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Thalidomide (Thalomid) is a derivative of glutamic acid that was introduced as a nonbarbiturate hypnotic in 1956 by a West German company. It was used widely as an over-the-counter sedative and antiemetic drug in countries other than the United States. Because of its presumed safety and antinausea effect, it was given to pregnant women suffering from morning sickness and to influenza patients experiencing nausea. Subsequently, over 12,000 malformed babies were born as the result of fetal exposure to thalidomide early in pregnancy. When its teratogenic effects-notably flipperlike limbs-became known, thalidomide was withdrawn from the market in 1961. In the mid-1960s, after it was given as a sedative to a small number of leprosy patients in Israel afflicted with erythema nodosum leprosum, it was noted that the patients’ symptoms rapidly and markedly improved.

Ventura and Roberts (abstract #2268) made an interesting observation of a disease response in a patient with angiosarcoma. This patient initially received radiation to a large mass in the neck and had a minor response-less than 10% shrinkage of the

The 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.

Research 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.

An 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).

Researchers 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).

A 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).

The FDA has approved Merck & Co.'s Emend (aprepitant) for use with other antiemetic medicines for the prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy.

ode Gray policies exist at several bureaucratic levels, with Chancellors Memo 51 (CM-51) being the highest policy level. CM-51 states that all LSUHSC personnel, except "approved and emergency personnel," must evacuate LSUHSC when emergency status is declared. Having participated in prior hurricane coverages and debriefings by my department, I performed in a manner consistent with past experience and current policy.

The 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.

In the wake of the Hurricane Katrina crisis, untold numbers of medical records may have been lost. Many evacuees forgot or misplaced their medications, and some do not remember the names of all their medications. With no access to previous medical records, the evacuees’ doctors have no way of confirming medications, immunizations, test results, and other past history. The storm has led to increased demands for electronic hospital records.

As 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.

Last 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.

With 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.

With 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.

With 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.

THOUSAND OAKS, California—Amgen and Abgenix, Inc. (Fremont, California) have signed a definitive merger agreement under which Amgen will acquire Abgenix for approximately $2.2 billion in cash plus the assumption of debt. The acquisition of Abgenix provides Amgen with full ownership of one of its most important advanced pipeline products, panitumumab. The agent, which inhibits the epidermal growth factor receptor (EGFR), has shown significant improvement in progression-free survival for metastatic colorectal cancer patients who have failed standard chemotherapy (see ONI December 2005, page 14). Abgenix also brings to the merger its proprietary fully human monoclonal antibody technology, XenoMouse.

Once again, the National Cancer Institute (NCI) faces the likelihood of an annual operating budget lower in actual dollars than the previous year. In the waning days of December 2005, Congress passed the budget for the Department of Health and Human Services (HHS) for fiscal year (FY) 2006, which began October 1, 2005.

Amooranin (AMR), derived from the Amoora rohituka stem bark, shows clinical potential in treating human cancers, Steven Melnick, MD, PhD, said at the Society for Integrative Oncology (SIO) annual meeting (abstract 57). Dr. Melnick, chief, Department of Pathology and Clinical Laboratories, Miami Children's Hospital, said that the Amoora rohituka stem bark is one of the components of a natural preparation used for the treatment of human malignancies in the Ayurvedic system of medicine in India. Derived from stem bark that grows wild in Asia, the preparation contains parts of three medicinal plants: Amoora rohituka stem bark, Glycyrrhiza glabra roots, and Semicarpus anacardium fruits.

For transplant patients with severe acute graft-versus-host disease (GVHD), a novel treatment option may be in the form of another transplant, this time with mesenchymal stem cells (MSCs), according to research presented at the American Society of Hematology annual meeting

Cancer drug regulators at the FDA and the European Medicines Agency (EMEA) have agreed to seven programs aimed at providing each agency with a better understanding of the basis of the scientific advice the other offers, as well as optimizing product development and avoiding unnecessary duplication. The seven initiatives resulted from an agreement finalized on Sept. 16, 2005, between the FDA, EMEA, and the European Commission, the executive body of the European Union.

Accumulating clinical experience with MammoSite breast brachytherapy is supporting its safety, efficacy, and good cosmetic outcomes, while also providing lessons to improve its use, according to a pair of studies presented at the 47th Annual Meeting of the American Society for Therapeutic Radiology and Oncology

The malignant stem cells believed to develop into cells associated with acute myeloid leukemia (AML) appear to be distinguishable from normal stem cells with the use of a novel antigen marker, Gerrit Jan Schuurhuis, PhD, said at the 2005 American Society of Hematology annual meeting (abstract 4). Dr. Schuurhuis is associate professor of hematology, VU University Medical Center, Amsterdam, The Netherlands.

SOUTH SAN FRANCISCO, California—Hana Biosciences has received FDA clearance for its Investigational New Drug Application for Zensana (ondansetron oral spray) to prevent chemotherapy-induced nausea and vomiting. In a press release, Hana said it is initiating a series of pivotal pharmacokinetic trials, including comparison of Zensana with ondansetron tablets (Zofran). Zensana is the first multidose oral spray 5-HT3 antagonist. Patients experiencing nausea and vomiting have difficulty swallowing and holding down pills. Zensana delivers full doses of ondansetron. In addition, drug delivery via a spray to the oral mucosa avoids degradation in the gastrointestinal tract and metabolism by liver enzymes.

The myriad changes that oncology physicians have experienced in the last 20 years are certainly applicable to oncology nurses, in particular, the technology explosion and its effects on diagnosis, treatment, and survivorship; the emergence of cancer as a disease of the elderly; challenges posed by shortages of health care workers; and the fact that almost all cancer patients today are treated as outpatients. Recent therapeutic innovations and management approaches have been keenly felt by oncology nurses, who typically play a major role in patient education.

A 1999 Institute of Medicine (IOM) report, "Ensuring Quality Cancer Care," suggested that many cancer patients in the United States are not receiving the care known to be effective for their disease. The IOM committee recommended a number of remedial steps including the development of a national quality care monitoring system. CC&E spoke with Eric C. Schneider, MD, assistant professor of health policy and management, Harvard School of Public Health, and assistant professor of medicine, Harvard Medical School, about, among other things, the ongoing initiatives to link quality care performance measures to the delivery and reimbursement of oncology services.

On the weekend before Hurricane Katrina struck, Gabriela Ballester, MD, was the hematology/oncology fellow on call for LSU patients at University Hospital (part of the Medical Center of Louisiana at New Orleans, along with Charity Hospital). She shared her story in a telephone interview with ONI.

DENVER-Dose escalation of high dose rate (HDR) brachytherapy may improve long-term survival in men with intermediate- or high-risk prostate cancer, according to findings of a study presented at the 47th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 63).

Several developments in the past few years have incrementally progressedthe field and provided additional insights into the managementof advanced colorectal cancer. This review discusses the componentsof current cytotoxic chemotherapy regimens for advanced colorectalcancer: fluorouracil (5-FU), capecitabine (Xeloda), irinotecan(Camptosar), and oxaliplatin (Eloxatin). The equivalence of severalfront-line regimens has provided opportunities for increased tailoringof therapies for individual patients. Preliminary data onpharmacogenomics provides hope that we will be able to better matchpatients with regimens and doses on the basis of individualized predictionsof toxicity and response. The importance of second-line therapyin overall survival has again been highlighted; the best outcomes haveoccurred in patients treated with 5-FU, oxaliplatin, and irinotecan incombination with targeted therapies during the course of their disease.Elderly patients are no exception to this finding. Combination regimensand second-line therapy should be offered to elderly patients whohave adequate performance status and no contraindicated comorbidconditions, without regard for their chronological age.

Colorectal cancer is a worldwide public health problem, with nearly 800,000new cases diagnosed each year resulting in approximately 500,000deaths. In the United States, it is the second leading cause of cancer mortality,and nearly 60,000 deaths will be attributed to this disease in 2005. Whendiagnosed as advanced, metastatic disease, colorectal cancer is traditionally associatedwith a poor prognosis, with 5-year survival rates in the range of 5% to 8%. Thissurvival rate has remained unchanged over the past 35 to 40 years. However, duringthe past 5 years, significant advances have been made in treatment options so thatimprovements in 2-year survival are now being reported, with median survival ratesin the 21- to 24-month range in patients with metastatic disease.