ONCOLOGY Vol 10 No 6

Prior to 1981, Kaposi sarcoma (KS) was considered a rare human cancer occurring primarily among elderly Italian and Jewish men of eastern European ancestry. I wrote a review of KS research and clinical experiences that appeared in CA: A

Major investigative studies have yielded considerable data on various aspects of Kaposi's sarcoma (KS), including cellular and molecular events leading to the development of HIV-associated KS, histopathologic features, clinical

Inflammatory cytokines plus the human immunodeficiency virus Tat protein apparently trigger the development of early Kaposi's sarcoma. Activated spindle cells provide a self-perpetuating, autocrine-supported mechanism for further development of hyperplastic lesions. In more advanced stages, a true neoplastic process may develop. [ONCOLOGY 10(Suppl):34-36, 1996]

The unique epidemiology of Kaposi's sarcoma among patients with the acquired immunodeficiency syndrome suggests a multifactorial cause. Although the human immunodeficiency virus (HIV) plays a major role in the

In the early 1980s, we first began to see cases of Kaposi's sarcoma (KS) in patients with the lymphadenopathy now known to be associated with infection by the human immunodeficiency virus (HIV). During that period, we

Treatment options for patients with acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) have changed very little over the past decade. Research has been hampered by the absence of an accepted

Dr. Safai: Dr. Abrams, I am not convinced that the apparent drop in KS incidence is real. I see many referred patients who have developed KS, but whose KS has never been reported, since it was not the initial presentation of HIV infection. In many cases, the lesions are not even biopsied.

A study currently underway at the Medical College of Wisconsin is looking at why farmers do or do not follow safe-use guidelines when applying pesticides and is measuring their levels of pesticide exposure

Multiple myeloma is a malignant disease characterized by excess proliferation of monoclonal plasma cells. Its progression leads to bone marrow failure, increased risk of infection, and painful osteolytic bony lesions. Although patients are most often

Results of a phase III multicenter European study reported in a recent issue of the European Journal of Cancer demonstrate that anastrozole (Arimidex), a new aromatase inhibitor, in doses of 1 and 10 mg orally once daily, is an effective treatment for

Physicians today are facing more ethical dilemmas as patient decisions are being based less on beneficence and more on business models of success, says Sister Patricia Talone, ethics consultant, Mercy Health Corporation of Southeastern

In the United States, the implementation of antibody testing in 1985 of all donated blood for human immunodeficiency virus type 1 (HIV-1) resulted in a substantial decrease in the transmission of HIV through blood transfusions. To further decrease

Further follow-up of a randomized trial comparing combined chemotherapy and radiotherapy with radiotherapy alone for inoperable squamous cell cancers of the head and neck confirms the trial's initial finding of greater efficacy for the combined

NeXstar Pharmaceuticals made four DaunoXome-related presentations at the 9th NCI-EORTC Symposium on New Drugs in Cancer Therapy in Amsterdam, The Netherlands. Parkash S. Gill, MD, associate professor medicine and pathology at the

The National Cancer Institute (NCI) recently announced that the breast cancer death rate in American women continued to decline through 1993.

Almost exactly one decade ago, in an editorial published in the New England Journal of Medicine [1], I noted that "progress is slow but sure" in the development of monoclonal antibodies for clinical use. At that time, only muromonab-CD3 (Orthoclone OKT3) was approved for human use to prevent rejection of kidney transplants. In the ensuing 10 years, only one oncologic monoclonal antibody product, satumomoab pendetide (OncoScint CR/OV, Cytogen, Princeton, New Jersey) [2] has been approved by the FDA. Progress surely has been slow.

his excellent review analyzes ophthalmologic complications following high-dose irradiation of the orbit and surrounding structures as a necessary adjunct to the treatment of patients with carcinomas of the head and neck region. It confirms the critical importance of dose-fraction size in the production of radiation complications, especially in nerve tissue.

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.

Parsons and colleagues present an excellent summary of their clinical experience with ocular complications of radiotherapy for primary periocular malignancies, together with a retrospective review of the literature on this subject. The authors emphasize the roles of both total dose and dose-per-fraction in radiation-associated eye complications.

pplication of the techniques of flow cytometry and image analysis to quantitation of DNA and estimation of events in the cell cycle in human tumors has achieved considerable popularity as a laboratory procedure but so far has failed to be of practical clinical value. As brilliantly summarized by Dr. Ross, retrospective studies have repeatedly shown abnormal DNA values to be of prognostic significance in several organ systems, among them, tumors of the urothelium [1] and prostate [2] and, perhaps to a lesser extent, mammary carcinomas [3].

This comprehensive report summarizes the current management of primary liver cancer and of metastatic colorectal cancer in the liver. Numerous tests to help define the location and stage of disease have been evaluated. It now appears that spiral CT with arterial portography is superior to other nonoperative methods in evaluating liver tumors. Immunoscintography using monoclonal antibodies is currently under development and appears to be of potential great value. Subclinical, micrometastatic disease is the bane of all efforts at surgical control of cancer. An ability to detect this would have far-reaching consequences. Complete evaluation of patients with these diseases must include a medical evaluation, including liver function tests and a chest CT. Particular attention must also be paid to cardiac, pulmonary, and renal function.

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.

That nucleic acids can be measured spectrophotometrically in intact, fixed, or viable single cells was demonstrated in a series of publications by Caspersson in the 1930s and '40s, culminating in his now classic monograph [1]. In that paper, Caspersson demonstrated an increase in nucleic acid content in proliferating vs resting cells and malignant vs benign cells. However, although his measurements of ultraviolet absorption were specific for nucleic acids, the absorption maximums for DNA and RNA were too close to be distinguished. Probably, he was measuring differences in RNA, which are more striking than differences in DNA.

The article by Dr. Ross provides an overview of the current status of the medical literature regarding the role of DNA ploidy and cell cycle analysis in cancer diagnosis and patient prognosis. The scope of the article is quite broad, covering virtually every organ system and, as such, provides only a brief summary of the data in each diagnostic category. From these data, there is general agreement about the value of detection of aneuploidy in tumor specimens but a lack of consensus about the importance of cell proliferation analyses, such as S-phase fraction (SPF) measurements. This conclusion reflects the inherent variability in the two determinations. Detection of aneuploidy by analytic cytometry is reliable; it is accurate and depends upon the specimen (frozen vs formaldehyde- fixed, presence of necrosis, cellularity) as well as the quality of specimen preparation. Thus, DNA ploidy analysis can easily be standardized, minimizing intralaboratory variation. Cell cycle analysis, however, is more complex and as yet is not standardized.

Dr. Sardi and colleagues lay out, in a clear and concise fashion, current alternatives for the management of primary and metastatic liver tumors. Their emphasis on "high-value" treatments is crucial. In this group of patients, unnecessary treatments not only are costly in terms of dollars but also reduce the quality of the short life remaining in patients with unresectable disease.

Dr. Krasna provides a well-illustrated review of the applications of thoracoscopy in lung and esophageal tumors. These include: staging of tumors; diagnosis of indeterminate pulmonary nodules; definitive resections of various tumors, especially in cases of poor reserve; and diagnosis and treatment of malignant pleural disease [1]. However, there remains considerable disagreement among thoracic surgical oncologists over the proper applications of these techniques.

Staging is extremely important in determining the proper treatment of patients with thoracic malignancies. Staging groups can be used to predict outcome after cancer treatment and allocate patients to appropriate treatment

Primary and metastatic liver tumors continue to be a significant health problem in the United States. Hepatic resection or, in selected cases, transplantation are the only curative therapies for patients with resectable

Several new agents undergoing clinical development appear to be effective and tolerable in the management of metastatic breast cancer. In recent years, a number of new and exciting combinations have been described, with an efficacy similar or, in some cases, apparently superior to that of standard chemotherapeutic regimens, such as FAC and CMF. The next several years will witness a large number of comparative clinical trials, the major purpose of which will be to establish the role of these new drugs and combinations in the management of metastatic breast cancer. Almost simultaneously, similar strategies will be pursued for adjuvant therapy for primary breast cancer, with the goal of improving the curative efficacy of current regimens. These prospects are exciting; however, enthusiasm must be tempered with the knowledge that long-term toxicity is always a distinct possibility. Therefore, the development of new combinations, especially in the setting of adjuvant chemotherapy, should follow a systematic, conservative strategy. [ONCOLOGY 10(Suppl):30-36, 1996]

Monoclonal antibodies (MoAbs) of murine origin, when labeled with radionuclides that emit gamma rays, target tumors, permitting detection of disease. SatumoMoAb pendetide (Oncoscint CR/OV), a murine MoAb, was