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WASHINGTON—When David Satcher, MD, was 6 years old, he told everyone he wanted to be a doctor. Now 58, Dr. Satcher presides as the nation’s top physician, the US Surgeon General.

VIENNA, Austria-Even cancer patients whose pain is well controlled with regular daily opioids sometimes need rescue doses for breakthrough pain. For inpatients, this is often done with injected doses. Hakan Samuelsson, MD, has tested an injector pen that patients can use for self-administration of rescue doses. A pilot study suggests that this approach may be a useful option for most patients who need rescue opioid doses, he reported at the 9th World Congress on Pain.

NEW YORK–A favorable long-term prognosis makes sentinel lymph node biopsy unnecessary for the vast majority of patients with ductal carcinoma in situ (DCIS), New York investigators have concluded from a 15-year follow-up of more than 300 patients.

NEW ORLEANS-Hairy cell leukemia (HCL) has the highest reported surface expression of CD20 of leukemias studied to date, according to research reviewed at the ASH meeting. In a symposium presentation, Deborah A. Thomas, MD, and colleagues from the M.D. Anderson Cancer Center in Houston, reported that the anti-CD20 monoclonal antibody rituximab (Rituxan) is active against HCL. Response appears to correlate with a decrease in serum interleukin-2 (IL-2) receptor levels. In a poster presentation, Robert J. Kreitman, MD, and colleagues from the National Cancer Institute reported that recombinant immunotoxins containing truncated Pseudomonas exotoxin and targeting either CD25 or CD22 can induce some major responses in patients with refractory HCL.

Former US surgeon general C. Everett Koop, MD, and Quintiles Transnational Corp. have launched an interactive, consumer Internet resource to enable interested individuals to sign up online for possible participation in clinical drug trials via the

NEW ORLEANS-Patients undergoing staged breast reconstruction with saline-filled implants and subsequent radiation therapy experienced more complications and required more replacement procedures than patients who underwent reconstruction without radiation therapy, according to a retrospective study presented at the 68th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons (now the American Society of Plastic Surgeons).

In a significant advance in the treatment of acute childhood lymphoblastic leukemia (ALL), researchers from the Pediatric Oncology Group have found that the use of drugs known to cross into the central nervous system results in high survival rates

VIENNA, Austria-A new oral inhalation system for morphine is almost as efficient as IV dosing, Aradigm Corp and SmithKline Beecham researchers reported at the 9th World Congress on Pain. B. A. Otulana, MD, said that the dose-corrected bioavailability of morphine with the new device was 75% of that with intravenous morphine, a major increase over the 5% bioavailability achieved with other nebulizers. This approach might provide a useful, noninvasive alternative to parenteral morphine administration.

SAN DIEGO-Patients with relapsed or refractory low-grade or follicular non-Hodgkin’s lymphoma (NHL) may respond to rituximab (Rituxan) up to 4 months after completion of therapy. Salvage therapy should therefore be delayed at least until that time for patients with stable disease after rituximab treatment, Antonio J. Grillo-Lopez, MD, of IDEC Pharmaceutical Corp., advised in a poster presentation at the ASH meeting.

BETHESDA, Md-The Adult AIDS Clinical Trials Group (AACTG) will continue its research activities for another 5 years under a new grant from the National Institute of Allergy and Infectious Diseases. NIAID will provide the group $80 million in the first year of renewed funding.

Just deciding to go out for an evening can be a big decision for someone taking care of a sick family member. The caregiver can feel guilty or may not have anyone to take care of the sick relative, or may simply feel too depressed to go

BALTIMORE-The monoclonal antibody rituximab (Rituxan) may be effective in purging in vivo autografts for indolent lymphoma, and post-transplant may serve as adjuvant immunotherapy, according to research presented at the ASH meeting.

HERSHEY, Pennsylvania-A phase II study is about to begin testing a novel approach to enhancing the effectiveness of chemotherapy, one that uses a new agent to deactivate a critical DNA repair mechanism in malignant cells. Shutting down this repair system appears to increase the killing power of currently available drugs that work by disrupting DNA.

NEW ORLEANS—A new technique for breast reconstruction, used after a new method of skin-sparing mastectomy, offers patients a scar-free result, according to the surgeon who developed the method, Gino Rigotti, MD, head of the Plastic Surgery Department, Verona General Hospital, Italy.

DURHAM, North Carolina-Umbilical cord blood transplantation may be a viable option for adult patients with hematologic malignancies who do not have suitably matched donors as a source of stem cells, according to reports presented at the ASH meeting.

NEW ORLEANS-Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) may benefit from treatment with monoclonal antibody treatments directed against the CD20 and/or CD52 antigens, according to data presented at the ASH meeting. Increasing dosing frequency of rituximab (Rituxan) to three times per week produced responses in half of CLL/SLL patients treated in a phase I/II trial reported by John C. Byrd, MD, of the Hematology-Oncology Service at Walter Reed Army Medical Center, Washington, DC. In a separate study at M.D. Anderson Cancer Center in Houston, one-third of patients with CLL refractory to fludarabine (Fludara) responded to the anti-CD52 monoclonal antibody Campath-1H.

NANTES, France-High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) leads to better event-free survival and freedom from progression in people with intermediate and high-grade non-Hodgkin’s lymphomas (NHL) than does the standard therapy. That was conclusion of a randomized trial comparing autologous PBSCT with CHOP (cyclophosphamide, doxorubicin, Oncovin, prednisone) and reported by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes, at the ASH meeting.

NEW ORLEANS-Combining rituximab (Rituxan) with the conventional CHOP regimen can produce prolonged disease-free survival in low-grade lymphomas and can increase complete response (CR) rates to over 60% in patients with intermediate-grade or high-grade non-Hodgkin’s lymphoma (NHL). These results from two separate studies were reported at poster presentations at the American Society of Hematology (ASH) meeting.

ROCKVILLE, Maryland—The monoclonal antibody rituximab (Rituxan), which is directed against the CD20 antigen expressed in most B-cell malignancies, can be given repeatedly to patients with non-Hodgkin’s lymphoma (NHL) and may produce longer responses with retreatment. This unusual increase in response duration is in contrast to the ever-diminishing efficacy seen with repeated rounds of chemotherapy, researchers reported at the ASH meeting. The increase may indicate that some novel anti-tumor immune response is acting in addition to classic antibody-dependent, cell-mediated cytotoxicity (ADCC) in patients who respond to rituximab.

SEATTLE-A new chemotherapy agent called CMA-676 that specifically targets tumor cells led to remissions in 34% of patients with acute myeloid leukemia (AML) in relapse and was well tolerated. Eric Sievers, MD, of the Fred Hutchinson Cancer Research Center reported the results of the phase II trial at the ASH meeting.

NANTES, France-The anti-CD20 monoclonal antibody rituximab (Rituxan) produced a 69% overall response rate in patients with B-cell post-transplant lymphoproliferative disease (PTLD), according to a retrospective analysis presented at the ASH meeting by Noël Milpied, MD, of the Centre Hospitalier Regional et Universitaire de Nantes. The analysis also showed that rituximab is effective in both solid organ and bone marrow transplant recipients (see Table 1).

ROCHESTER, Minnesota-Adding a radioactive antibody aimed at the CD20 antigen to rituximab (Rituxan), a chimeric anti-CD-20 antibody, raised overall response rates to 80% and complete response rates to 21% in patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL). Preliminary data from this multicenter trial was reported at the ASH meeting by Thomas E. Witzig, MD, of the Mayo Clinic.

At the beginning of the 1997 International Union AgainstCancer (UICC) conference in Kobe, Japan, the speakers invoked Buddhist imagery to inspire the audience to embrace cancer genetics in the “battle” against “the enemy.” Asura, a figure with

The article by Laheru and Jaffee offers an excellent summary of immunotherapies for gastrointestinal malignancies. Thoughtful descriptions of the antibody, cytokine, and cel- lular components of the immune system provide useful background information that facilitates an understanding of specific passive and active cancer immunotherapies. Immunotherapies that have demonstrated efficacy in colon cancer clinical trials, including levamisole (Ergamisol), passive monoclonal antibody vaccines, and bacillus Calmette- Guérin (BCG)–autologous tumor vaccines, are appropriately reviewed. In addition, novel approaches at varying stages of clinical testing are clearly summarized; these include the use of an anti-idiotypic antibody, genetically modified tumor and dendritic cells, recombinant protein, and viral and DNA vaccines. Some additional approaches, studies, and perspectives are also worthy of mention as a supplement to this review.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in

The number of autologous periperal blood progenitor cell (PBPC) transplants performed annually has increased dramatically over the past decade. Autologous PBPC transplants have quickly moved from the exclusive province of the academic medical center to part of the armamentarium of the practicing community oncologist

Dr. Costabile presents a thorough review of the biological causes of erectile dysfunction after cancer treatment and of our current range of medical treatments to restore erections. I believe, however, that despite the technical progress made in understanding and remediating erectile dysfunction during the last 20 years, the majority of men who develop such problems following cancer treatment still do not resume a satisfying sex life.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Erectile dysfunction is a common occurrence as men age. Approximately 20% of men over the age of 50 years report difficulty in achieving or maintaining an erection, and as many as 60% of men age 70 and older suffer from erectile dysfunction.[1]

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients