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LUGANO, Switzerland-For low-grade lymphomas, fludarabine (Fludara)-based combination therapy may have greater efficacy than single-agent flu-darabine, especially when a monoclonal antibody is part of the combination, a series of recent European investigations suggest. The investigations, presented at the Eighth International Conference on Malignant Lymphoma (ICML), show that various combination therapies hold promise, although a lack of coordination among non-US study groups has hampered progress somewhat.

BOSTON-Most advanced cancer patients suffer from pain that could be relieved with broader use of opioid analgesics, according to Eduardo Bruera, MD, F.T. McGraw Chair in the Treatment of Cancer, M.D. Anderson Cancer Center.

WASHINGTON-A 2-year, $1 million study by the Institute of Medicine (IOM) will explore the scientific and policy implications of complementary and alternative medicine (CAM). The study is being funded by 16 units of the National Institutes of Health, including the National Cancer Institute, and the Agency for Healthcare Research and Quality. The IOM, a part of the National Academy of Sciences, will name a committee of about 16 experts to carry out the study. Panel members will be chosen from among leading CAM specialists and more conventional disciplines.

MIAMI BEACH -The Bcr-Abl tyrosine kinase inhibitorPD173955 (PD17) binds to the targetATP binding pocket even moreefficiently than STI-571 (imatinibmesylate, Gleevec). It shows 15 to20 times greater efficacy in chronicmyelogenous leukemia (CML) celllines because it can bind to eitheropen or closed activation loops.

BETHESDA, Maryland-A national survey, now in progress, will enable the National Cancer Institute (NCI) for the first time to examine the interrelationship of people’s knowledge about cancer, their sources of cancer information, and their cancer-related behavior. The Health Information National Trends Survey (HINTS), a telephone survey of 8,000 randomly selected, representative US adults, began in late October. Data collection is expected to take 5 months.

ROCKVILLE, Maryland-A quick HIV-1 diagnostic test with high specificity and sensitivity has received conditional approval by the US Food and Drug Administration (FDA) for use in detecting antibodies to the most common form of the virus found in the United States.

BOSTON-Darbepoetin alfa (Ara-nesp), the new long-lasting erythropoietic agent, is safe and effective for treatment of chemotherapy-induced anemia in older patients, Lodovico Balducci, MD, of the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, told ONI at the third meeting of the International Society of Geriatric Oncology (SIOG abstract P-12).

WASHINGTON-Young women who are depressed, think of themselves as being at low risk for breast cancer, or have relatively painless mammograms are likely to skip diagnostic follow-up, according to Alexis Bakos, PhD, MSN, RN,C. In a podium presentation at the Oncology Nursing Society’s 27th Annual Congress (abstract 10), Dr. Bakos said that 25% to 60% of women do not return for follow-up and that the goal of her study was to determine who does not return, and why.

BUFFALO, New York-Medianprogression-free survival hasstill not been reached after 6 yearsmedian follow-up of 40 patientswith low-grade or follicular non-Hodgkin’s lymphoma (NHL) treatedin the first clinical trial ofrituximab (Rituxan) in combinationwith CHOP (cyclophosphamide[Cytoxan, Neosar], doxorubicinHCl, vincristine [Oncovin],and prednisone), Myron S.Czuczman, MD, reported.

BETHESDA, Maryland-Six initial breast cancer research grants totaling $2.5 million have been awarded through the National Cancer Institute-Avon Foundation’s Progress for Patients program to fund innovative translational science at 10 research institutions. The program administers a $20 million pledge from the Avon Foundation. The initial grants consist of $1.99 million from the Avon Foundation and $660,000 from NCI.

SAN DIEGO, California-Pro-genics Pharmaceuticals’ humanized monoclonal antibody (MoAb) PRO 140 has been shown to block HIV entry into immune system cells. The agent acts by binding to a portion of the CCR5 fusion coreceptor present on the outer membrane of immune system cells. William C. Olson, PhD, vice president of research and development at Progenics, Tarry-town, New York, presented the research at the 42nd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) (abstract H-178).

ROCKVILLE, Maryland-Forthe first time, the US Food and DrugAdministration has approved the useof a radioisotope attached to a monoclonalantibody for the treatmentof cancer.

NEW YORK-Patients with advanced colorectal cancer experienced a significantly better response rate with a combination of oxaliplatin (Eloxatin) and infusional fluorouracil (5-FU)/leucovorin (LV), compared with infusional 5-FU/LV or oxaliplatin alone, Mace Rothenberg, MD, of Vanderbilt University Medical Center, said at the Chemotherapy Foundation Symposium XX. The data, presented for the first time in the United States, were the basis for the recent FDA approval of oxaliplatin.

WASHINGTON-A federal court has invalidated the FDA’s "Pediatric Rule" after concluding that its requirement that drug companies test the safety of adult drugs in children is contrary to the intent of Congress.

ORLANDO, Florida-Updateddata from two separate studiesratify earlier results showing thatfollowing CHOP (cyclophosphamide[Cytoxan, Neosar], doxorubicinHCl, vincristine [Oncovin],prednisone) with radiation improvesresults for patients with early-or limited-stage non-Hodgkin’slymphoma (NHL), according todata reported at the 43rd AnnualMeeting of the American Society ofHematology (abstract 3023) .

PALO ALTO, California-Varian Medical Systems, Inc. has received 510(k) clearance from the FDA for Acuity, a new digital imaging product that integrates planning, simulation, and verification software for treating cancer with radiation therapy. It works with Varian’s RPM Respiratory Gating System to track tumor motion during simulation and verification. It is intended to accelerate adoption of intensity modulated radiation therapy (IMRT). By performing patient set-up and treatment plan verification, Acuity frees the linear accelerator to be used exclusively for treatment delivery, Varian said in a press release announcing the new product.

WASHINGTON-President Bush has proposed policy changes to restrict the ability of drug companies to extend their patents past their expiration date. Mr. Bush said current federal laws and regulations try to balance the goals of innovation and accessibility.

NEW ORLEANS-Having a previous pregnancy improves the prognosis for women who develop early-stage breast cancer later in life, according to a study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 152). The findings suggest that a more aggressive treatment approach should be considered for those patients who have not had a pregnancy.

Plastic surgical reconstruction extends the capabilities of surgical and radiation therapy for cancer patients. Resection defects that are large, involve functional structures, aesthetically sensitive areas, and/or are at increased risk for wound healing complications are successfully reconstructed with a wide variety of techniques. Cancer and the complications of cancer treatment can involve virtually any area of the body, and to address every potential circumstance, the breadth of oncologic reconstruction must be extensive. A multidisciplinary team approach is the optimal method of cancer treatment, and plastic surgical reconstruction has become a critical component of that treatment, with the ability to restore form and function to the involved areas.

This article underscores what I believe is an important concept in the current state of the art of cancer therapy-namely that reconstructive plastic surgery is a key component in the treatment of many cancer patients. Clearly, the treatment of advanced-stage malignancies is now interdisciplinary, multimodal, and comprehensive. Chemotherapy and radiation therapy are becoming increasingly complementary modalities in the treatment of patients with more advanced disease.

Drs. Konner and O’Reilly have provided a thorough review of current perspectives on pancreatic cancer. The disease is lethal, difficult to diagnose in its early stages, and resistant to standard chemotherapy regimens. Surgery can be curative if performed when the tumor is small (< 2 cm), but only a minority of patients have small tumors.

LUGANO, Switzerland-Forlow-grade lymphomas, fludarabine(Fludara)-based combination therapymay have greater efficacy thansingle-agent fludarabine, especiallywhen a monoclonal antibody is partof the combination, a series of recentEuropean investigations suggest.The investigations, presentedat the Eighth International Conferenceon Malignant Lymphoma(ICML), show that various combinationtherapies hold promise, althougha lack of coordinationamong non-US study groups hashampered progress somewhat.

ORLANDO-In a phase IIIstudy, imatinib mesylate (Gleevec),formerly known as STI-571, produceda 96% complete hematologicresponse rate and a 68% completecytogenetic response rate in newly diagnosedchronic myeloid leukemia(CML) patients, Brian Druker, MD,said on behalf of the IRIS (InternationalRandomized Interferon vs STI-571) Study Group at the 38th AnnualMeeting of the American Societyof Clinical Oncology (abstract 1).

The past year hasseen a number of excitingadvances in the managementof patients withhematologic malignancies.The principal developmentshave beenthose focused on the conceptof targeted therapy.Though this conceptis not new, continuedevolution in therapeuticstrategies and advancesin knowledge of the biologyof various cellulartargets more than everare bringing about thepotential for new therapieswith additive or synergisticpotential and minimal additional toxicity.

This special “Annual Highlights” supplement to Oncology NewsInternational is a compilation of the major advances in the managementof the lymphomas and leukemias during 2002, as reported in ONI.Commentaries by the editors, Drs. Gregory Bociek, James Armitage,and Michael Keating, provide perspective and prediction as to howthese developments may affect clinical practice.

The American Cancer Society has estimated that 23,300 women will develop ovarian cancer in 2002, and 13,900 women will die from the disease.[1] The 5-year survival rate is about 80% for women with stage I disease, 50% for women with stage II disease, 25% for women with stage III disease, and 15% for women with stage IV disease. Among women with advanced-stage disease, optimal debulking surgery, as well as platinum/taxane-based adjuvant therapy prolongs disease-free and median survival.[2,3] Population-based data suggest that guidelines for therapy are not uniformly followed in community practice.[4] In addition, older patients appear to receive less aggressive treatment than younger patients.

The review by Drs. Konner and O’Reilly addresses a number of important issues in pancreatic cancer. Adenocarcinoma of the pancreas is a devastating disease,[1] not only because it will occur in approximately 30,000 Americans this year, and perhaps 200,000 people worldwide, but also because of its high associated mortality. Pancreatic adenocarcinoma is one of the least treatable and, therefore, most lethal of all cancers. Fully 95% of all patients with an established diagnosis of adenocarcinoma of the pancreas will die of their disease.

Pancreatic cancer is a leading cause of cancer-related mortality. Treatment has limited efficacy, and 5-year survival rates remain less than 5%. Insights from epidemiology and discoveries in molecular genetics have laid

HOMBURG, Germany-Afterconducting trials comparingCHOP (cyclophosphamide [Cytoxan,Neosar], doxorubicin HCl,vincristine [Oncovin], prednisone)with and without etoposide andvarying time intervals, the GermanHigh-Grade Non-Hodgkin’s LymphomaStudy Group concluded thatCHOP plus etoposide is the newstandard regimen for younger patientswith low-risk non-Hodgkin’slymphoma (NHL), and CHOP at2-week intervals is the new standardregimen for aggressive NHL in olderpatients.

WASHINGTON-A federal court has invalidated the FDA’s "Pediatric Rule" after concluding that its requirement that drug companies test the safety of adult drugs in children is contrary to the intent of Congress.