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ORLANDO--Just as oncologists base treatment decisions on disease stage, they may base business decisions on the stage of the managed care market in their area, said Paula Filler, vice president of the Sachs Group, Maplewood, NJ, in her presentation at an education meeting of the American Society of Clinical Oncology (ASCO).

The chairpersons of six National Cancer Institute (NCI)-sponsored cooperative groups have announced the formation of a new entity called the Coalition of National Cancer Cooperative Groups, Inc. The coalition was formed to establish a common platform upon which the cooperative groups can operate, while remaining complementary to the work already being performed within the existing NCI structure.

Researchers looking at a group of leukemia patients have found that a genetic defect that they discovered 2 years ago serves as an early warning signal, calling for a more aggressive approach to treatment in these patients.

BETHESDA, Md--Officials of the National Cancer Institute (NCI) and the Environmental Protection Agency (EPA) are attempting to resolve their conflicting interpretations of data regarding cancer in children. The NCI has forcefully challenged the EPA’s contention that the United States is in the midst of an epidemic of childhood malignancies.

SAN ANTONIO--Women who have locoregional cancer recurrence after breast-conserving surgery and radiation therapy can safely undergo immediate breast construction and use of a TRAM flap after mastectomy for the recurrent disease. However, the breast reconstruction procedure should include use of a free flap, which has a lower risk of necrosis and flap loss than pedicle flaps, Bonnie Baldwin, MD, said at the San Antonio Breast Cancer Symposium.

CHICAGO--The drop in AIDS mortality in 1997 in New York City, one of the epicenters of the epidemic in the United States, more than matched the overall US decline in deaths due to AIDS recorded in the first half of last year (48% vs 44%).

FORT LAUDERDALE, Fla--Opinions from a diverse panel of experts, expressed at a special session of the NCCN (National Comprehensive Cancer Network) third annual conference, reflect a nation heading toward convergence on the issue of providing broad access to peer-reviewed clinical trials.

SILVER SPRING, Md--On September 26, 1998, an event known to its organizers as simply "The March" will take place across the nation. Conceived by Ellen L. Stovall, executive director of the National Coalition for Cancer Survivorship, "The March: Coming Together to Conquer Cancer" is not a march in the traditional sense, but will encompass many different events in many cities.

ORLANDO--Whether women age 40 to 49 should have routine mammo-gram screening continues to be debated, but a University of Chicago study shows that women in this age group benefit from mammography screening as much as women over 50. Jeffrey D. Bradley, MD, lead study author, presented the finding at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).

WASHINGTON--Medicare patients who participate in most clinical cancer trials sponsored by the federal government would have their patient-care costs covered for the first time, under a proposal contained in President Clinton’s budget request for fiscal year 1999.

WASHINGTON--A survey of an industry trade group finds that US research-based pharmaceutical companies plan to spend $20.6 billion for research and development in 1998, an amount equal to 19.6% of the industry’s projected annual revenues. This represents an increase of 10.7% over last year’s R&D funding by the companies, according to the Pharmaceutical Research and Manufacturers of America (PhRMA).

DALLAS--The Susan G. Komen Breast Cancer Foundation, producer of the country’s largest series 5K runs known as Race for the Cure, today announced nine new race sites for the 1998 series, bringing the total number of run/fitness walks to 86. Sites added include Austin, Texas; Evansville, Indiana; Grand Rapids, Michigan; Greeley, Colorado; Madison, Wisconsin; Richmond, Virginia; San Antonio, Texas; Thibodaux, Louisiana; and Tupelo, Mississippi.

SAN BRUNO, Calif--Practice guidelines and outcomes measurement are increasingly viewed as the keys to lowering medical costs while maintaining quality. Once guidelines are devised, the next step is implementation, and this may best be achieved by making guidelines readily accessible via computer programs.

WASHINGTON--One key element to increasing survivorship among lung cancer patients lies in finding ways to detect the disease early, and recent results in the quest for a preclinical biomarker for the malignancy offer great promise, a National Cancer Institute scientist told a Capital Hill briefing.

A steroid drug enhances the ability of a vitamin D analog to kill cancer while reducing a potentially serious side effect of vitamin D therapy, according to investigators at the University of Pittsburgh Cancer Institute (UPCI). Their findings on dexamethasone and the vitamin D derivative, 1,25-dihydroxyvitamin-D³ (1,25-D³), in an animal model were reported in the January 21, 1998, issue of the Journal of the National Cancer Institute.

CHICAGO--A new recipe for the "cocktail" of drugs used to suppress HIV calls for a doubling of the protease inhibitor component, researchers reported at the Fifth Conference on Retroviruses and Opportunistic Infections. Joseph P. Eron, MD, of the University of North Carolina, Chapel Hill, described a phase II open-label study comparing four regimens.

College students who smoke not only are endangering their health but also are likely to have adopted other risky behaviors. A new study by researchers at Dana-Farber Cancer Institute and the Harvard School of Public Health has found that college students who smoke are more likely to use marijuana and other illegal drugs, to be sexually promiscuous, and to be uninvolved in sports and athletic activities.

RESEARCH TRIANGLE PARK, NC--A federal panel has recommended to the National Toxicology Program (NTP) that it review and possibly test a group of products, including three herbs, for their potential to cause cancer or to lead to reproductive and developmental problems.

New research has found the gene responsible for Peutz-Jeghers syndrome, a rare inherited disorder that can lead to cancer in many different organs. Unexpectedly, the work may also have uncovered a new category of tumor-suppressor genes.

ORLANDO--For the first time, the keynote address at the American Society for Therapeutic Radiology and Oncology (ASTRO) meeting was delivered by a psychiatrist--Dr. David Spiegel, of Stanford University School of Medicine--who advised the group on how to help their cancer patients cope with their diagnosis.

Approximately 10% of all epithelial ovarian carcinoma cases are associated with inheritance of an autosomal-dominant genetic mutation conferring a predisposition to cancer with variable penetrance. Two such manifestations

Pharmacoeconomics and outcomes research are two new sciences that are beginning to affect the practice of oncology. As cost awareness in cancer care becomes acute, practicing oncologists must understand how to apply these sciences to their practices. This publication represents the proceedings of the symposium, Economics and Quality of Life in Oncology Clinical Practice, which was held on November 19, 1997, on the occasion of the EORTC meeting during The First European Conference on the Economics of Cancer. The presentations at the symposium provided an overview of some studies that have begun to explore the variety of activities comprising outcomes assessment, and how such data can be used to help deliver high quality patient care in a cost-conscious environment.

Cancer researchers and clinicians need to adopt a new attitude toward race classifications as interracial parentage in the United States continues to increase. “I want to uncouple race and genetics,” stated Edison Liu, MD, at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer held in Washington, DC.

Postmenopausal minority women can be successfully recruited for a program to reduce dietary fat and can achieve significant changes in their eating habits, stated Carolyn K. Clifford, phd, at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer in Washington, DC.

Of acute-care doctors and nurses responding to a national survey, 62% said that clinically hopeless patients have a “dignified death” in the hospital only “sometimes.” Another 33% said that this scenario occurs “frequently,” and just 5% said “always.”

Diet is a well-established factor in cancer prevention. According to two Baylor College of Medicine researchers, cultural factors play a more powerful role than cost in determining the food choices of people with low incomes. Speaking at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer, the researchers said that blacks and Hispanics typically eat a less healthy diet than whites, but not because of cost.

WASHINGTON--One of Shakespeare’s characters wanted to "kill all the lawyers." Rep. Scott McInnis (R-Colo) just wants to cap their legal fees, at least in any national tobacco agreement. In introducing a bill to limit any legal fees from a settlement to $150 an hour plus expenses, Rep. McInnis noted that some states have entered into contracts with private attorneys that called for payments of up to 25% of funds collected from tobacco cases.

BETHESDA, Md--The new consumer liaison group to the NCI director has chosen three of its 15 members to serve as co-chairs and has identified four areas of concern for its initial attention.

Regardless of their race, poor rural Americans face similar problems that make it extremely difficult for them to receive adequate health care, reported two experts at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer in Washington, DC. Many rural Americans are white working poor, noted Linda Linville, phd, assistant director for cancer control at the University of Kentucky Markey Cancer Center in Lexington. Although they technically do not belong to a racial minority, white working poor individuals generally are among the medically underserved.

TUCSON--The Arizona Cancer Center has received a 5-year, $500,000 Bristol-Myers Squibb Unrestricted Cancer Research Grant. Sydney E. Salmon, MD, Regents Professor of Medicine and director of the center, will serve as the grant administrator. Dr. Salmon announced the new funding at a ceremony held to dedicate the center’s $22.5 million expansion project adding 30 new cancer research laboratories to the center.