2000

NEW ORLEANS-Prolonged hospitalization and toxic effects have limited the use of peripheral blood stem cell transplants for hematologic malignancies to younger, fitter patients. But a new nonmyeloablative approach may allow otherwise-excluded patients to also benefit, according to two studies presented at the American Society of Hematology meeting.

Rituximab as Single Agent May Improve Response in Subset of Multiple Myeloma Patients

February 01, 2000

CLEVELAND-Rituximab (Rituxan) as a single agent appears to be active in a subset of multiple myeloma patients who have CD20+ plasma cells. That finding, reported at the ASH meeting, came as a result of a study by Mohamad A. Hussein, MD, and colleagues at the Cleveland Clinic Taussig Cancer Center to evaluate the effectiveness of rituximab in improving the response rate to melphalan/prednisone (Alkeran/Deltasone) as well as progression-free survival.

‘Blind Spots’ and ‘Halos’ in Adult Solid Tumor Chemotherapy

February 01, 2000

NEW YORK—Ezra Greenspan, MD, has been at the helm of the Chemotherapy Foundation since its founding in 1968. At its 17th annual symposium, in what he termed an “op-ed” piece, Dr. Greenspan, clinical professor of medicine, Mt. Sinai School of Medicine, highlighted what he considers the “blind spots and halos” in adult solid tumor chemotherapy.”

Medicare Now Covers Prostate Cancer Screening for Men Age 50 and Older

February 01, 2000

WASHINGTON-Medicare now provides coverage for prostate cancer screening. As of Jan. 1, all men, age 50 and older with Medicare benefits, are eligible for one digital rectal exam and one prostate-specific antigen (PSA) test each year. Congress directed the Health Care Financing Administration to cover prostate cancer screening for beneficiaries, beginning this year, in the Balanced Budget Act of 1997.

Consider High-Dose Melphalan as Standard Conditioning for Multiple Myeloma

February 01, 2000

NANTES, France-As the conditioning regimen for autologous transplantation in multiple myeloma, high-dose melphalan (Alkeran) 200 mg/m² is as effective as, but less toxic than, melphalan 140 mg/m² plus total body irradiation. This approach should be considered as the standard conditioning regimen, French investigators contended at the ASH meeting.