FDA Guidances for Early Human Testing of New Drugs
March 1st 2006Officials at the National Cancer Institute have welcomed two new guidance documents issued by the FDA. The two aim at making it easier for clinical researchers to conduct small-scale human studies of exploratory drugs prior to phase I trials. The documents are designed to increase the number of promising drugs that researchers can evaluate by administering them at microdose levels to small numbers of patients before deciding whether the agents warrant further human study.
Inpatient Hem/Onc Unit Adds Phase I Clinical Trial Program
March 1st 2006When an adjacent hospital closed its research unit with cancer trials pending, the Arthur G. James Cancer Hospital, Ohio State Univesity, Columbus, successfully added a clinical study component to an existing hematology-oncology unit, to ensure that patients could enroll in phase I trials and receive the care they need during their enrollment.
North Shore-LIJ Opens $17 Million Monter Cancer Center
March 1st 2006The North Shore-Long Island Jewish (LIJ) Health System has opened its Monter Cancer Center, a $17 million, 37,000-square-foot facility that offers a spectrum of cancer services in a stunning outpatient setting, providing patients with a calming atmosphere complete with indoor gardens and skylights.
Unrelated CBTs Successful in Adult Acute Leukemia Pts
March 1st 2006Unrelated cord blood transplantation (UCBT) appears at least as effective as haploidentical T-cell-depleted peripheral blood stem cell transplantation (PBSCT) in adults with acute leukemia, with outcomes varying according to leukemia subtype, according to a retrospective analysis of European transplant patients.
Longer PFS With Maintenance Rituximab After CVP in FL
March 1st 2006In patients undergoing treatment for follicular lymphoma, (FL) maintenance rituximab (Rituxan) after a cyclophosphamide, vincristine, and prednisone (CVP) regimen appears to confer a survival benefit, Sandra Horning, MD, professor of medicine, Stanford University, said at the 47th Annual Meeting of the American Society of Hematology (abstract 349).
Clinical Care Doesn't End Post-treatment
March 1st 2006This case study illustrates some of the off-treatment issues your patients may face and provides some practical solutions to help patients overcome them whether you see them for regular follow-up or just receive an occasional phone call requesting assistance.
With Baby Boomers Aging, Medicare Financing System Must Be Restructured
March 1st 2006The Medicare program needs to be restructured if it is to remain solvent for the generation of baby boomers now reaching age 60. Since many cancer patients are Medicare beneficiaries, the health of the program is vital to the oncology community.
Commentary (Burt): Genetics of Colorectal Cancer
March 1st 2006Approximately 6% of colorectal cancers can be attributed to recognizable heritable germline mutations. Familial adenomatous polyposis is an autosomal dominant syndrome classically presenting with hundreds to thousands of adenomatous colorectal polyps that are caused by mutations in the APC gene.
Commentary (Offit): Genetics of Colorectal Cancer
March 1st 2006Approximately 6% of colorectal cancers can be attributed to recognizable heritable germline mutations. Familial adenomatous polyposis is an autosomal dominant syndrome classically presenting with hundreds to thousands of adenomatous colorectal polyps that are caused by mutations in the APC gene.
Commentary on Abstracts #613, #1645, #1035, and #1384
February 2nd 2006Thalidomide (Thalomid) has been commercially available in the United States since October 1998. The use of thalidomide in the treatment of malignancies is growing as its potential utility for treating multiple myeloma, renal-cell cancer, and AIDS-
Cancer Genome Atlas Launched With $100 Million Pilot
February 1st 2006The Cancer Genome Atlas (TCGA) will begin with a $100 million pilot project aimed at determining the feasibility of undertaking a full-scale, comprehensive effort to systematically identify and characterize the genetic mutations and other genomic changes associated with cancer.
Process of Angiogenesis Plays a Role in Response of Cancers to Radiation Therapy
February 1st 2006Research on angiogenesis is revealing the role this phenomenon plays in the response of cancers to radiation and, in the process, providing some important lessons for clinicians, according to a keynote address given by Judah Folkman, MD, professor of cell biology, Children's Hospital and Harvard Medical School, at the 47th Annual Meeting of the American Society for Therapeutic Radiology and Oncology.
Anti-TGF-β Reduces RT-Induced Lung Injury in Animals
February 1st 2006An antibody to transforming growth factor-β (TGF-β) attenuates the inflammatory and fibrotic response that occurs in normal lung tissue after radiation, investigators reported at the 47th annual meeting of the American Society for Therapeutic Radiology and Oncology (abstract 137).
Gene Expression Signatures Find Best Tumor/Drug Match
February 1st 2006Researchers have developed a new approach to drug discovery that takes advantage of the gene expression signatures of tumors to generate potential drug matches. A proof-of-principle of this technique revealed a potential new combination therapy for children with acute lymphocytic leukemia (ALL).
Rituximab Plus GM-CSF Active in CLL Patients, Including Elderly Untreated
February 1st 2006A combination regimen of rituximab (Rituxan) plus granulocyte-macrophage colony-stimulating factor (GM-CSF) appears to induce objective responses in patients with chronic lymphocytic leukemia (CLL), particularly in elderly untreated patients, according to a study presented at the 47th Annual Meeting of the American Society of Hematology (abstract 721).
Bendamustine Active in Pts With Refractory B-Cell NHL
February 1st 2006The novel alkylating agent bendamustine appears to induce responses in patients with refractory B-cell non-Hodgkin's lymphoma (NHL), Jonathan W. Friedberg, MD, of the James P. Wilmont Cancer Center, Rochester, New York, said at the 47th Annual Meeting of the American Society of Hematology (abstract 229). The study was sponsored by Cephalon, Inc., which is developing the new agent as Treanda.
Everyone's Guide to Cancer Supportive Care
February 1st 2006As an oncologist, I am always on the lookout for good patient education material. This book, which is based on the experience of the Stanford Integrative Medicine Clinic Cancer Supportive Care Program, is a good choice for a highly literate, print-oriented patient or family member. The book is divided into five parts: (1) Cancer: Diagnosis, Information, and Treatment, (2) The Role of the Mind, (3) The Care of the Body, (4) Supportive and Social Services for Life and Death Issues, (5) Planning for the Future, and (6) Resources. These five parts are divided into 50 individual chapters covering specific topics, and the chapters are focused, concise, and practical.
A World Away: So Much Need, So Few Resources
February 1st 2006Last year, I had the opportunity to spend a week at a cancer institute in equatorial Africa. A colleague of mine, Waafa El-Sadr, MD, heads a Columbia University program establishing health-care units in African nations to treat HIV-infected people with antiretro-viral drugs. Waafa was initiating one such unit at the Ocean Road Cancer Institute (ORCI) in Dar el Salaam, Tanzania. When doctors there expressed a need for a visiting oncologist to update them on issues relevant to HIV-infected patients with cancer, Wafaa thought of me. She felt that my experience treating AIDS patients in the days prior to the elaborate regimens we now have would be particularly instructive in the ORCI setting.
Management of Cancer in the Elderly
February 1st 2006With the aging of the Western population, cancer in the older person is becoming increasingly common. After considering the relatively brief history of geriatric oncology, this article explores the causes and clinical implications of the association between cancer and aging. Age is a risk factor for cancer due to the duration of carcinogenesis, the vulnerability of aging tissues to environmental carcinogens, and other bodily changes that favor the development and the growth of cancer. Age may also influence cancer biology: Some tumors become more aggressive (ovarian cancer) and others, more indolent (breast cancer) with aging. Aging implies a reduced life expectancy and limited tolerance to stress. A comprehensive geriatric assessment (CGA) indicates which patients are more likely to benefit from cytotoxic treatment. Some physiologic changes (including reduced glomerular filtration rate, increased susceptibility to myelotoxicity, mucositis, and cardiac and neurotoxicity) are common in persons aged 65 years and older. The administration of chemotherapy to older cancer patients involves adjustment of the dose to renal function, prophylactic use of myelopoietic growth factors, maintenance of hemoglobin levels around 12 g/dL, and proper drug selection. Age is not a contraindication to cancer treatment: With appropriate caution, older individuals may benefit from cytotoxic chemotherapy to the same extent as the youngest patients.
Commentary (Muss): Management of Cancer in the Elderly
February 1st 2006With the aging of the Western population, cancer in the older person is becoming increasingly common. After considering the relatively brief history of geriatric oncology, this article explores the causes and clinical implications of the association between cancer and aging. Age is a risk factor for cancer due to the duration of carcinogenesis, the vulnerability of aging tissues to environmental carcinogens, and other bodily changes that favor the development and the growth of cancer. Age may also influence cancer biology: Some tumors become more aggressive (ovarian cancer) and others, more indolent (breast cancer) with aging. Aging implies a reduced life expectancy and limited tolerance to stress. A comprehensive geriatric assessment (CGA) indicates which patients are more likely to benefit from cytotoxic treatment. Some physiologic changes (including reduced glomerular filtration rate, increased susceptibility to myelotoxicity, mucositis, and cardiac and neurotoxicity) are common in persons aged 65 years and older. The administration of chemotherapy to older cancer patients involves adjustment of the dose to renal function, prophylactic use of myelopoietic growth factors, maintenance of hemoglobin levels around 12 g/dL, and proper drug selection. Age is not a contraindication to cancer treatment: With appropriate caution, older individuals may benefit from cytotoxic chemotherapy to the same extent as the youngest patients.