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PONTE VEDRA BEACH, Fla-A descriptive study drawing cancer patients from seven outpatient clinics has found that female patients with bone metastases were prescribed half the pain medication as male patients with the same pain intensity scores. The disparity was significant whether the researchers counted all of the analgesics prescribed to each patient or only the opioid analgesics.

SAN FRANCISCO-Umbilical cord blood from unrelated donors can be a useful source of hematopoietic stem cells for treating hematologic malignancies in adults as well as infants, according to a multicenter study presented by Mary J. Laughlin, MD, at the 42nd Annual Meeting of the American Society of Hematology (ASH). Dr. Laughlin is director of the Allogeneic Transplant Program, Case Western Reserve University, University Hospitals Ireland Cancer Center.

HOUSTON-Preclinical studies showing that irinotecan (Camptosar) has broad-spectrum activity in vitro and in vivo in xenografts derived from pediatric tumors are being followed by phase I and phase II clinical trials. Susan Blaney, MD, associate professor of pediatrics at Texas Children’s Cancer Center in Houston said that irinotecan has shown activity in pediatric neuroblastoma, rhabdomyosarcoma, and medulloblastoma (including glioma) in preclinical studies.

NASHVILLE, Tennessee-Irinotecan (Camptosar) has moved from scientific investigation to clinical application, but questions remain about its optimal use. These questions and related issues were outlined at the opening session of the Vanderbilt University Symposium, "Irinotecan: from Scientific Investigation to Clinical Application," by program chairman Mace L. Rothenberg, MD. Dr. Rothenberg is associate professor of medicine, Ingram Associate Professor of Cancer Research, at Vanderbilt University Medical Center in Nashville, Tennessee. The symposium was sponsored by Pharmacia Oncology.

WASHINGTON-Twenty-two public health organizations have again called on the federal government to initiate action against R.J. Reynolds Co. to stop it from making unsubstantiated health-related claims about its Eclipse cigarette.

ROCHESTER, Minnesota-According to Richard M. Goldberg, MD, the potential advantages of oral irinotecan include prolonged blood levels, less toxicity, greater convenience, and reduced cost. Interestingly, more complete responses and sustained remissions were associated with oral irinotecan vs IV administration in mice with CX-1 colon cancer xenografts. Dr. Goldberg is chair of gastrointestinal oncology research at the Mayo Clinic in Rochester, Minnesota.

NEW YORK-The Association of Cancer Online Resources (ACOR) has launched a new website, Cancer-pain.org, to provide cancer patients with the education and support they need to obtain effective pain relief.

NEW YORK-"In my sculpture, I see women as rich earthbound creatures. They are rooted to the ground while simultaneously reaching up and outward, vulnerable yet strong," says Leonda Finke, creator of the bronze sculpture shown at left (Standing Figure #3 ? by Leonda Finke). The sculpture was featured in the 2001 desk calendar of the New York-based Creative Center for Women With Cancer. The calendar is sponsored by Novartis Pharmaceuticals.

ROCHESTER, Minnesota-Accurate surrogate markers that would help researchers predict clinical response to systemic cancer chemotherapy and greatly speed development of new treatments may be on the way. Alex A. Adjei, MD, PhD, discussed these anticipated markers that will be much more precise than those currently in use. Dr. Adjei is consultant in oncology at the Mayo Clinic in Rochester, Minnesota.

CHICAGO-Obtaining an individual patient’s genetic profile for genetic polymorphisms known to affect drug responsiveness or risk of drug toxicity will become a routine part of medical care over the next 25 years and will dramatically transform the prescribing process, Mark J. Ratain, MD, predicted at the Vanderbilt University Symposium. Dr. Ratain is professor of medicine and chairman of the Committee on Clinical Pharmacology at the University of Chicago.

PORTLAND, Oregon-Cyclooxygenase 2 (COX-2) inhibitors are attracting attention as potential anti-cancer drugs because of evidence of increased survival in patients with low levels of COX-2. Charles D. Blanke, MD, FACP, associate professor of medicine, Oregon Health Sciences University in Portland, reviewed current COX-2 research for participants at the Vanderbilt University symposium.

PISCATAWAY, New Jersey-Three aspects of topoisomerase I are currently under intensive investigation by researchers hoping to improve cancer chemotherapy: the mechanism of topoisomerase I poisoning, cellular processing and repair, and mechanisms of resistance to topoisomerase I inhibitors. These issues were reviewed at the Vanderbilt University Symposium by Leroy F. Liu, PhD, who heads the Department of Pharmacology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, in Piscataway.

The American Cancer Society is one of a number of groups supporting a new bill that would authorize Medicare to pay for smoking cessation counseling and Medicaid to pay for both prescription and nonprescription smoking cessation drugs. The

PONTE VEDRA BEACH, Florida-Cancer patients with bone metastases who received around-the-clock (ATC) analgesics took substantially more medication but did not have better pain relief than patients on as-needed (pro re nata, PRN) dosing regimens in a study reported by Christine Miaskowski, RN, PhD.

PITTSBURGH-In its most recent position statement on assisted suicide, the Oncology Nursing Society (ONS) calls for continued dialog on any and all ethical dilemmas, such as assisted suicide. The statement emphasizes the caring component of nursing and calls for effort to improve compassionate and competent care for the dying.

BETHESDA, Md-Most oncologists probably never thought they would need to worry about overdiagnosing cancer. Yet overdiagnosis-the detection of an actual cancer that will never harm the patient-is emerging as a clinical concern. In this interview, medical oncologist Barnett "Barry" Kramer, MD, discusses the issue of overdiagnosis with Patrick Young, ONI’s Washington Bureau Chief.

After nearly 30 years of dedication, the International Bone Marrow Transplant Registry (IBMTR) and the Autologous Blood and Marrow Transplant Registry (ABMTR), by nearly any criterion, can be considered a success. The Registry contains over 120,000 patient records that are an invaluable source of information on both autologous and allogeneic bone marrow transplantations. Through the voluntary efforts of more than 350 institutions, it annually registers over 20% of all transplants occurring in nearly 50 countries and, by some estimates, nearly half of all transplants in North America.

PONTE VEDRA BEACH, Fla-Breast cancer patients were less stressed by treatment-related symptoms when they used virtual reality software to solve a mystery, visit an art museum, or go deep-sea diving during chemotherapy sessions. Susan M. Schneider, PhD, RN, AOCN, reported the results of the pilot study at the Oncology Nursing Society’s Sixth National Conference on Cancer Nursing Research.

NEW BRUNSWICK, New Jersey-Although camptothecins can cure colon cancer in animals, they are active but not curative in human tumors. The question of why drugs that are effective in animal models are sometimes less effective in clinical studies, as well as issues related to resistance to cytotoxic drugs were discussed by Eric H. Rubin, MD. Dr. Rubin is associate professor at the Cancer Institute of New Jersey, Robert Wood Johnson Medical School in New Brunswick.

NEW ORLEANS-New findings reported at the 92nd Annual Meeting of the American Association for Cancer Research (AACR) support an emerging view that genetic mutations not only contribute to cancer etiology but even to individual variability in response to cancer treatment.

INDIANAPOLIS-"Preclinical models suggest a role for glutamine supplementation in patients with cancer, but confirmation of clinical efficacy is needed," according to Patrick J. Loehrer, Sr., MD. "Glutamine plays an important and varied role in normal humans, and cancer significantly alters glutamine synthesis and catabolism," explained Dr. Loehrer, who is professor of medicine at Indiana University Medical Center in Indianapolis.

SAN ANTONIO, Texas-Irinotecan is metabolized via CYP3A4 to the less active oxidative metabolites APC and NPC and is bioactivated in the liver and intestine by human carboxylesterases (hCE) to the topoisomerase I inhibitor SN-38 (Figure 1). The pharmacology of irinotecan (Camptosar, CPT-11), a water-soluble, semisynthetic derivative of camptothecin, was reviewed at the Vanderbilt University Symposium by John G. Kuhn, PharmD, of the Departments of Medicine and Pharmacology, University of Texas Health Science Center, San Antonio, and College of Pharmacy, University of Texas.

BUFFALO-New work on the role of schedule and dose in determining the efficacy of two classes of drugs-thymidylate synthase inhibitors and topoisomerase I inhibitors-was described by Youcef M. Rustum, PhD, at the Vanderbilt University Symposium. Dr. Rustum is senior vice president for scientific affairs and graduate education at Roswell Park Cancer Institute in Buffalo.

NEW ORLEANS-A genetic variant has been found to double an HIV-infected individuals’ risk of developing non-Hodgkin’s lymphoma (NHL). Charles S. Rabkin, MD, HIV/Cancer Coordinator, Viral Epidemiology Branch, National Cancer Institute, presented the report at the 92nd Annual Meeting of the American Association for Cancer Research (AACR).

FORT LAUDERDALE, Fla-Studies show that chronic lymphocytic leukemia (CLL) responds to therapy with alemtuzumab (Campath). However, the monoclonal antibody is immunosuppressive, and patients who receive it should be on prophylactic antibiotics, Susan O’Brien, MD, said at the 6th Annual Conference of the National Comprehensive Cancer Network (NCCN).

BETHESDA, Maryland-An understanding of how camptothecins intrude between topoisomerase I and DNA is helping to refine the anticancer activity of these drugs, and studies of the pathway from initial camptothecin binding to final cell death may help unravel the mechanisms behind drug resistance. Yves Pommier, MD, PhD, chief of the National Cancer Institute’s Laboratory of Molecular Pharmacology reviewed recent developments in these areas at the Vanderbilt University Symposium.

WASHINGTON-Tobacco companies are not getting the same bang for their advertising dollars as they once did. Cigarette sales in the United States in 1999, the first year affected by the Master Settlement Agreement between the tobacco industry and 46 states, dropped despite an increase in spending for advertising and promotions.

MEMPHIS-‘‘Camptothecin activity is schedule dependent and is very S-phase-specific at concentrations we can achieve in vivo," Peter J. Houghton, PhD, said while summarizing the results of preclinical studies with camptohecins. "Protracted administration is optimal, and threshold concentrations are critical," he continued. Dr. Houghton is chairman of the Department of Molecular Pharmacology at St. Jude Children’s Research Hospital in Memphis.