ONCOLOGY Vol 14 No 12 | Oncology

Johns Hopkins to Study Alternative Therapies for Breast Cancer, Prostate Cancer

December 01, 2000

Can tart cherries alleviate cancer pain? Does prayer help heal African-American women with breast cancer? To answer such questions, Johns Hopkins Medicine has been awarded a 5-year, $7.8 million grant from the National Institutes of Health

Management of Advanced/Metastatic Prostate Cancer: 2000 Update

December 01, 2000

Over the past several years, the clinical presentation of prostate cancer has evolved so that more patients than ever before are presenting with clinically localized disease. However, a significant number of men continue to

National Cancer Institute Launches Lung Screening Study

December 01, 2000

The National Cancer Institute (NCI) is recruiting 3,000 current and former smokers for its Lung Screening Study, a year-long study of spiral computed tomography (CT) scans for lung cancer screening. Although the study will not determine if the

Childhood Cancers Subject of New Law

December 01, 2000

At the end of its session, Congress passed a children’s health bill (H.R. 4365) that established a variety of new health programs. One section of the bill authorizes the CDC to study environmental and other risk factors for childhood cancers,

Thalidomide in Hematologic and Oncologic Disease

December 02, 2000

The use of thalidomide (Thalomid) in the treatment of hematologic diseases and in solid tumors as monotherapy or in combination with other agents is an exciting development in cancer therapy. Researchers actively involved in studying the role of thalidomide in cancer treatment were convened at a special investigators’ meeting held this past May in New Orleans. The articles in this supplement are based on the presentations made at this investigators’ meeting.

Book Review: Progress in Anti-Cancer Chemotherapy, Volume II

December 01, 2000

The book Progress in Anti-Cancer Chemotherapy, Volume II is the second of a series of three books edited by Drs. Hortobagyi and Khayat, and published by different publishing houses between 1998 and 1999. Volume II is a collection of

Congress Passes Breast/Cervical Cancer Bill

December 01, 2000

Congress finally passed a bill (H.R. 4386/S. 662) that allows states to provide medical treatment for women with breast and cervical cancer. At their option (there is no requirement), states can treat women who have tested positive in a screening

Prostate Cancer Research

December 01, 2000

A second omnibus health-care bill-this one called the Public Health Improvement Act (H.R. 2498)-was passed quietly at the end of the 2000 session, with a prostate cancer section included. That section was originally a free-standing bill called

Aging and Cancer

December 01, 2000

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

Pharmacology of Antineoplastic Agents in Older Cancer Patients

December 01, 2000

People over the age of 65 are a fast-growing segment of the US population, and with the incidence of cancer increasing with age, the challenges of treating older cancer patients are also on the rise. Drs. Lichtman and Skirvin present a comprehensive review of the antineoplastic agents used in elderly cancer patients. They highlight the important factors of chemotherapy pharmacology in elderly cancer patients, with emphasis on the impact of physiologic changes-especially renal clearance-in dosing and toxicity. In addition, descriptions of significant toxicities are provided. The following additional issues should be considered.

Management of Advanced/Metastatic Prostate Cancer: 2000 Update

December 01, 2000

Over the past several years, the clinical presentation of prostate cancer has evolved so that more patients than ever before are presenting with clinically localized disease. However, a significant number of men continue to

Aging and Cancer

December 01, 2000

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

Pharmacology of Antineoplastic Agents in Older Cancer Patients

December 01, 2000

Drs. Lichtman and Skirvin have written an excellent review on the pharmacology of antineoplastic agents in older cancer patients. However, as in any text (often due to space limitations), one can find shortcomings, some of which will be covered in this commentary.

Irinotecan in Preoperative Combined-Modality Therapy for Locally Advanced Rectal Cancer

December 03, 2000

Irinotecan (CPT-11, Camptosar) is a semisynthetic water-soluble derivative of the plant alkaloid camptothecin. This review will focus on the potential use of irinotecan in combination with fluorouracil (5-FU) in the preoperative combined-modality treatment of advanced rectal cancer.

Colorectal Cancer: Chemotherapy Treatment Overview

December 03, 2000

Fluorouracil (5-FU) has remained the standard therapy for the treatment of advanced colorectal cancer for over 40 years. Unfortunately, only a minority of patients experience objective clinical response.

Oxaliplatin in Colorectal Cancer: Current Studies

December 01, 2000

One of the more promising chemotherapeutic agents for patients with metastatic colorectal cancer is oxaliplatin (Eloxatin), a third-generation platinum derivative with a unique mechanism of action. Preclinical studies

Phase I Study of Irinotecan and Concurrent Radiation Therapy for Upper GI Tumors

December 03, 2000

Irinotecan (Camptosar) is an active chemotherapeutic agent for lung, gastric, esophageal, and colorectal cancers and a potent radiosensitizer. This phase I study was designed to assess the maximum tolerated dose of weekly

Irinotecan in Esophageal Cancer

December 03, 2000

Irinotecan (Camptosar) has shown activity in several solid tumor malignancies, including gastric and pancreatic cancer. In vitro studies suggest antitumor activity in esophageal cancer cell lines. Sequence-dependent synergy

Novel Combinations With Oxaliplatin

December 01, 2000

Oxaliplatin (Eloxatin) is a novel antineoplastic platinum derivative that may exert its cytotoxic effects by blocking DNA replication/transcription, thus resulting in cell death in proliferating cells, as well as apoptosis.

Management of Advanced/Metastatic Prostate Cancer: 2000 Update

December 01, 2000

Over the past several years, the clinical presentation of prostate cancer has evolved so that more patients than ever before are presenting with clinically localized disease. However, a significant number of men continue to

Irinotecan in the Management of Patients With Pancreatic Cancer

December 03, 2000

Synergy with no overlapping toxicities has been demonstrated for the combination of irinotecan ( Camptosar, CPT-11) and gemcitabine (Gemzar) in vitro. Results of a single-institution phase I study in which patients with

Thalidomide for Recurrent Renal-Cell Cancer in a 40-Year-Old Man

December 01, 2000

A pilot study was performed at The University of Texas M. D. Anderson Cancer Center to determine the feasibility of using thalidomide in a population of renal-cell carcinoma patients who had progressive disease despite chemotherapy and immunotherapy. Metastatic renal-cell carcinoma patients with adequate oral function were entered onto a study after signing an internal review board-approved informed consent. There were no exclusion criteria for prior therapy. Nineteen previously treated patients and one untreated patient with progressive renal-cell carcinoma received oral thalidomide as a single agent. The starting dose was 200 mg and the dose was increased by 100 to 200 mg every week until it reached 1,200 mg/d. Response was assessed on the basis of a radiographic reduction of the metastatic sites involved. A case report describing one of the patients involved in the pilot trial is included. [ONCOLOGY 14(Suppl 13):33-36, 2000]

Rectal Cancer: Integrating Oxaliplatin Into Chemoradiation Studies

December 01, 2000

The current standard of care for patients with stage T3 rectal cancer is adjuvant combined-modality treatment with radiation and fluorouracil (5-FU)-based chemotherapy. Although data from randomized phase III trials comparing

Intrahepatic Therapy for Resected Hepatic Metastases From Colorectal Carcinoma

December 01, 2000

A significant number of patients with colorectal cancer will present with hepatic metastases as their only site of metastatic disease. Surgical resection in patients with a limited number of metastases will lead to long-term

Reducing Tobacco Use: A Report of the Surgeon General-2000

December 01, 2000

Tobacco use, particularly smoking, remains the number 1 cause of preventable disease and death in the United States. This report of the Surgeon General on smoking and health is the first to offer a composite review of the various methods used to

Oxaliplatin in Tumors Other Than Colorectal Cancer

December 01, 2000

Oxaliplatin (Eloxatin) has demonstrated significant activity in a variety of tumor types in addition to colorectal cancer. Several studies have reported on the effectiveness of oxaliplatin as single-agent treatment or in

Irinotecan-Based Combinations for the Adjuvant Treatment of Stage III Colon Cancer

December 03, 2000

Irinotecan (Camptosar) is a topoisomerase I inhibitor with demonstrated antitumor activity against a wide variety of malignancies. Phase II studies have shown that this agent has significant single-agent activity against both chemotherapy-naive and fluorouracil (5-FU)-refractory colorectal cancer. Phase III studies now indicate that irinotecan/5-FU/leucovorin combinations have antitumor activity superior to standard 5-FU/leucovorin regimens alone. These irinotecan-based combinations are now entering clinical trials for the adjuvant treatment of resected stage III colon cancer. It is hypothesized that the superior antitumor activity of these irinotecan-based combinations seen in the metastatic setting will translate into improved survival and increased cure rates in these earlier-stage patients. [ONCOLOGY 14(Suppl 14):47-50, 2000]

Oxaliplatin With 5-FU or as a Single Agent in Advanced/Metastatic Colorectal Cancer

December 01, 2000

No adequate second- or third-line therapy is available in the United States for patients with metastatic colorectal cancer and disease progression following treatment with fluorouracil (5-FU)-based therapy and an irinotecan (CPT-

Efficacy of Oxaliplatin in the Treatment of Colorectal Cancer

December 01, 2000

Colorectal cancer is one of the leading causes of cancer death. The mainstay of chemotherapy in colorectal cancer patients for the past 40 years has been fluorouracil (5-FU). Oxaliplatin (Eloxatin) is a novel platinum compound with promising activity in colorectal cancer. As a single agent, oxaliplatin has produced response rates of 12% to 24% in patients with previously untreated advanced colorectal cancer, and 10% to 11% in patients with relapsed or refractory advanced colorectal cancer. In phase II trials, oxaliplatin combined with 5-FU, with or without leucovorin, was associated with response rates of 60% and higher when used as front-line therapy, and when used in patients with relapsed or refractory advanced colorectal cancer, response rates ranged from 25% to 50%. In the front-line setting, two randomized trials of 5-FU and leucovorin, with or without oxaliplatin, demonstrated that the addition of oxaliplatin significantly increases response rate and time to tumor progression, but not survival, over 5-FU plus leucovorin alone. The reasons for this discrepancy are unclear, and several possibilities are being considered. Additional phase III trials are underway to clarify the contribution of oxaliplatin in the treatment of patients with locally advanced and metastatic colorectal cancer. [ONCOLOGY 14(Suppl 11):9-14, 2000]

Development of Angiogenesis Inhibition as Therapy for Prostate Cancer

December 02, 2000

Angiogenesis is essential to prostate cancer progression. The first study of antiangiogenic therapy in patients with locally advanced prostate cancer at The University of Texas M. D. Anderson Cancer Center showed that

Thalidomide in Multiple Myeloma

December 02, 2000

Recent evidence suggests that angiogenesis is increased in multiple myeloma and has prognostic value in the disease. Based on the increased angiogenesis observed in myeloma, thalidomide (Thalomid) has been studied as

Irinotecan and Thalidomide in Metastatic Colorectal Cancer

December 02, 2000

Fifteen patients with metastatic colorectal cancer were treated with irinotecan (CPT-11, Camptosar) at 300 to 350 mg/m2 every 21 days and thalidomide (Thalomid) at 400 mg/d. Of the 15 patients, 11 were in a pilot study and 4

Pharmacology of Antineoplastic Agents in Older Cancer Patients

December 01, 2000

The fastest growing segment of the US population is the group over the age of 65 years. In the next 30 years, this group will comprise over 20% of the population. Because 60% of all cancers occur in this age group, there will be an expected rise in the total cancer burden.

Irinotecan and High-Dose Fluorouracil/Leucovorin for Metastatic Colorectal Cancer

December 03, 2000

Two randomized phase III trials with irinotecan as second-line treatment of metastatic colorectal cancer have shown that irinotecan (CPT-11, Camptosar) significantly improves survival when compared with best supportive care or continuous infusion of fluorouracil (5-FU) after failure of 5-FU.

Aging and Cancer

December 01, 2000

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

Management of Advanced/Metastatic Prostate Cancer: 2000 Update

December 01, 2000

Over the past several years, the clinical presentation of prostate cancer has evolved so that more patients than ever before are presenting with clinically localized disease. However, a significant number of men continue to

The Evolving Role of Irinotecan: A Broad-Spectrum Chemotherapeutic Agent

December 03, 2000

Irinotecan (Camptosar, CPT-11), a member of the camptothecin family, represents the most active camptothecin available for clinical use today. Irinotecan is a topoisomerase I inhibitor. Topoisomerase enzymes support the topologic structure of DNA, thus facilitating translation and transcription. The enzyme topoisomerase I plays a crucial role in the relegation of single-strand breaks and in relieving torsional DNA stress.[1,2] Irinotecan and other camptothecin analogs interfere in this process by stabilizing the topoisomerase I/DNA cleavable complex.[2] This process is not compatible with prolonged cell survival.

Thalidomide in Solid Tumors: The London Experience

December 02, 2000

Investigators at the Royal Marsden Hospital and University College in London have studied thalidomide (Thalomid) as both low-dose (100 mg orally, every night) and high-dose (600 mg, given as 300 mg twice per day)