ONCOLOGY Vol 14 No 5

edicare has scheduled a national meeting on self-injectable drugs for May 18 in Baltimore. The meeting comes

Researchers at Memorial Sloan Kettering Cancer Center are examining the effectiveness of bringing psychological support into the homes of women with advanced stages of lung cancer through telephone and videophone counseling programs

AstraZeneca recently filed a supplemental new drug application with the US Food and Drug Administration (FDA) for a new indication for its oral hormonal medication bicalutamide (Casodex). The supplemental application asks the FDA to approve

The US Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) recently voted to support approval of gemtuzumab ozogamicin (Mylotarg) for the treatment of patients ³ 60 years old with CD33-positive, relapsed

The National Institutes of Health (NIH) is sponsoring a Consensus Development Conference on Adjuvant Therapy for Breast Cancer, to be held in Bethesda, Maryland, on November 1-3, 2000.

Women treated with tamoxifen (Nolvadex) had a 13% higher risk of disease progression than those treated with anastrozole (Arimidex), according to the North American and the European Tamoxifen or Arimidex Randomized Group Efficacy and

The results of an exploratory analysis published in the March 2000 issue of Urology suggest that prolonged combined androgen blockade (CAB) significantly increases survival in patients with advanced prostate cancer.

The US Food and Drug Administration (FDA) has approved irinotecan (Camptosar) as first-line therapy for patients with metastatic colorectal cancer in conjunction with fluorouracil (5-FU) and leucovorin. The approval follows unanimous

Patients who have newly diagnosed leukemia are often overwhelmed with the complexities of their disease and its required therapy. In their book, Understanding Leukaemia and Related Cancers, Drs. Mughal and Goldman offer patients a

The House Judiciary Committee overwhelmingly approved what has been a controversial bill (H.R. 1304) allowing independent physicians in a given community to negotiate jointly with a managed care plan. Doing so is currently against

The US Food and Drug Administration (FDA) has approved bexarotene (Targretin) for the treatment of cutaneous T-cell

The National Library of Medicine has started posting information about clinical trials in its new Clinical Trials

New data from three additional trial studies confirm that long-term use of exisulind (Aptosyn) prevents the formation of precancerous colorectal adenomatous polyps in patients with familial adenomatous polyposis (FAP). These clinically significant

The inadequate treatment of pain associated with malignancy remains a significant clinical problem.[1-4] Despite published guidelines on the appropriate management of cancer pain, 50% of dying patients experience moderate to severe pain.[1,5-8] One of the greatest barriers to the proper treatment of cancer pain remains health care professionals’ lack of knowledge regarding the appropriate use of analgesic medications.[9-11] The failure to refer to and limited availability of knowledgeable specialists in pain and palliative care also contribute to this pervasive problem.[12]

To assist in converting patients from one opioid agent to another in their daily practice, many oncologists carry pocket dosage conversion guides based on package inserts approved by the US Food and Drug Administration (FDA). One such guide issued by the manufacturer of transdermal fentanyl (Duragesic), reproduced in Table 3 of the expert consensus article written by Breitbart et al, presents the equivalent of 25 µg/h of transdermal fentanyl as 45 to 134 mg/d of oral morphine. In another guide, distributed by one of the manufacturers of controlled-release morphine, the 25 µg/h strength of transdermal fentanyl is said to be equianalgesic to 15 mg of controlled-release morphine administered every 12 hours (and both are deemed equivalent to 10 mg of controlled-release oxycodone every 12 hours). Faced with such a wide range of conversion factors, it is of little surprise-as Breitbart et al point out-that clinicians often fail to achieve equianalgesia when converting patients from one opioid to another.

Despite being one of the more common genitourinary neo plasms, superficial transitional cell carcinoma involving the urinary bladder can be a confusing entity for the treating physician. This confusion stems, in large part, from the binary classification

The two research groups from Long Island Jewish Medical Center and Yale University have collaborated to write an excellent overview of the biological basis of radio-sensitivity, especially as it applies to radiotherapy. The content of the paper reflects the excellence of these investigators’ contributions to the field of radiobiology. It is particularly refreshing to read an account of radiobiology that does not resort to the mathematical overanalysis that has plagued the field in the past.

Rosen and colleagues have provided a comprehensive review of the biological basis of radiation sensitivity, including recent insights into the DNA damage response. They correctly emphasize that local control of tumors is still a major clinical problem, and that a better understanding of the biological basis for radiation resistance/sensitivity has significant potential to be exploited for therapeutic gain. They also assert that further progress in local tumor control is unlikely to be achieved by technologic improvements in the delivery of such radiation therapies as three-D (3D) conformal radiotherapy, intensity-modulated radiation therapy (IMRT), altered fractionation, or even chemosensitization.

The article by Sarkodee-Adoo and colleagues on the management of infections in patients with acute leukemia provides an authoritative review of approaches to the prevention and treatment of infections in this high-risk population. Indeed, among the different populations of patients with neoplastic diseases, those with acute leukemia, particularly acute myelogenous leukemia (AML), are at very high risk for the development of severe infectious complications.[1,2]

Improvements in outcome following treatment for acute leukemia have derived from various sources: the introduction of new chemotherapeutic agents; the development of effective drug combinations; the use of multistage approaches to induction consolidation, and maintenance therapy to optimize durable control; and advances in supportive care to reduce treatment-related mortality. Certainly, infectious morbidity and mortality have plagued effective antileukemic therapy for many years. As a result, control of infectious complications has been an important area of clinical study. Through the concerted efforts of many clinical investigators, progress has occurred, and, today, infectious mortality is an infrequent complication of antileukemic therapy.

Baselli and Greenberg have presented a comprehensive overview of intravesical strategies for the management of superficial urothelial malignancies of the bladder, both past and present. A number of points made in the article deserve further

For many oncologists and their patients with metastatic breast cancer, these are quite confusing times. A growing body of evidence suggests that pure dose-escalation strategies of high-dose chemotherapy with stem-cell support are unlikely to provide much additional benefit in patients with advanced breast cancer.[1] In fact, selection bias may explain much of the potential benefit seen in so many single-arm high-dose chemotherapy studies.[2]

Drs. Olin and Muss provide an excellent review of current state-of-the-art treatments and treatment strategies for patients with metastatic breast cancer. They explore a number of the existing questions in the treatment of metastatic breast cancer and emphasize the need for ongoing clinical trials.

The explosion of new knowledge about radiation sensitivity and radiation biology is such that even the scholarly, relatively extensive review of the subject authored by Drs. Rosen, Fan, Goldberg, and Rockwell covers but a small proportion of this vast, complex topic.

Many cancer patients are undermedicated and inappropriately managed for pain, leading to a diminished quality of life. Patients with moderate to severe pain often require opioid analgesics. Recently published guidelines

Approximately 54,400 new cases of transitional cell carcinoma of the bladder were reported in the United States in 1999, with an estimated 12,500 deaths attributable to this cancer. Close to 75% of all bladder tumors are confined

Recent studies have elucidated some of the molecular and cellular mechanisms that determine the sensitivity or resistance to ionizing radiation. These findings ultimately may be useful in devising new strategies to improve the

In 1999, metastatic breast cancer claimed the lives of almost 45,000 women. For the vast majority of patients, metastatic breast cancer is an incurable disease with a median survival of only 2 to 3 years after diagnosis. The

Several recent studies have addressed the management of infectious problems in patients with acute leukemia. Although those studies have served to emphasize the fundamental management principles formulated and proven

Based on an educational session featured at the 1999 annual meeting of the American Society of