Initial Size of Aggressive Lymphoma Guides RT Dose
March 1st 2001CHICAGO-A study of 129 patients with intermediate-grade and large-cell immunoblastic lymphomas shows that the radiotherapy dose should be adjusted to the initial size of the tumor, said Richard Wilder, MD, assistant professor of radiation oncology, M.D. Anderson Cancer Center. The study constitutes the largest series of these patients in the modern era of chemoradiation, he said.
Group Room Radio Goes International
March 1st 2001LOS ANGELES-The Group Room, a weekly syndicated radio call-in talk show about cancer, is expanding internationally after 5 successful years of broadcasting in the United States. Vital Options TeleSupport Cancer Network, the not-for-profit cancer communications, advocacy, and support organization that produces the show, announced that its first live broadcast from Europe took place January 28, 2001, at The Royal Marsden Hospital, London. A broadcast from Paris followed on February 9. Selma R. Schimmel is host of The Group Room and CEO and founder of Vital Options.
Panel Supports Letting FDA Regulate Tobacco Industry
March 1st 2001WASHINGTON-The President’s tobacco commission is supporting the federal regulation of tobacco products. The Supreme Court ruled last March that the Food and Drug Administration (FDA) does not have the authority to regulate tobacco products, and federal legislation that would have provided the agency with the ability to regulate tobacco products failed in Congress last year.
Rituximab in the Treatment of Autoimmune Hemolytic Anemia
March 1st 2001Based on a previously published experience (Blood 92:3409, 1998), 5 additional patients with autoimmune hemolytic anemia (AIHA) have since been treated with rituximab (Rituxan). We present a summary of all 6 patients (5 female, 1 male;
Trends in Cigarette Smoking Among High School Students: United States, 1991-19
March 1st 2001One of the 10 leading health indicators that reflect the major health concerns in the United States is cigarette smoking among adolescents. To examine changes in cigarette smoking among high school students in the United States from 1991 to 1999, the
New Patient Privacy Regulations May Hinder Research
March 1st 2001WASHINGTON-New patient privacy regulations instituted by the Department of Health and Human Services (HHS) will affect oncology from research to private practice. The new rules set privacy standards governing the release of health information that might reveal the identity of individual patients.
FDA Grants Marketing Clearance for New Formulation of Fluorouracil
March 1st 2001The US Food and Drug Administration (FDA) recently granted marketing clearance for a new formulation of fluorouracil (5-FU) as treatment of actinic keratoses. This "Microsponge" formulation of the antimetabolite, manufactured by Advanced
Ibritumomab tiuxetan (Zevalin) consists of an anti-CD20 murine IgG1 kappa monoclonal antibody covalently bound to tiuxetan (MX-DTPA), which stably chelates yttrium-90 for therapy. Ibritumomab tiuxetan therapy involves pretreatment with
Ibritumomab tiuxetan (Zevalin) is a murine anti-CD20 monoclonal antibody covalently bound to the chelator tiuxetan, which can securely chelate yttrium-90. We performed a randomized controlled trial
Systemic Therapy for Older Women With Breast Cancer
March 1st 2001Cancer and aging seem to go hand in hand. Most cancers and most cancer deaths occur in individuals over age 65 years. Likewise, as we age, osteoarthritis, heart disease, diabetes, and memory lapses seem to become part of our daily burden. Drs. Kimmick and Muss have detailed a strategy for managing breast cancer in older women. However, as they point out, there are several problems with defining optimal therapy for the elderly.
Empiric Antifungal Therapy for the Neutropenic Patient
March 1st 2001Among the most significant complications a neutropenic patient can experience is an invasive fungal infection. In this issue of Oncology, Drs. Wingard and Leather thoroughly review the epidemiology, clinical presentation, and empiric treatment of these infections, particularly those associated with Candida and Aspergillus. They emphasize the need for better methods of identifying individuals at high-risk for invasive fungal infections because those individuals are more likely to benefit from antifungal prophylaxis or empiric therapy. The goal of such a targeted approach is to limit the amount of antifungal agents given, thereby decreasing the number of adverse effects and diminishing the selection of antifungal-resistant species.[1]
Empiric Antifungal Therapy for the Neutropenic Patient
March 1st 2001The article written by Drs. Wingard and Leather presents a thoughtful review of the current approaches to empiric antifungal therapy in neutropenic patients. Empiric antifungal therapy has evolved as a standard of care for the prevention of invasive fungal infections in neutropenic patients who remain persistently febrile despite the use of broad-spectrum antibacterial antibiotics.[1-3] Empiric antifungal therapy in this setting provides early treatment for clinically occult invasive fungal infections and systemic prophylaxis for neutropenic patients at highest risk.
Systemic Therapy for Older Women With Breast Cancer
March 1st 2001Breast cancer is a common problem in older women. As the number of medical illnesses increases with age and the life expectancy decreases, the benefits of systemic therapy for women with breast cancer become questionable. All women over age 65 years are at high enough risk of breast cancer to consider the risk/benefit ratio of preventive therapy with tamoxifen (Nolvadex) or participation in the Study of Tamoxifen and Raloxifene (STAR) trial. Adjuvant chemotherapy and hormonal therapies for early breast cancer significantly improve disease-free and overall survival; recommendations for their use are based on risk of tumor recurrence. Use of tamoxifen in the adjuvant setting in women with receptor-positive tumors is a relatively simple decision in light of its favorable toxicity profile. The delivery of adjuvant chemotherapy is a more complicated decision, and the patient’s wishes, estimated life expectancy, presence of comorbid conditions, and estimated benefit from treatment should be considered. The primary goal of the treatment of metastatic breast cancer is palliation. We discuss trials specific to older women and make appropriate treatment recommendations. Unfortunately, there is a paucity of data from clinical trials in women over age 70 years. However, because the clinical trial is the primary scientific mechanism for testing the efficacy of a treatment, every effort should be made to enter older women into treatment protocols. [ONCOLOGY 15(3):280-299, 2001]
High-dose therapy (HDT) with peripheral blood stem cell transplantation is a treatment option for patients with advanced follicular, marginal, and mantle cell lymphoma. In this setting, frequent contamination of peripheral blood stem cell harvests by
Tositumomab/iodine-131 tositumomab (Bexxar) is a radioimmunotherapeutic agent in development for patients with low-grade or transformed non-Hodgkin’s lymphoma (NHL). This analysis focuses
Brachytherapy for Carcinoma of the Lung
March 1st 2001An estimated 157,000 patients died of lung cancer in the United States in the year 2000.[1] Although surgery can be curative, only about 20% of patients are amenable to complete surgical resection. Most of the other patients are treated with radiation
Activated T Cells Can Alter Behavior of Leukemic B Cells
February 1st 2001SEATTLE-Xcyte Therapies is testing in preclinical studies the feasibility of a new technology that would take T cells from patients with B-cell chronic lymphocytic leukemia (B-CLL) and spur them into action with key antibodies, with the goal of reinfusing them into the patient ready to fight B-cell tumors. Mark L. Bonyhadi, PhD, of Xcyte Therapies in Seattle, Washington, reported that the company’s Xcellerate technology "produces activated T cells that can interact with leukemic B cells and alter their behavior in vitro. We hope this will be followed by apoptosis or clearance of B cells in B-CLL patients."
Response Continues for at Least 8 Months with Ibritumomab Tiuxetan
February 1st 2001ROCHESTER, Minnesota-More than half of follicular non-Hodgkin’s lymphoma (NHL) patients who progress after rituximab (Rituxan) treatment respond to the experimental drug ibritumomab tiuxetan (Zevalin), according to a multicenter clinical trial. Although most of the study’s 54 patients had only partial remissions after treatment with ibritumomab tiuxetan, their response continued for at least 8 months. In some cases, remissions have lasted up to 2 years.
Chemotherapy Without Methotrexate Achieves Superb Results in Children With NHL
February 1st 2001NEW YORK-Short-term, intensive multiagent chemotherapy without high-dose methotrexate produces excellent outcomes in children with advanced non-lymphoblastic non-Hodgkin’s lymphoma, according to a Children’s Cancer Group (CCG) study. The estimated 5-year event-free survival (EFS) was 77% and the overall survival rate was 80% for the 39 patients enrolled in the pilot study, according to lead researcher Mitchell S. Cairo, MD, director of Pediatric Blood and Marrow Transplantation at Columbia University, New York.
Iodine I 131 Tositumomab Induces Response in 70% of Patients Progressing After Rituximab
February 1st 2001STANFORD, California-Seventy percent of low-grade and transformed low-grade non-Hodgkin’s lymphoma (NHL) patients respond to the drug iodine I 131 tositumomab (Bexxar) even though progressing after rituximab (Rituxan). A study of 40 patients who had previously failed to respond or progressed on rituximab, also showed that 40% had a complete response or remission after treatment with iodine I 131 tositumomab.
Ibritumomab Tiuxetan Produces 73% Response Rate in B-cell NHL
February 1st 2001ROCHESTER, Minnesota-A phase-III clinical trial has shown that 73% of B-cell non-Hodgkin’s lymphoma (NHL) patients respond to the radioimmunotherapy ibritumomab tiuxetan (Zevalin) vs 47% for rituximab (Rituxan). The study concluded that ibritumomab tiuxetan (Zevalin) is not only safe and effective, but the objective response rates achieved with it are statistically superior to those achieved with rituximab alone.