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PITTSBURGH-University of Pittsburgh researchers have shown that immature dendritic cells can be genetically modified to serve as an effective vehicle for presenting tumor antigens to the immune system. Such cells were shown to induce a significant and therapeutic tumor-specific immune response in an animal model.

Measurement of the quality of life (QOL) of patients, particularly those with cancer, has recently become a major scientific endeavor. The rapid growth of the hospice movement throughout the world during the past half-century has underscored the importance of palliation when a cure no longer seems possible.

The article by Castiel highlights the benefits and potential risks of estrogen replacement in cancer patients. For patients with malignancies that are not “estrogen sensitive,” adding hormone replacement therapy (HRT) to the therapeutic regimen can only improve quality of life.

Drs. Boyd and Mehta provide a comprehensive yet concise overview of the role of radiosurgery in the management of selected patients with brain metastases.

Gemcitabine is a potent radiosensitizer in both laboratory studies and in the clinic. Initial laboratory studies showed that gemcitabine radiosensitizes a wide variety of rodent and human tumor cells in culture. Maximum

Worldwide, approximately 100,000 patients have undergone stereotactic radiosurgery for a variety of intracranial lesions, of which brain metastases represent the most common treatment indication. This article summarizes the major issues surrounding the management of brain metastases, and also analyzes 21 independent reports of Gamma Knife– or linear accelerator–based radiosurgery, representing over 1,700 patients and more than 2,700 lesions. Variable reporting in the studies precludes a definitive, rigorous analysis, but the composite data reveal an average local control rate of 83% and median survival of 9.6 months, both of which are comparable to results in recent surgical reports. The most important prognostic factors for survival appear to be fewer than three lesions, controlled extracranial disease, and Karnofsky performance score (KPS). The exact impact of dose has not been clarified, but a dose-response relationship, especially for ³ 18 Gy, is emerging. The role of whole-brain radiotherapy remains unresolved. It may enhance local control but does not convincingly improve survival and, in some series, is associated with an increased risk of late complications. Chronic steroid dependence and increased intracranial edema do not appear to be common problems. This is an opportune time for the completion of ongoing randomized trials to validate these observations. [ONCOLOGY 13(10):1397-1409,1999]

Chemotherapy agents known to enhance the effects of radiation in preclinical studies have been used concurrently with radiotherapy in numerous clinical trials with the prospect of further enhancing radiation-induced

Fluorinated pyrimidines have long been used as radiosensitizers in combined-modality therapy for solid tumors. Nonetheless, the most commonly used drug, 5-fluorouracil (5-FU), is inconvenient to administer, particularly

That hypoxic tissues are more resistant to the effects of radiation than well-oxygenated tissues has been known for many decades, and repeated in vitro demonstrations have confirmed that to achieve the same degree of cytotoxicity, hypoxic cells require about three times the radiation dose that well-oxygenated cells need. Hypoxic cell sensitizers enhance the tissue response to standard radiation, generally by mimicking the effects of oxygen, which induces the formation and stabilization of toxic DNA radicals. Although many hypoxic cell sensitizers like the nitroimidazoles have been evaluated in combination with radiation, these agents have had no or only minimal therapeutic impact due to either their limited potency or their toxicity at biologically relevant concentrations. This article reviews several new modalities that either increase oxygen delivery or sensitize hypoxic tissues. These modalities, all currently in early clinical evaluations, include: (1) tirapazamine, a bioreductive agent; (2) gadolinium texaphyrin, a hypoxic cell sensitizer with biolocalization properties using magnetic resonance imaging; (3) RSR13, an allosteric modifier of hemoglobin; and (4) bovine hemoglobin modified by the attachment of polyethylene glycol polymers.[ONCOLOGY 13(Suppl 5):61-70,1999]

Health-related quality of life (HRQL) is a multidimensional construct that represents the patient’s perspective on valued aspects of health and functioning. Over the last several years, the pharmaceutical industry, as well as health care providers and the patient advocacy community, have shown increasing interest in HRQL as an outcome measure. Pharmaceutical companies and other sponsors of cancer clinical trials are seeking novel approaches with which to establish the benefits of treatment and to differentiate their products from other marketed products. Health care providers hope to provide cancer patients with therapies that positively affect their quality of life. To date, however, most oncology drug approvals have been based on traditional end points, such as survival and tumor response rate. This article will focus on some of the lessons learned from recent reviews of HRQL data and will describe some of the many challenges that lie ahead. ONCOLOGY 13(10):1439-1442, 1999]

Obliteration of the tumor vasculature is an effective means of achieving tumor regression. Antiangiogenic agents have begun to enter cancer clinical trials. Ionizing radiation activates the inflammatory cascade and increases the

Three-dimensional (3D) image-based treatment planning and new delivery technologies have spurred the implementation of external beam radiation therapy techniques, in which the high-dose region is conformed much

Because treatment for most brain tumors remains inadequate, there has been a sustained interest in using concurrent chemotherapy and radiotherapy to improve local control, prolong overall survival, and reduce

The taxanes, paclitaxel and docetaxel, are novel antimitotic agents that are under extensive investigation in clinical trials in patients with various solid tumors. The taxanes have demonstrated significant activity against

NEW YORK-Researchers have seen encouraging early results in head and neck and other cancers with use of the attenuated adenovirus, ONYX-015, David H. Kirn, MD, vice president of clinical research, Onyx Pharmaceuticals, (Richmond, Calif), said at Current Concepts in Cancer Therapy II, a symposium sponsored by Long Ridge Associates.

NEW YORK-IDEC, the developer of rituximab (Rituxan), the first monoclonal antibody approved by the FDA for cancer therapy, is pushing ahead with research to increase the agent’s effectiveness in non-Hodgkin’s lymphoma.

ARLINGTON, Va-There are certainly things we can do individually to avoid getting cancer, yet other preventive measures must be taken by society at large, Devra Lee Davis, PhD, of the World Resources Institute, Washington, said at the Second Comprehensive Cancer Care Conference. The meeting was sponsored by the University of Texas Houston Medical School and the Center for Mind-Body Medicine, in collaboration with the NCI and the National Center for Complementary and Alternative Medicine.

ATLANTA-AIDS prevalence among inmates of US prisons is five times higher than that of the general population, Theodore Hammett, PhD, said at the National HIV Prevention Conference.

Depression is the most common postoperative complication seen in patients who have undergone surgery for brain tumors, but it is seldom recognized or treated, according to preliminary findings of a study presented at the annual meeting of the

All of the talk about a potential Medicare drug benefit has overshadowed the question of what can be done to lower drug costs for non Medicare patients, who, after all, constitute the majority in this country. With this in mind, Rep. Bernie Sanders

WASHINGTON-“Meeting with members of Congress to push an issue can seem intimidating, but the key is to remember that legislators are people, too, and to treat the encounter as the beginning of a relationship,” Robin Carle said at the 1999 Kidney Cancer Association (KCA) annual convention.

Jane Henney, MD, commissioner of the FDA, says that the agency is going to crack down on Internet sales of unapproved new drugs, health fraud (eg, where a site claims some drug will cure cancer), and drugs sold without a valid prescription.

NEW ORLEANS-A modification of SPECT (single proton emission computed tomography) scintimammog-raphy with the radionuclide technetium sestamibi is a promising adjunct to equivocal mammograms that are difficult to interpret, said David H. Feiglin, MD, professor of radiology, SUNY Health Science Center, Syracuse. He presented the findings of his collaborative study at the American Roentgen Ray Society annual meeting.

WASHINGTON-Call it “Fear of Filing.” A survey by the American Society of Clinical Oncology (ASCO) indicates that third-party payers, including Medicare, are more willing to cover patient-care costs in cancer clinical trials than is commonly assumed. Yet often physicians won’t discuss enrollment in such trials with patients out of fear that insurers will deny payment.

MILAN, Italy-A small Italian study of gabapentin (Neurontin) in patients with neuropathic cancer pain only partially responsive to opioid therapy suggests that the anticonvulsant may have a role to play in this situation.

NEW ORLEANS-“To paraphrase Madison Avenue, this is not your father’s thermal imaging,” said Yuri R. Parisky, MD, associate professor of radiology, University of Southern California Norris Cancer Center and Hospital. He was referring to a new form of computer-enhanced thermal breast imaging that he and his colleagues at USC are studying, along with investigators at the TRW Center for Medical Image Analysis, Ogden, Utah, and Howard University, Washington, DC.

PHILADELPHIA-SmithKline Beecham announced in a press release that the FDA has approved Kytril (granisetron HCl) Tablets, its 5-HT3 receptor antagonist, for the prevention of nausea and vomiting associated with radiation, including total body irradiation (TBI) and fractionated abdominal radiation. Kytril Tablets (2 mg, once daily) are currently indicated for the prevention of nausea and vomiting associated with emetogenic cancer therapies.

BETHESDA, Md-The National Cancer Institute will provide $16 million over 4 years to the HMO Research Network to expand and strengthen its cancer research efforts and to initiate studies aimed at increasing effective cancer prevention and control among enrollees in health maintenance organizations.

ATLANTA-A prospective study, presented at the 35th Annual Meeting of the American Society of Clinical Oncology, has found the utility of routine endometrial biopsy among women with breast cancer treated with tamoxifen (Nolvadex) to be “limited at best.” Another study presented at the meeting finds sonography to be inadequate as a substitute for endometrial biopsy in healthy women receiving tamoxifen prophylaxis.

WASHINGTON-Congressional backers of “The Medicare Cancer Clinical Trials Coverage Act” see its chances of passage improving, in part because of the active support of cancer advocacy groups and the direct involvement of oncologists . The legislation, actually two identical bills introduced in the House and Senate, would create a 5-year demonstration program in which Medicare would pay for patient care during cancer clinical trials and determine the true costs of such coverage.