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ROCKVILLE, Maryland-The FDA has approved the MammoSite Radiation Therapy System (Proxima Therapeutics, Alpharetta, Georgia), to deliver adjuvant radiation therapy after breast-conserving surgery for patients with early-stage disease. The device is designed to irradiate the surgical site with minimal exposure to surrounding tissue. It consists of a hollow catheter, to which an inflatable balloon is attached. After surgery, the device is implanted, the balloon inflated, and a radiation source is placed in the catheter. The balloon centers the radiation source at the wound site. After a series of treatments, generally extending over several days, the catheter is withdrawn.

New data for 1999 show that death rates for all cancers continued to decline in the United States. However, the number of cancer cases is expected to rise in coming years due to the growth and aging of the population, according to a recent report. The "Annual Report to the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age and Aging on the US Cancer Burden" was published in a recent issue of the journal Cancer (94:2766-2792, 2002).

ORLANDO-Pemetrexed (Alimta) plus cisplatin (Platinol) with folic acid/vitamin B12 supplementation should be considered standard front-line therapy for patients with malignant pleural mesothelioma, Nicholas J. Vogelzang, MD, said at the plenary session of the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 5).

TEL HASHOMER, Israel-Israeli investigators report that a new technique delivering waves of paclitaxel (Taxol) directly into recurrent brain tumors has produced significant responses in patients with recurrent glioblastoma (ASCO abstract 316).

A 66-year-old Asian woman presents with chronic heartburn and epigastric discomfort. She has suffered with these symptoms most of her adult life and underwent multiple upper gastrointestinal series in her homeland, China. The radiologic

Every 3 years, the National Cancer Institute (NCI) asks researchers, advisory panels, and advocacy groups to recommend "extraordinary opportunities for investment," which it defines as "broad-based, overarching areas of scientific pursuit that hold tremendous promise for significantly expanding our understanding of cancer."

WASHINGTON-More than one in four American high school students smoke cigarettes, but tobacco use among this age group has steadily declined since 1997, according to a school-based study by the Centers for Disease Control and Prevention (CDC).

WASHINGTON-In 1997, the Nuclear Regulatory Commission issued new guidelines for radiation therapy that, for the first time, permitted outpatient use of radioactive iodine therapy in selected patients (ie, highly compliant patients discharged to low-occupancy settings). Previously, this therapy had required inpatient treatment and 3 days of isolation.

SAN FRANCISCO-Use of tyrosine kinase inhibitors, including PKI166 (investigational, Novartis) and imatinib mesylate (STI571, Gleevec) can significantly reduce the size of metastatic bone tumors, decrease angiogenesis, and preserve bone structures, according to animal studies presented at the 93rd Annual Meeting of the American Association for Cancer Research.

Dr. Yee and his colleagues have offered a comprehensive overview of the epidemiology, diagnosis, and therapy of both gallbladder carcinoma and cholangiocarcinoma. They correctly note the infrequency of these two neoplasms, with approximately 7,500 cases diagnosed in the United States each year, two-thirds of which are gallbladder cancer. Unfortunately, neither the incidence rate nor prognosis of these neoplasms has changed substantially since biliary tumors were last reviewed in this journal[1]; the median 5-year survival rate has remained at 5%. Some progress has been made, however, in our understanding of the etiology of cancers of the biliary tract, and a body of literature continues to emerge exploring the question of how best to approach screening and prophylaxis in high-risk populations.

In December 2000, ONCOLOGY’s Jim McCarthy sent me a letter, inviting me to prepare an article for the journal on "The Current Status of Chemotherapy Sensitivity Assays." I was informed that the paper would be referred to one or two reviewers, who would write a commentary to be published alongside the paper. The commentary, I was told, might be "entirely laudatory, highly critical, or somewhere in between," and the result, "both lively and informative."

R115777 (Zarnestra) is an orally available methylquinolone derivative from Johnson & Johnson Pharmaceutical Research and Development L.L.C. that is a potent and selective nonpeptidomimetic farnesyltransferase inhibitor (FTI).[1] FTIs represent a new class of agents that were originally developed to inhibit tumors by interfering with posttranslational processing of oncogenic Ras protein. The anticancer activity of FTIs might stem from their ability to effect various proteins other than Ras that can also mediate signal transduction, apoptosis, angiogenesis, and growth.[2]

Drs. Yee and colleagues have done an excellent job of surveying the treatment of gallbladder cancer and cholangiocarcinomas. These relatively uncommon tumors are among the more difficult encountered by surgical, medical, and radiation oncologists, as evidenced by the lack of new therapies or change in prognosis over the past several decades.

The article by Dr. William Breitbart and Lucia DiBiase offers an excellent in-depth review of our current knowledge of the epidemiology, pharmacologic, and nonpharmacologic interventions in the field of pain management in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

Concern about prescribing controlled substances underlies, in part, the undertreatment of pain, even in palliative care settings. That the same is true for human immunodeficiency virus (HIV) patients is therefore not surprising, particularly given injection drug use as a risk factor.

Cancers of the gallbladder and biliary tract are uncommon malignancies in the United States with a combined incidence of less than 8,000 new cases per year, about 5,000 of which are gallbladder cancer and about 2,000 to 3,000 of which are cholangiocarcinomas, including intrahepatic, hilar, and distal bile duct cancers.[1] For gallbladder cancer with mucosa-confined disease, the 5-year survival rate is approximately 32%, and for advanced disease, less than 10% of patients survive longer than 1 year.[2]

As active participants in the care of patients with acquired immunodeficiency syndrome (AIDS), oncologists need to be aware of the many facets of pain management in this population. This two-part article, which began in the

Neoplasms of the biliary tract tree are uncommon and have a poor overall prognosis. Although numerous risk factors have been identified, little is known about the pathogenesis of these tumors, and no effective screening

ORLANDO-When combined with standard antiemetic therapy, the neurokinin-1 (NK1) receptor antagonist aprepitant (MK-869[M]) protects against acute and delayed chemotherapy-induced nausea and vomiting, according to two separate studies (ASCO abstracts 1467 and 1467).

SAN ANTONIO, Texas-An exercise rehabilitation program similar to that used for cardiac patients significantly improved both exercise tolerance and quality of life (QOL) for cancer patients participating in a pilot study. Stacey Young-McCaughan, RN, PhD, and colleagues tested the exercise program in patients at two military medical centers in San Antonio, Texas. Lieutenant Colonel Young-McCaughan is deputy director of the Congressionally Directed Medical Research Programs at the US Army Medical Research and Materiel Command at Fort Detrick, Maryland.

SEATTLE-The proportions of deaths in HIV-infected individuals caused by non-AIDS-related diseases have increased since the advent of highly active antiretroviral therapy (HAART), according to a study presented at the 9th Conference on Retroviruses and Opportunistic Infections (abstract 14). Mitchell I. Wolfe, MD, MPH, medical epidemiologist, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), presented the data.

The world’s first clinically operational molecular imager with lutetium oxyorthosilicate (LSO) technology-the biograph LSO, manufactured by Siemens Medical Solutions-has produced a precisely registered, combined positron-emission tomography (PET)/computed tomography (CT) image in 7 minutes at the Hong Kong Baptist Hospital. The biograph LSO imager uses the high-speed properties of LSO as the PET scintillator to provide shorter scan times and unmatched patient throughput.

SAN FRANCISCO-More than one-third of cancer outpatients report two or more symptoms such as pain, fatigue, nausea, depression, and sleep disturbances. Because severity of individual symptoms and risk of clinical depression both worsen as the number of symptoms increases, these symptom clusters or groupings have important clinical implications, according to Marylin J. Dodd, RN, PhD, professor of nursing at the University of California at San Francisco.

The National Cancer Institute (NCI) announced recently that it is expanding access to its clinical trials to more oncologists around the country. This new policy will allow cancer patients anywhere in the United States to participate more easily in advanced (phase III) treatment trials.

ORLANDO-Allogeneic bone marrow transplant (BMT) significantly reduced relapse rates and increased event-free survival (EFS) rates, but not overall survival, in adults with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission.

SEATTLE-A new HIV-1 vaccine that uses a replication-defective adenovirus vector has proved to be safe, well tolerated, and immunogenic to date in an ongoing phase I trial, according to research presented at the 9th Conference on Retroviruses and Opportunistic Infections (abstract 12). Emilio Emini, PhD, senior vice president of vaccine research at Merck Research Laboratories, presented the results.

Oncology care will be the focus of one of the new Medicare disease management demonstration programs soon to be initiated. Medicare remains convinced that disease management services can provide substantial savings. There is, however, a problem: Fee-for-service Medicare, which includes most recipients, does not allow for disease management, except in one or two instances, such as diabetes self-education. The Medicare+Choice program-comprised mostly of health maintenance organizations-offers disease management, but seniors have, for the most part, avoided this plan. Therefore, Medicare has selected 15 sites for case management and disease management services, which will be offered to Medicare fee-for-service beneficiaries with complex chronic conditions. Quality Oncology, Inc, of McLean, Va, will implement an urban disease management program targeting beneficiaries in Broward County, Fla.

SAN FRANCISCO-Routine use of aspirin provides a modest reduction in the recurrence of large bowel adenomas, according to the results of a randomized, double-blind, placebo-controlled study presented by the Polyp Prevention Study Group. Paradoxically, the group found that an 80 mg daily dose, the equivalent of one baby aspirin, was much more effective in preventing polyps than was the 325 mg daily dose, the amount contained in a typical adult aspirin.

ORLANDO-Giving rituximab (Rituxan) after high-dose chemotherapy/autologous peripheral blood stem cell transplantation for B-cell non-Hodgkin’s lymphoma (NHL) produced better survival and freedom from progression rates than would be expected with a conventional transplant regimen, according to a phase II study reported at the 43rd Annual Meeting of the American Society of Hematology (abstract 3578).

WASHINGTON, DC-Recombinant human erythropoietin is accepted treatment for chemotherapy-related anemia, but a panel of four oncology nurses convened to review an evidence-based clinical practice guideline for anemia concluded that guidelines are not being consistently followed. The panel’s findings were presented by Denise Oseguera, RN, of University of California, Los Angeles, and Susan Ross, MD, of MetaWorks Inc., Medford, Massachusetts.