ONCOLOGY Vol 12 No 10 | Oncology

New Biological Markers May Accurately Predict Prognosis in Head and Neck Cancer Patients

October 01, 1998

Findings that tissue levels of two proteins correlate closely with the prognosis of head and neck cancer may significantly alter the detection, staging, and treatment of this disease, according to an article published in the June 3rd issue of the Journal of

Silicone Breast Implants: An Oncologic Perspective

October 01, 1998

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

US Clinical Trial of New Cervical Cancer Detection System to Begin

October 01, 1998

NetMed, Inc., a developer and marketer of medical and health-related technologies, announced the commencement of a multicenter US clinical trial of the PAPNET cervical cancer detection system as a primary screening test for Pap smears. The

Novel Form of Vitamin K May Stop Liver Cancer Cell Growth

October 01, 1998

Scientists at the University of Pittsburgh have discovered how a novel form of vitamin K exerts its cancer-killing effects in primary liver cancers, which are notoriously resistant to chemotherapy. The research results, published in the May issue of the

Red Cross Launches First Virus-Inactivated Blood Component

October 01, 1998

An extra margin of safety is now available to the approximately 400,000 people in the US who receive transfusions of blood plasma annually. PLAS+SD (Pooled Plasma, Solvent/Detergent Treated) is an FDA-approved product that virtually eliminates

Does Pelvic Irradiation Play a Role in the Management of Prostate Cancer?

October 01, 1998

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

Pediatric Hematology/Oncology Seminar and Workshops Announced

October 01, 1998

Advances in Pediatric Hematology/Oncology will be held November 19 through 21, 1998, at the Hilton Clearwater Beach Resort, Florida (formerly the DoubleTree). Topics presented by nationally renowned speakers include:

Be a Survivor Breast Cancer Guides Available in Several Formats

October 01, 1998

It’s a truism that we learn best when we get information from several senses," concludes a favorable review in the respected Journal of the National Cancer Institute of an interactive CD-ROM entitled "Be a Survivor: Your Interactive Guide to

Irinotecan May Extend Survival in People With Metastatic Colorectal Cancer

October 01, 1998

Data presented at the American Society of Clinical Oncology meeting by Professor Eric Van Cutsem, MD, PhD, University Hospital Gasthuisberg, Leuven, Belgium, demonstrate, for the first time, that people with metastatic colorectal cancer who

Non-Hodgkin’s Lymphoma: Approaches to Current Therapy

October 02, 1998

This is the beginning of an exceedingly exciting era for the study of the non-Hodgkin’s lymphomas. A new pathologic classification system has been developed to incorporate the biology that has been developed since the introduction of the Working Formulation more than 15 years ago. Large enough numbers of patients have been uniformly treated and followed so as to enable the development of new and accurate prognostic indices. These will allow us to adapt our treatment strategies to the patients' individual risk of failure. Finally after years of similar treatment strategies that have yielded at best marginal improvement, new therapeutic modalities are now available and offer the promise of improved survival and even lessened toxicity for our patients.

PHS Recommendations for the Management of Health-Care Worker Exposures to HIV: Part 2

October 01, 1998

Health-care organizations should make available to their workers a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place health-care workers at

Researchers Combine TP53 Gene Therapy and Chemotherapy in Advanced Cancer

October 01, 1998

Doctors at the University of Pittsburgh Cancer Institute are exploring a new experimental therapy in which they transfer the tumor-suppressing gene TP53 (alias p53) into patients to reverse tumor progression. University of Pittsburgh clinical

Silicone Breast Implants: An Oncologic Perspective

October 01, 1998

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

Silicone Breast Implants: An Oncologic Perspective

October 01, 1998

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

Recent Advances in Oral Fluoropyrimidine Therapies

October 01, 1998

Recent strategies to improve the outcome of fluoropyrimidine chemotherapy for patients with cancer have focused on better selection of patients likely to respond to such therapy and on protracted exposure to 5-fluorouracil (5-FU). Cellular

Hepatic Colorectal Metastasis: Current Status of Surgical Therapy

October 01, 1998

Metastatic colorectal cancer to the liver develops in over 50,000 US patients each year and is rapidly fatal if untreated. Even the most active chemotherapeutic agents rarely prolong survival for more than 3 years. Liver

Does Pelvic Irradiation Play a Role in the Management of Prostate Cancer?

October 01, 1998

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

Commentary (Rosen et al): Early Detection of Cutaneous Lymphoma

October 01, 1998

Cutaneous lymphomas comprise a spectrum of diseases characterized by infiltration of the skin by malignant lymphocytes. The clinical manifestations of cutaneous lymphomas vary, and they can mimic benign dermatoses,

Hepatic Colorectal Metastasis: Current Status of Surgical Therapy

October 01, 1998

Metastatic colorectal cancer to the liver develops in over 50,000 US patients each year and is rapidly fatal if untreated. Even the most active chemotherapeutic agents rarely prolong survival for more than 3 years. Liver

Early Detection of Cutaneous Lymphoma

October 01, 1998

Cutaneous lymphomas comprise a spectrum of diseases characterized by infiltration of the skin by malignant lymphocytes. The clinical manifestations of cutaneous lymphomas vary, and they can mimic benign dermatoses,

Blood and Marrow Transplantation in Relapsed or Refractory Non-Hodgkin’s Lymphoma

October 02, 1998

It was not until 1995 that a phase III randomized trial demonstrated that autologous stem cell transplants (ASCT) improve the progression-free and overall survival of patients with relapsed refractory diffuse aggressive non-Hodgkin’s lymphoma. Investigators are now focusing on improving the clinical benefit of transplants. The relative contributions made by more intensive preparative regimens, purging, concomitant immunotherapy, and the timing of transplants are under study. Also, as transplant trials shift from relapsed disease to initial therapy, anticipated benefits must be balanced against both short-term and long-term toxicities.[ONCOLOGY 12(Suppl 8):56-62, 1998]

Infusional 5-FU: Historical Evolution, Rationale, and Clinical Experience

October 01, 1998

The cycle-specific schedule-dependent antimetabolite 5-fluorouracil (5-FU) has been in clinical use for 40 years and has evolved as an important agent in the treatment of a large spectrum of tumors, including all gastrointestinal

Newer Treatments for Non-Hodgkin’s Lymphoma: Monoclonal Antibodies

October 02, 1998

Significant advances have been made in the application of monoclonal antibody-based therapies to the treatment of patients with lymphoma. The most promising areas appear to be the use of unconjugated monoclonal

The Role of Dihydropyrimidine Dehydrogenase (DPD) Modulation in 5-FU Pharmacology

October 01, 1998

Over the past several years, the pyrimidine catabolic pathway and, in particular, the first enzymatic step involving dihydropyrimidine dehydrogenase (DPD) have been recognized as being critical in determining the ultimate

Establishing the Diagnosis of Lymphoma: From Initial Biopsy to Clinical Staging

October 02, 1998

Successful therapy for most of the non-Hodgkin’s lymphomas requires an accurate pathologic diagnosis. Routine morphologic examination of excisional biopsies from nodal or extranodal sites provides the cornerstone for establishing a definitive diagnosis. The list of ancillary studies, however, used to complement these routine approaches is increasing both in number and complexity. Proper use of these diagnostic tools can be of great help in arriving at the correct diagnosis in difficult cases. Fine-needle aspiration and needle-core biopsies have a role in lymphoma staging and in the assessment of recurrent disease, but are limited as primary diagnostic tests. This review will focus on the standard approaches used to establish a diagnosis of malignant lymphoma, and the clinical utility of immunophenotypic, molecular genetic, and cytogenetic studies in providing useful data for diagnosis. The standard practice of synthesizing all of the data from multiparameter analysis to arrive at a diagnosis in difficult cases will be emphasized. [ONCOLOGY 12(Suppl 8):11-16, 1998]

Current Approaches to Therapy for Indolent Non-Hodgkin's Lymphoma

October 02, 1998

Progress in the treatment of indolent non-Hodgkin’s lymphoma has been slow and the disease remains incurable despite the relatively long median survival of patients. Decades of clinical trials resulted in standard

Management of Intermediate-Grade Lymphomas

October 02, 1998

Intermediate-grade lymphomas are defined by the Working Formulation to include four histologic subgroups: follicular large-cell, diffuse small-cleaved-cell, diffuse mixed small- and large-cell, and diffuse large cell (Groups

Does Pelvic Irradiation Play a Role in the Management of Prostate Cancer?

October 01, 1998

The optimal management of patients with lymph node-positive prostate cancer remains controversial. The role of pelvic irradiation in patients at high risk for nodal involvement continues to be debated. Studies of prostate

Clinical Development of Eniluracil: Current Status

October 01, 1998

Eniluracil is a potent inactivator of dihydropyrimidine dehydrogenase (DPD), which is the first enzyme in the degradative pathway of systemically administered 5-fluorouracil (5-FU). Two completely oral regimens of eniluracil plus 5-FU are being evaluated in clinical trials: (1) a chronic schedule with both agents administered BID in a 10:1 ratio for 28 days of a 5-week course, and (2) a 5-day schedule of eniluracil once daily on days 1 through 7 and 5-FU once daily on days 2 through 6. The clinical development of eniluracil is being pursued in several tumor types, including colorectal cancer, breast cancer, and pancreatic cancer. Response rates achieved in a phase II study of the chronic schedule of oral eniluracil/5-FU in patients with colorectal cancer compare favorably with those obtained in trials of intravenous 5-FU and leucovorin, while results from other trials are awaited. Safety analysis for the 28-day schedule has revealed a low incidence of severe toxicities, particularly as compared with standard 5-FU regimens. [ONCOLOGY 12(Suppl 7):52-56, 1998]

Chemotherapy for Gastric Carcinoma: New and Old Options

October 01, 1998

Although gastric carcinoma is an uncommon disease in North America, its incidence is alarmingly high in Asia, South America, Eastern Europe, and countries of the former Soviet Union. Screening for gastric carcinoma is performed only on a limited basis in Japan; in the rest of the world, therefore, patients often present with advanced disease at the time of diagnosis.

Management of High-Grade Lymphomas

October 02, 1998

High-grade non-Hodgkin’s lymphomas generally refer to immunoblastic lymphoma, lymphoblastic lymphoma, and small-noncleaved-cell lymphoma, three histological subtypes that were associated with the worst prognosis at the

Oral 5-FU Alternatives for the Treatment of Head and Neck Cancer

October 01, 1998

The common clinical presentations of head and neck cancer include early (stage I or II) disease, locally or regionally advanced (stage III or IV, M0) disease, and recurrent or metastatic disease (< 5% of patients).

The Oral Fluorouracil Prodrugs

October 01, 1998

Discussed herein are selected oral fluorinated pyrimidines that are converted to 5-fluorouracil (5-FU) in vivo to exert antitumor activity. These agents include capecitabine (Xeloda), tegafur-uracil (UFT) plus leucovorin (Orzel), and S-1 (BMS247616). These agents offer the convenience of an orally administered therapy with potentially fewer toxic effects than conventional bolus regimens of 5-FU plus leucovorin. These oral agents provide prolonged 5-FU exposure at lower peak concentrations than observed with bolus intravenous administration of 5-FU and may confer pharmacoeconomic advantages by reducing administration costs and toxicity-related hospitalizations. These regimens also have the potential for improved therapeutic activity by achieving higher 5-FU concentrations in the tumor or by biochemically modulating 5-FU. Phase III trials in patients with advanced colorectal carcinomas are comparing the antitumor activity of these agents with that of intravenous 5-FU plus leucovorin. [ONCOLOGY 12(Suppl 7):48-51, 1998]

Biochemical and Clinical Pharmacology of 5-Fluorouracil

October 01, 1998

The cellular and clinical pharmacology of fluoropyrimidines is characterized by marked interpatient variability in tumor response and patient tolerance. Understanding the metabolic pathways followed by 5-fluorouracil (5-FU) has

Silicone Breast Implants: An Oncologic Perspective

October 01, 1998

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

Management of Mantle Cell Lymphoma

October 02, 1998

Manifestations of mantle cell lymphoma were recognized in the 1970s as distinct from those associated with the more readily classifiable lymphomas. It was not until the 1990s, however, that observation of a combination of immunologic, cytogenetic, and molecular genetic abnormalities characteristic of this new malignancy confirmed its existence. The clinical and pathologic entity was named mantle cell lymphoma and in 1994 was incorporated into the Revised European American Lymphoma Classification. Mantle cell lymphoma is a CD5 positive, B-cell lymphoma that usually displays the t(11;14). The lymphoma has a striking male predominance and is widely disseminated at diagnosis in 80% of patients. Mantle cell lymphoma responds poorly to available therapies, and the median survival is approximately 3 years.[ONCOLOGY 12(Suppl 8):49-55, 1998]

Oral 5-FU Analogues in the Treatment of Breast Cancer

October 01, 1998

Three oral 5-fluorouracil (5-FU) therapies have been approved by the US Food and Drug Administration or are in development for the treatment of patients with breast cancer: capecitabine, UFT, and 5-FU/eniluracil.

Hepatic Colorectal Metastasis: Current Status of Surgical Therapy

October 01, 1998

Metastatic colorectal cancer to the liver develops in over 50,000 US patients each year and is rapidly fatal if untreated. Even the most active chemotherapeutic agents rarely prolong survival for more than 3 years. Liver

Overview of Prognostic Factors in Non-Hodgkin’s Lymphoma

October 02, 1998

The non-Hodgkin’s lymphomas are a biologically heterogeneous group of diseases with varying clinical presentations and outcomes. A number of studies have identified variables that carried independent prognostic significance. Although several staging systems had evolved that incorporated these prognostic variables, they were still unable to predict outcome. Ideally, the object of a staging system is to predict the likelihood of treatment response, time to progression or disease-free survival, and overall survival, and to provide a way to compare the outcome of similar groups of patients among various clinical trials. The need for such a system led to the creation of prognostic models such as the M. D. Anderson Tumor Score and, more recently, the International Prognostic Index. These prognostic models may identify those patients at highest risk for treatment failure, thereby identifying those patients who may require different therapeutic approaches. [ONCOLOGY 12(Suppl 8):17-24, 1998]