ONCOLOGY Vol 13 No 3

Although rituximab was approved for the treatment of follicular, low-grade NHL, it is also being evaluated in other CD20+ tumors. Responses have previously been reported in large cell NHL and mantle cell NHL (Coiffier et al: Blood 92:1927-1932, 1998). These authors used 8 weekly infusions of rituximab at two different doses in 54 patients with intermediate- or high-grade NHL or mantle cell NHL. The complete remission rate was 9% with an overall response rate of 31%. Median time to progression as of publication was 246+ days.

The bcl-2 gene is overexpressed in 80% to 90% of patients with follicular NHL. The product of this gene, the bcl-2 protein, not only protects cells from apoptosis but also induces a form of acquired resistance to a wide array of chemotherapy agents (Kitada et al: Blood 91:3379-3389, 1998).

Early reports suggested that therapy with rituximab might be less effective in patients with bulky nodal disease. At the ASH meeting, Davis et al (abstract #1711) reported on 31 patients with indolent NHL and masses measuring ³ 10 cm who received rituximab in four weekly infusions. Of the 31 patients, 1 patient (4%) had a complete remission, and 11 patients responded partially, for an overall response rate of 43%. However, the duration of response was only 8.1 months.

The results published to date with Bexxar and IDEC-Y2B8 have been very promising. Bexxar is an iodine-131 anti-CD20 conjugate which, in a single-institution study including previously treated patients, achieved a response rate of 79%, including a 50% complete remission rate (Kaminski et al: J Clin Oncol 14:1974-1981, 1996), with complete remissions lasting a median of more than 16.5 months. Among previously treated patients, 71% achieved a complete remission and 39% attained a partial remission, for an overall response rate of 100%. The complete remissions lasted 3 to 17+ months (Kaminski et al : Proc Am Soc Clin Oncol 17:2a [abstract 6], 1998).

The low-grade NHLs remain incurable with conventional therapies. A variety of new, unique agents are being evaluated, which, hopefully, will improve these results. The purine analogs, particularly fludarabine (Fludara), have shown impressive activity in these patients and have become part of the standard treatment armamentarium. In patients who have not responded to an alkylating agent, fludarabine achieves a 12% to 15% complete remission rate with an overall response rate of about 50%. When used as initial therapy, fludarabine produces a complete remission in almost 40% of patients and an overall response rate of 60% to 70% (Solal-Céligny: J Clin Oncol 14:514-519, 1996).

Rituximab is highly effective in eradicating detectable lymphoma cells from the peripheral blood and bone marrow of patients with follicular NHL and can render most patientsPCR-negative. Several studies at ASH evaluated the ability of this antibody to provide effective in vivo purging, permitting the harvesting of large numbers of PCR-negative stem cells for autologous BMT (Gianni et al, abstract #481; Buckstein et al, abstract #2672). Engraftment has been successful in the few patients transplanted to date (Flinn et al, abstract #2673). Obviously, longer follow-up of larger numbers of patients is needed to better evaluate the long-term impact of this approach.

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of a suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference are being published in six installments in successive issues of oncology. This third part focuses on the prevention of osteoporosis and the cardiovascular effects of estrogens and antiestrogens. [ONCOLOGY 13(3):397-432, 1999]

Surgery is the only curative option for patients with colorectal cancer. The goal of other modalities, such as chemotherapy, immunotherapy, and radiotherapy, is to prolong survival and reduce the risk of recurrence.

Pediatric soft-tissue sarcomas are managed with a multimodality treatment program that includes surgery, chemotherapy, and external-beam radiotherapy (teletherapy). The use of teletherapy in young children can

The role of radiotherapy in combination with chemotherapy in advanced-stage Hodgkin’s disease remains controversial.

BACKGROUND: Extended-field radiotherapy is effective in patients with early-stage Hodgkin’s disease, and more than

This report aims to assess the effect of increased drug dose on the efficacy and toxicity of the BEACOPP regimen with

The chimeric monoclonal anti-CD20 antibody rituximab (Rituxan) has been shown to have clinical activity in patients with

Prostate cancer is the most common form of cancer (except skin cancer) in men. Several factors have been associated with an increased risk for prostate cancer, including age, ethnicity, family history, lifestyle, and

Ms. Bruner and colleagues from Fox Chase Cancer Center are to be congratulated for their comprehensive, well-designed program to maximize our understanding of prostate cancer in young men who are at high risk for developing the disease. I

The 1999 Asia Pacific Hospice Conference, “New Horizons in Hospice Care,” will take place in Hong Kong on June 2-4, 1999. An estimated 600 attendees are expected.

Campath-1H is an anti-CD52 monoclonal antibody that has demonstrated impressive activity in patients with relapsed chronic lymphocytic leukemia (CLL) and in those with T-cell prolymphocytic leukemia (T-PLL). Initial clinical trials with this agent were terminated early because of excessive toxicity, ie, myelosuppression and infections. Nevertheless, the investigators were impressed by the activity of the antibody in patients with advanced CLL.

Bruner et al describe a model for risk assessment and genetic counseling of individuals and families at increased risk for prostate cancer. This model includes the establishment of a prostate cancer risk registry and screening clinic for unaffected

Bruner and colleagues describe a comprehensive, long-term research program designed to understand, model, and modify prostate cancer risk. According to the investigators, the main problem with early prostate cancer risk screening is the