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NEW YORK-The need to test new biologically targeted therapies and the presence of vocal patient advocate groups are among the factors galvanizing the National Institutes of Health to seek wider patient participation in clinical trials, Mary McCabe, RN, said during a Cancer Care, Inc. teleconference. She also made clear that patients need to ask many questions before enrolling. Only 1% to 3% of cancer patients take part in clinical trials, said Ms. McCabe, director of the National Cancer Institute’s Office of Education and Special Initiatives. "We would like to see that change," she said.

LITTLE ROCK, Arkansas-Thalidomide appears to enhance the response rate produced by irinotecan (Camptosar) in metastatic colorectal cancer, while decreasing the drug’s gastrointestinal toxicities, reported Rangaswamy Govindarajan, MD. In addition, thalidomide is well tolerated at 400 mg/d, inhibits tumor necrosis factor-alpha, has antiangiogenic properties, and costimulates CD8+ T-cells, Dr. Govindarajan noted. He is assistant professor of medicine in the Division of Hematology/Oncology at the University of Arkansas for Medical Sciences, Little Rock, Arkansas.

NASHVILLE, Tennessee-"Camptothecins have radiosensitizing as well as cytotoxic effects, and combining a camptothecin such as irinotecan with radiation on the right schedule might produce a powerful antitumor regimen," according to Allan Chen, MD, PhD. Dr. Chen is assistant professor of radiation oncology at Vanderbilt University Medical Center in Nashville, Tennessee.

DURHAM, North Carolina- Topoisomerase I inhibitors have shown promising activity in difficult-to-treat tumors of the central nervous system (CNS), according to Henry S. Friedman, MD. In studies of camptothecins, both irinotecan (Camptosar) and topotecan (Hycamtin) showed "prodigious activity" in slowing tumor growth and causing tumor regression in subcutaneous xenografts of human gliomas, Dr. Friedman told those attending the Vanderbilt University Symposium. Dr. Friedman is Jones B. Powell, Jr., Professor of Neuro-Oncology at Duke University Medical Center in Durham, North Carolina.

PEAPACK, New Jersey-Potential directions for irinotecan (Camptosar) clinical research in the future and for the application of novel therapeutics were presented by Langdon Miller, MD, of Pharmacia Oncology Development in Peapack, New Jersey.

The article by Drs. Levine, Seneviratne, and Tulpule is an excellent review of the available literature on the incidence and treatment of lymphoma related to the acquired immunodeficiency syndrome (AIDS).

Advances in antiretroviral therapy have dramatically improved human immunodeficiency virus (HIV)-associated morbidity and mortality. The use of highly active antiretroviral therapy (HAART) has led to a decrease in the incidence of opportunistic diseases, including some malignancies. Moreover, increased use of effective antiretroviral therapy may alter the incidence, presentation, prognosis, and therapeutic recommendations for patients with acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin’s lymphoma.

Over the past 3 decades, hematopoietic stem cell transplantation has become a lifesaving art that is applied to a variety of malignant and nonmalignant disorders.[1] In the 1970s, several groups demonstrated that advanced leukemia and aplastic anemia patients were cured using sibling-matched allogeneic bone marrow transplantation. By the 1980s, many published reports confirmed that relapsed and refractory lymphoma patients could attain long-term disease-free survival as a result of utilizing autologous bone marrow transplantation.

The demographics of the US population continue to change dramatically, as the absolute number and proportion of older people relative to the remainder of the population increases. Last year, the number of persons older than 65 years was estimated to be 35 million, representing almost 13% of the overall population; by 2030, the older population is expected to double. Along with the general aging of the population, the percentage of persons older than 85 years is also growing rapidly, as is the ethnic and racial diversity within the older population.

Over time, the spectrum of the acquired immune deficiency syndrome (AIDS) epidemic has changed, especially with the advent of highly active antiretroviral therapy (HAART). The goal of this article is to delineate changes

Estramustine is nornitrogen mustard linked to estradiol. It binds to tubulin and to microtubule-associated proteins, depolymerizes cytoplasmic microtubules, and disrupts the nuclear matrix. It has limited clinical

The aging of the population is a social phenomenon that will present a challenge to clinical practice in the 21st century. Women constitute a majority of the elderly population as they outlive males by 5 to 7 years. Ovarian,

This is the first in a series of reports on presentations from "Ensuring Quality Cancer Care," a symposium held in Chicago and sponsored by the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and the VA Chicago Health Care System. The reports, which put the discussions into a broader context, have been prepared for ONI by researchers at Northwestern University, working under the direction of Dr. Charles L. Bennett.

An underinvestigated area of breast cancer survivorship involves the possible impairment of cognitive function following adjuvant chemohormonal therapy. Numerous reports of disturbing and disruptive changes in short- and

The editors of this impressive new book indicate in their preface that this text was compiled to give "undivided attention" to granulomatous disorders other than sarcoidosis. Toward that end, they have assembled an impressive array of experts from

WASHINGTON-The nation’s health care industry is broken and urgently needs reorganization and reform to fix it, a new Institute of Medicine (IOM) report asserts. As a beginning, the report proposes that Congress appropriate $1 billion over the next 3 to 5 years to begin repairing what it calls a disjointed and inefficient system.

SkyePharma PLC and Chiron Corporation have received clearance from the US Food and Drug Administration (FDA) to return cytarabine liposome injection (DepoCyt) to the market. Liposomal cytarabine is the only FDA-approved treatment for

WASHINGTON-Smoking prevalence varies considerably from state to state among both adults and students, according to new data from the Centers for Disease Control and Prevention (CDC). In 1999, adult prevalence ranged from 13.9% in

BETHESDA, Md-The National Cancer Institute has opened its arms wider to the advocacy community with a new program called Consumer Advocates in Research and Related Activities, or CARRA. NCI plans to recruit 150 consumer advocates under the CARRA program who will serve 3-year terms. The advocates are to represent survivors’ concerns, provide their ideas and viewpoints directly to the NCI staff, and serve as links between the advocacy communities and the Institute.

SAN ANTONIO-By inserting a thin, hollow fiberoptic ductoscope through breast ducts in the nipple, physicians can examine the ductal system of the breast and accurately locate ductal lesions (see images).

BETHESDA, Md-Revised guidelines for treating HIV-infected adults provide new recommendations for when physicians should initiate anti-HIV therapy. "The new treatment guidelines provide patients and their doctors with evidence-based recommendations for initiating antiretroviral therapy that take into account both the benefits and potential risks of currently available treatment regimens," said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID).

Not only has the Health Care Financing Administration (HCFA) backed off on threats to reduce Medicare and Medicaid payments to oncologists for in-office chemotherapy infusion drugs, but now HCFA is making it clear that oncologists can

SAN FRANCISCO-Studies presented at the 42nd Annual Meeting of the American Society of Hematology (ASH) show that thalidomide (Thalomid) has value as a single agent in treating advanced and refractory myeloma and that thalidomide combined with dexamethasone is useful in treating resistant and newly diagnosed disease.

LONDON-SkyePharma PLC and its marketing partner, Chiron Corporation (Emeryville, California) have received clearance from the US Food and Drug Administration to return DepoCyt (cytarabine liposome injection) to the market.

WASHINGTON-President Bush has called on Congress to enact a bipartisan and "strong Patients’ Bill of Rights." In letters to Republican and Democratic leaders on Capitol Hill, he outlined the basic principles that he believes such a law should embody.

ROCKVILLE, Md-Research on managing cancer pain lags well behind studies of cancer biology, both in quality and quantity, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). That conclusion emerged from a literature review by researchers at the AHRQ-supported New England Medical Center Evidence-based Practice Center.

BOSTON-For the cancer patient who can’t hold a breath or stay still during radiation therapy, a team of medical experts and engineers is working on a tracking solution worthy of James Bond-spy cameras and robotic vision.

BOSTON-In a study of 1,253 breast cancer patients treated with breast-conserving surgery and radiotherapy, the risk of a second malignancy jumped from 5% at 5 years of follow-up to 16% at 10 years. Barbara L. Fowble, MD, of Fox Chase Cancer Center, reported the results at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

In their article in this issue, Drs. Jatoi and Loprinzi review much of the data on weight loss and anorexia in cancer patients from the standpoint of the impact of nutrition and various pharmacologic agents on management, and they make some sound recommendations for therapy. The benefit of nutritional interventions in this area are often overhwhelmed by the patient’s complex disease course and, therefore, are difficult to demonstrate.

Drs. Jatoi and Loprinzi provide a comprehensive but succinct overview of the management of cancer-associated anorexia and weight loss. These clinician researchers, who have added much to our understanding of this problem, present a balanced and reasonable approach to the management of these common paraneoplastic syndromes.