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HOUSTON-Adding rituximab (Rituxan) to standard chemotherapy increased complete remission (CR) rates for chronic lymphocytic leukemia (CLL) and reduced the number of bone marrow cells expressing the CLL-associated cell-surface markers CD5 and CD19, according to Michael J. Keating, MD. "Fludarabine, cyclophosphamide, and rituximab (FCR) is the most active regimen explored by our group in previously untreated CLL, and the toxicity profile is similar to that seen with FC alone," said Dr. Keating, professor of leukemia developmental research at the University of Texas M. D. Anderson Cancer Center in Houston.

LYON, France-In one of the most eagerly awaited presentations at the 42nd Annual Meeting of the American Society of Hematology, Bertrand Coiffier, MD, predicted that the combination of rituximab (Rituxan) plus CHOP "may be the new standard for treatment of aggressive B-cell lymphomas in elderly patients." Head of hematology at Hospices Civilese de Lyon, Lyon, France, Dr. Coiffier presented an interim analysis of results from a European phase III trial of rituximab plus CHOP (cyclophosphamide, doxorubicin, Oncovin [vincristine], prednisone) in elderly patients with diffuse large B-cell lymphomas (DLBCL).

CHICAGO-Intensity modulated radiation therapy (IMRT) offers dramatic advantages for selected pediatric patients, such as those with sarcomas of the chest, abdomen, or pelvis, as well as children with tumors of the head and neck or brain, said Suzanne Wolden, MD, a radiation oncologist at Memorial Sloan-Kettering Cancer Center

SAN FRANCISCO-Iodine I 131 tositumomab (Bexxar) attains complete remission in more than one third of non-Hodgkin’s lymphoma (NHL) patients, and these responses can last several years, according to a 10-year study.

BOSTON-Gene expression profiling may help predict survival outcomes for patients with diffuse large B-cell lymphoma (DLBCL), the most common lymphoid malignancy, according to a study reported by Margaret Shipp, MD, director of the Lymphoma Program at Dana-Farber Cancer Institute in Boston. In the study, gene expression profiling was able for the first time to identify curable and noncurable lymphomas from a pool of intermediate-risk patients.

SAN FRANCISCO-Interim results of a trial of the combination of rituximab (Rituxan) and fludarabine (Fludara), a novel approach for the treatment of low-grade or follicular B-cell lymphoma, suggest excellent antitumor activity. Rituximab, an anti-CD20 monoclonal antibody, is the only approved monoclonal antibody therapy for refractory or relapsed low-grade or follicular non-Hodgkin’s lymphoma (NHL).

SAN FRANCISCO-The anemia drug darbepoetin alfa (ARANESP) effectively alleviates anemia, boosting hemoglobin counts and reducing the need for red blood cell transfusions, according to the results of two separate studies.

NEW YORK-Low doses of arsenic trioxide (ATO) given by intravenous injection are highly effective at inducing remission in patients with relapsed acute promyelocytic leukemia (APL) and should be tested in patients with newly diagnosed disease. These results and recommendation were based on research conducted at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York.

BETHESDA, Md-Why don’t all Americans get the best available cancer care? Answers both tentative and diverse have emerged from the first four of seven regional hearings conducted by the President’s Cancer Panel (PCP). The hearings are intended to elicit testimony from people throughout the nation.

BOSTON-Health care providers are not generally part of the discussion about the future of health care in the United States-but they need to speak up in the perilous times ahead, Harvard University economist Marc J. Roberts, PhD, challenged physicians at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

WASHINGTON-Gene therapy is unlikely to cure cancer on its own, but may enhance existing treatments when used in combination, said Chuan-Yuan Li, PhD, of Duke University Medical Center. "Combining gene therapy with radiation therapy produces a synergistic effect on tumors and merits further study," he said at the Susan G. Komen Breast Cancer Foundation grants conference "Reaching for the Cure."

WASHINGTON, DC-Rituximab (Rituxan) given three times per week has significant activity in chronic lymphocytic lymphoma (CLL) and in small lymphocytic lymphoma (SLL), but platelets must be monitored closely in patients with preexisting thrombocytopenia. These results from a phase-I/II rituximab study were described by John C. Byrd, MD, of Walter Reed Medical Center in Washington, DC.

BETHESDA-"BL22 is the first agent since purine analogs capable of inducing complete remission in the majority of patients with hairy cell leukemia, and the only agent that can induce complete remission in most patients with chemotherapy-refractory or variant HCL," according to Robert J. Kreitman, MD. "Its sparing of T cells," he continued, "may also allow improved clearing of minimal residual disease."

HOUSTON-High-dose chemotherapy (HDCT) plus rituximab (Rituxan) produces responses comparable to HDCT with total body irradiation and stem cell transplant for aggressive mantle cell lymphoma (MCL), according to Jorge E. Romaguera, MD, of the University of Texas M. D. Anderson Cancer Center in Houston, Texas. In a poster presentation, Dr. Romaguera said that HDCT with rituximab (but without total body irradiation or stem cell transplant) produced a complete response (CR) rate of 86%.

EAST MELBOURNE, Australia-Dose-intensified CEOP (cyclophosphamide, epirubicin, Oncovin [vincristine], prednisolone) produces significantly more toxicity than a standard dose CEOP regimen (s-CEOP), but does not improve outcome in non-Hodgkin’s lymphoma patients, according to a phase-III trial conducted in Australia and New Zealand by the Australian Leukemia and Lymphoma Group (ALLG).

BOSTON-Women who receive postlumpectomy radiotherapy to their left breast are not at greater risk of heart attacks, according to a study presented by Katherine Vallis, MD, at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

Although bone pain from osteoblastic metastases can be ameliorated 50% to 80% of the time by use of intravenously or orally administered radiopharmaceuticals, we cannot accurately predict who will or will not

Corticosteroids play a vitally important role in the treatment of patients with advanced cancer. While the scientific data, as reviewed by Wooldridge et al, are often slim, most physicians who treat patients with cancer quickly become comfortable with prescribing synthetic glucocorticoids for a variety of indications. Wooldridge et al have provided a much needed synthesis of the medical literature on the use of steroids, both as part of chemotherapeutic treatment for a variety of malignancies and in symptom control.

Drs. Wooldridge, Anderson, and Perry have succinctly reviewed the use of corticosteroids in patients with advanced cancer. The common uses of corticosteroids-namely, the treatment of nausea and vomiting, hypersensitivity reactions, and appetite stimulation-are well covered. In addition, the use of corticosteroids for the treatment of spinal cord compression and bone pain are also reviewed. The authors provide a definitive summary of the available published literature.

Although bone pain from osteoblastic metastases can be ameliorated 50% to 80% of the time by use of intravenously or orally administered radiopharmaceuticals, we cannot accurately predict who will or will not

Although bone pain from osteoblastic metastases can be ameliorated 50% to 80% of the time by use of intravenously or orally administered radiopharmaceuticals, we cannot accurately predict who will or will not

Dr. Subir Nag et al are to be congratulated for their excellent, thorough analysis and presentation of the use and role of

The first attempt at using monoclonal antibodies in lymphoma therapy, reported in 1980, was unsuccessful. Since that time, several immunotherapeutic approaches to treating non-Hodgkin’s lymphoma have been developed,

The article by Nag and colleagues of the American Brachytherapy Society is a well-intentioned effort to establish guidelines

The field of stereotactic radiosurgery is rapidly advancing as a result of both improvements in radiosurgical equipment and better physician understanding of the clinical applications of stereotactic radiosurgery. This

The first attempt at using monoclonal antibodies in lymphoma therapy, reported in 1980, was unsuccessful. Since that time, several immunotherapeutic approaches to treating non-Hodgkin’s lymphoma have been developed,

Physicians who diagnose and treat cancer have an enormous responsibility. They not only have to be aware of the medical aspects of cancer screening, diagnosis, and treatment, but also have the difficult task of talking about these issues with their patients.

Despite impressive response rates, none of the current array of monoclonal antibodies has produced cures. The median duration of response following rituximab is about 1 year, and all patients eventually relapse and require additional treatment

Other active unconjugated antibodies are in various stages of their clinical development. CAMPATH-1H has recently been approved for the treatment of refractory chronic lymphocytic leukemia (Keating et al: Blood 94:705a[abstract 3118],

Once the radioimmunoconjugates (RICs) become more widely available, the practicing physician will be faced with important questions regarding their role relative to the unconjugated antibodies, and with a decision as to which is the