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Careful Monitoring of Saltz Regimen is Advised

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BOSTON-In a letter to the editors of the New England Journal of Medicine, researchers from two cooperative groups call for "vigilant monitoring" of patients receiving the combination of irinotecan (Camptosar), fluorouracil (5-FU), and leucovorin for metastatic colorectal cancer, due to an excess number of deaths observed in patients receiving this combination in two randomized NCI-sponsored trials. They added that specific clinical factors that increase the risk of adverse effects in patients receiving this regimen have not yet been identified.

SAN FRANCISCO-Definitive head and neck radiation produces two treatment morbidities that can affect tolerance and result in treatment breaks. Chronic xerostomia commonly occurs after 50 Gy of radiation and acute, transient mucositis can cause treatment delays that affect the efficacy of the regimen. The Radiation Therapy Oncology Group (RTOG) recently completed a randomized, placebo-controlled trial to see if pilocarpine given concurrently with radiation could prevent those toxicities.

R115777 Shows Promise Against Breast, Colorectal, and Other Solid Tumors

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SAN FRANCISCO-Many signaling cascade proteins, such as Ras, that lead to cancerous changes require an isoprenyl moiety attached by farnesyl transferase for activity. Farnesyl transferase inhibitors (FTI) are under study as a possible way to derail cancer progression. Three early studies of one such compound, R115777, show that it has promise against breast, colorectal, and other solid tumors. Janssen Research Foundation of Titusville, New Jersey, sponsored all three studies.

Treatment-Related Fatigue Widespread, But Undertreated, Seldom Discussed

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BETHESDA, Maryland-Fatigue among cancer patients "is an important problem, and it’s a legitimate topic for clinical investigation," National Cancer Institute Clinical Director Gregory A. Curt, MD, told Oncology News International, lamenting, " I don’t think it’s high on the radar for the physicians."

Fluorouracil Portal Vein Infusion Improves Disease-Free Survival

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WASHINGTON-Disease-free survival improved significantly for patients with resectable colon cancer who received portal vein infusion of fluorouracil (5-FU) after surgery, said Mark S. Roh, MD, of the National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Center, Pittsburgh. Patients did not, however, experience any improvement in their rate of liver metastasis, he added.

Antibody May Improve Survival in Recurrent Glioblastomas

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SAN FRANCISCO-In a phase II trial of the chimeric monoclonal antibody 131I-chTNT-1/B (Cotara), survival in 22 patients with recurrent glioblastoma multiforme was significantly increased, compared with that of historical controls.

Nebulized Fentanyl Relieves Dyspnea in Cancer Patients

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SAN FRANCISCO-Inhaled fentanyl can relieve the dyspnea that afflicts 70% of cancer patients and improve oxygen saturation in these patients. Patrick J. Coyne, RN, MSN, reported that fentanyl, currently used for breakthrough cancer pain, can be given through usual home health-care services.

Implantable Pump Improves Pain Control, Reduces Toxicity

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SAN FRANCISCO-A trial to compare comprehensive medical management (CMM) to CMM plus intrathecal morphine delivery via an implantable, programmable drug delivery system (IDDS) showed that the pump improved pain control by more than 15% and reduced medication side effects by nearly 50%. "The pump not only improved pain control and quality of life in patients with otherwise intractable cancer-related pain," Thomas J. Smith, MD, one of the study chairmen, told ONI, "but reduced costs associated with medication and side effects so much that by the third month of treatment, intrathecal morphine delivery should become cost-effective compared to the high doses of oral morphine typically used in these patients."

Veterinary Salve Relieves Hand-Foot Syndrome

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SAN FRANCISCO-An inexpensive over-the-counter veterinary preparation known as Bag Balm can curtail palmar-plantar erythrodysesthesia (hand-foot syndrome) and so eliminate the need to reduce chemotherapy dosages. Nadine Tchen, MD, reported that 8 of 12 patients treated with Bag Balm after developing hand-foot syndrome either had improvement or stabilization of symptoms, and were able to continue chemotherapy without changes in dose or schedule, following treatment with Bag Balm. Dr. Tchen is a clinical fellow in the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada.

Surgery Relieves Facial Paralysis due to Tumors

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SAN FRANCISCO-A new surgical method for reversing facial paralysis in brain tumor patients (see photo) will be reported at the Ninth International Facial Nerve Symposium taking place July 29 to August 1.

US Cancer Incidence and Mortality Continue to Decline

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BETHESDA, Md-The overall incidence of cancer in the United States dropped an average of 1.1% per year, and the mortality rate also declined an average of 1.1% per year during the period 1992 to 1998, according to an annual report on the status of cancer prepared by four cancer organizations.

Current Status of Thalidomide in the Treatment of Cancer

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Dr. Rajkumar has written an excellent overview of the current status of thalidomide (Thalomid) in the treatment of cancer. There is a constant demand for novel therapeutic strategies as alternative or complementary options to the existing armamentarium of chemotherapeutic agents for various malignant disorders.

CHICAGO-The Institute of Medicine (IOM) defines health care access as "timely use of affordable, continuous, quality health services which are sensitive to individual needs in order to achieve the best possible health outcomes," Jeanne Mandelblatt, MD, MPH, PhD, said at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University’s annual Health Policy Symposium.

Irinotecan (CPT-11, Camptosar) is a topoisomerase I inhibitor with a broad spectrum of antitumor clinical activity. Various schedules and doses have been studied, and major complications were delayed diarrhea and

ACS and NCCN Issue Cancer Pain Management Guidelines for Patients

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NEW YORK-One out of every three people being treated for cancer (and more than three quarters of those with advanced disease) has significant pain, but patients often lack the information to effectively manage their pain and get relief. Now, a new resource booklet is available from the American Cancer Society (ACS) and the National Comprehensive Cancer Network (NCCN) to enable cancer patients to collaborate more effectively with their physicians to make informed decisions about available pain treatment options.

Coverage for New Oral Cancer Drugs

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While many people continue to worry about Medicare’s coverage of currently available oral chemotherapy drugs, Rep. Deborah Pryce (R-Ohio) is waving a warning flag about future drugs. Her Access to Cancer Therapies Act (H.R. 1624)

Low Doses of Zoledronic Acid Reduce Complications of Bone Metastases

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Researchers at Cedars-Sinai Medical Center report that very low doses of a potent new bisphosphonate, zoledronic acid (Zometa), reduces the complications arising from multiple myeloma and breast cancer that have metastasized to the bone. The

French Researchers Discover How HIV Makes First Contact

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SAN FRANCISCO-When the HIV virus is acquired through breast-feeding or sexual activity, its first contact is with the epithelial cells of the gastrointestinal, anorectal, or genitourinary tracts. It then appears to use a raft mechanism and transcytosis to pass through the epithelial cells to enter and infect the submucosal target cells, French researchers said at the 40th Annual Meeting of the American Society for Cell Biology.

‘Virtual Supercomputer’ Program for Cancer Drug Discovery

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SANTA CLARA, Calif-Intel Corporation has announced an innovative medical research program that enlists the help of millions of personal computer users to speed up the drug discovery process. The program harnesses the "idle time" computational power of individual home computers to create a "virtual supercomputer."

ASCO Welcomes Tobacco Bill

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The American Society of Clinical Oncology (ASCO) is backing legislation (H.R. 1097) that would give the Food and Drug Administration (FDA) the authority to regulate tobacco products. The legislation explicitly states that nicotine should be

Turkish Towns Provide Genetic Link to Malignant Mesothelioma

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CHICAGO-An analysis of a six-generation extended pedigree of 526 people from two small Turkish villages showed that mesothelioma is genetically transmitted, and that building materials containing erionite may be a cofactor.