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Hepatocellular carcinoma (HCC) is the third most frequent cause of cancer death worldwide, causing 549,000 deaths in 2000-10% of all cancer deaths. There are strong etiologic associations with hepatitis C, hepatitis B, alcohol, other causes of cirrhosis, and dietary aflatoxins. The US incidence of HCC is 2.4/100,000 persons/year and rising due to the increased prevalence of hepatitis C.[1] After the current cohort of patients infected with the chronic hepatitis C virus passes, there will likely be a continued increase in the US incidence of HCC due to increasing rates of obesity-related nonalcoholic steatohepatitis, which causes many cases of "cryptogenic cirrhosis."

Surgery has evolved to become the standard of care for a defined subset of patients with hepatic colorectal metastases. Hepatic resections are now well-controlled procedures, with several centers reporting very low perioperative mortality rates.

In this article, Ravikumar and Gallos nicely summarize the current understanding of liver resection for metastases. My comments here will be limited to resection of colorectal metastases, as this is the most common and best characterized of the procedures described.

In this article, we present current surgical perspectives on the management of liver metastases, with a focus on state-of-the-art resection, by drawing on clinical data provided in the medical literature. Metastases from

Experts in cancer immunology and vaccine therapies discussed recent progress in cancer vaccine development at a satellite symposium of the 38th Annual Meeting of the American Society of Clinical Oncology (ASCO). More than 300

An estimated 14,600 new cases of multiple myeloma will be diagnosed in the United States in 2002. Multiple myeloma remains an incurable disease despite significant improvements in complete response rates and overall

The 4th Investigators’ Workshop sponsored by The University of Texas M. D. Anderson Cancer Center was held on July 25-29, 2001, in Colorado Springs, Colorado. The purpose of these annual workshops has been to review the latest data on new agents, with a particular focus on the broadly used agent irinotecan (CPT-11, Camptosar).

WASHINGTON-Final regulations issued by the Department of Health and Human Services guarantee Medicaid beneficiaries enrolled in managed care plans the same protections granted to people in private plans under legislation pending

Cancer Care has published the fourth edition of its handbook-A Helping Hand: The Resource Guide for People With Cancer. The 148-page booklet contains listings and descriptions of organizations that offer a wide variety of services, support, and information for people with cancer. In general, the booklet shows cancer patients what types of help are available to them and where they can find it, both nationally and regionally. Listings include cancer centers, commercial services that offer products of particular interest to people with cancer (such as wigs and prostheses), state pharmaceutical assistance programs, pharmaceutical manufacturers’ indigent drug programs, and useful tips on what to ask when contacting such services.

LUGANO, Switzerland-The chemotherapy/immunotherapy regimen FCR (fludarabine, cyclophosphamide, rituximab) has produced the highest complete response (CR) rate seen thus far in first-line treatment of chronic lymphocytic leukemia

Now that President Bush has appointed Julie Gerberding to head the Centers for Disease Control and Prevention (CDC), groups like the Trust for America’s Health are urging her to make cancer tracking a priority.

ORLANDO-Irinotecan, also known as CPT-11 (Camptosar), administered every 3 weeks to patients with fluorouracil (5-FU)-refractory colorectal cancer produced response rates and toxicity profiles similar to irinotecan given weekly in a phase

BOSTON-A single dose of a new long-acting 5-HT3 receptor antagonist called palonosetron matched the effectiveness of a single dose of dolasetron (Anzemet) against acute emesis and was more effective against delayed emesis in a phase III clinical trial conducted in patients receiving moderately emetogenic chemotherapy.

WASHINGTON-President Bush has signed legislation that reauthorizes the Prescription Drug User Fee Act (PDUFA), first enacted in 1992 to speed up the FDA’s processing of new drug applications. PDUFA III is the second 5-year

SAN FRANCISCO-In vitro studies suggest that a new anticancer agent, SCH66336, can slow cell proliferation in drug-resistant forms of Philadelphia (Ph)-positive leukemia, according to a presentation by Japanese researchers at the 93rd Annual Meeting of the American Association for Cancer Research (abstract 4235). When used in combination with antileukemic agents, SCH66336 induced apoptosis in leukemia cells resistant to imatinib mesylate (Gleevec).

ORLANDO-Allowing advanced cancer patients to start palliative care without giving up aggressive treatment substantially increased end-of-life hospice enrollment in one study and reduced cost of care in another. Both studies were presented at the

LONDON, UK-The combination of gemcitabine (Gemzar)/carboplatin (Paraplatin) was found to be better tolerated and associated with longer survival than MIP (mitomycin [Mutamycin], ifosfamide [Ifex], and cisplatin [Platinol]) in patients with

LOS ANGELES-The Society of Nuclear Medicine (SNM) has changed its logo for the first time in its 49-year history. The new logo is designed to create a bright, fresh look for SNM, Alan Maurer, MD, said at the Society’s 49th Annual Meeting. Dr. Maurer, director of nuclear medicine, Temple University, is the immediate past president of the SNM.

SAN FRANCISCO-A novel experimental compound, AP23573, can induce potent tumor shrinkage by inhibiting nutrient uptake in cancer cells and starving them, according to a presentation at the 93rd Annual Meeting of the American

BETHESDA, Maryland-Leaner times are in the offing for the National Institutes of Health (NIH), starting in the fall of 2003.

VANCOUVER, Canada-Ad-vectus Life Sciences Inc. has begun preclinical testing of its patented nanoparticle-based technology (Nanocure) at the University of North Carolina Brain Tumor Center. This series of studies will test the Nanocure

Rubinstein and colleagues provide an excellent review of mathematical models for estimating breast cancer risk, including the risk of carrying inherited mutations of BRCA1 and BRCA2. Since we and others reviewed early models to predict the likelihood of inherited susceptibility to breast cancer,[1] newer quantitative tools, most notably by Parmigiani and colleagues,[2] have been developed. These models have been made available on CD-ROM, over the Internet, and in other electronic versions that are accessible to most clinicians and researchers. These quantitative resources constitute useful and important aids in genetic counseling.

In their paper, Schwartz and colleagues review the risk factors for depression and suicide in patients with cancer and argue convincingly that screening for depression can be simply and quickly performed. They also delineate the efficacy and potential adverse effects of psychotherapeutic or psychopharmacologic treatments for these patients. Buttressing the identification and treatment of depression in the cancer patient are vital, ongoing scientific developments that flow from an increased understanding of interactions among the brain, endocrine system, and immune system. This rapidly evolving body of neurobiological knowledge has catalyzed fundamental changes in how we conceptualize depression in cancer patients and has important ramifications regarding the treatment and prevention of depressive syndromes in this setting.

Depression is a common but treatable condition among cancer patients. Screening for depression can be done simply and effectively, and a variety of practical treatment strategies are available. Numerous factors should be

Because irinotecan (CPT-11, Camptosar) is a topoisomerase I inhibitor with a broad spectrum of antitumor clinical activity, we investigated its activity in relapsed or refractory non-Hodgkin’s lymphomas (NHLs). Irinotecan at 300 mg/m² IV was administered every 21 days with intensive loperamide management of diarrhea.

Women at increased risk of breast cancer have important opportunities for early detection and prevention. There are, however, serious drawbacks to the available interventions. The magnitude of breast cancer risk is a crucial factor in the optimization of medical benefit when considering the efficacy of risk-reduction methods, the adverse effects of intervention, and economic and quality-of-life outcomes. Breast cancer risk assessment has become increasingly quantitative and is amenable to computerization. The assembly of risk factor information into practical, quantitative models for clinical and scientific use is relatively advanced for breast cancer, and represents a paradigm for broader risk management in medicine. Using a case-based approach, we will summarize the major breast cancer risk assessment models, compare and contrast their utility, and illustrate the role of genetic testing in risk management. Important considerations relevant to clinical oncology practice include the role of risk assessment in cancer prevention, the logistics of implementing risk assessment, the ramifications of conveying risk information with limited genetic counseling, and the mechanisms for genetics referral. Medical professionals can embrace new preventive medicine techniques more effectively by utilizing quantitative methods to assess their patients’ risks. [ONCOLOGY 16:1082-1099, 2002]

The hepatic metabolism and biliary secretion of irinotecan (CPT-11, Camptosar) and metabolites is complex and involves cytochrome P450 isoenzymes, carboxylesterases, glucuronosyltransferase, and the ATP-dependent export pumps MRP-2 and MXR. Enzyme-inducing antiepileptic drugs (EIAEDs) such as phenytoin and carbamazepine are known to induce several of the metabolic pathways relevant to ininotecan’s elimination. The North American Brain Tumor Consortium phase I study is designed to determine the maximum tolerated dose and pharmacokinetics of irinotecan given every 3 weeks to patients who are receiving EIAEDs.

Irinotecan and mitomycin (Mutamycin) possess significant single-agent activity against several tumor types, and mitomycin activates topoisomerase I, the cellular target of irinotecan. We conducted a phase I dose-escalation study of irinotecan and mitomycin in 37 evaluable patients with solid tumors. Antitumor responses included 2 complete responses, 5 partial responses, 10 minor responses, and a CA 19-9 tumor marker response.

ORLANDO-Capecitabine (Xeloda) might one day replace infusional fluorouracil (5-FU) as a radiosensitizing platform in the chemoradiation of advanced gastrointestinal malignancies, according to Tyvin A. Rich, MD, professor of radiation oncology, University of Virginia Health Sciences Center, Charlottesville. The oral fluoropyrimidine simplifies chemoradiation, is well tolerated, and is highly appealing to patients and physicians alike, he said.

HOUSTON-The COX-2 inhibitor celecoxib (Celebrex) appears to improve tumor response to capecitabine (Xeloda) and may help relieve hand-foot syndrome, according to results of a retrospective study by researchers at M.D. Anderson Cancer Center. Lead investigator Edward H. Lin, MD, assistant professor of medicine, Division of Gastrointestinal Medical Oncology, said that the group is planning a prospective trial of the combination.