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BETHESDA, Md-The National Institute of Allergy and Infectious Diseases (NIAID) has formed four public-private partnerships aimed at accelerating the development of promising HIV/AIDS vaccines.

WASHINGTON-The US Public Health Service (PHS) has released “Treating Tobacco Use and Dependence: A Clinical Practice Guideline,” which offers trial-based data on first- and second-line therapies to help smokers quit.

WASHINGTON-Pain in cancer patients is woefully undermanaged because of multiple barriers from patients, physicians, and the nation’s health care system, several speakers said at a congressional briefing.

ARLINGTON, Va-Nurses often take an active role in integrating complementary and alternative medicine (CAM) with conventional care in the hospital setting, said a panel of nurses at a session of the Comprehensive Cancer Care 2000 conference.

ATLANTA-The first patients have completed treatment using the MammoSite Radiation Therapy System (RTS) in a multisite, investigational clinical trial currently underway.

OAKLAND, California-The National Brain Tumor Foundation (NBTF) has announced its new cancer online resource and toll-free telephone number. Patients and family members who have detailed medical questions regarding brain tumors can contact a neuroscience nurse for a free consultation.

SILVER SPRINGS, Md-Recognizing that caregivers are the backbone of our health care system, developers of the Cancer Survival Toolbox advocacy program have added a new audiotape, “Caring for the Caregiver.” The tape provides cancer caregivers with self-advocacy tools to help them better cope with the disease and their own needs.

NEW ORLEANS-A meta-analysis of two independent phase III randomized multicenter studies “further strengthens the conclusion that the combination of irinotecan (CPT-11, Camptosar)/fluorouracil (5-FU)/leucovorin represents a new reference standard in the first-line treatment of patients with metastatic colorectal cancer,” said Leonard Saltz, MD, associate attending physician, Division of Solid Tumor Oncology, Memorial Sloan-Kettering Cancer Center.

NEW ORLEANS-Antiangiogenesis drugs under development may find their greatest utility in early-stage cancer and in combination with other agents, Michael S. Gordon, MD, said at a symposium sponsored by Agouron Pharmaceuticals (La Jolla, Calif). The symposium, “Novel Mechanisms in the Future of Cancer Treatment,” was held in conjunction with the American Society of Clinical Oncology’s 36th Annual Meeting.

Individual physicians and those in small group practices are urged to begin implementing internal audit procedures for “high risk” billing operations.

NEW YORK-Regimens based on cisplatin (Platinol), irinotecan (Camptosar), and paclitaxel (Taxol) may provide a better alternative than cisplatin and 5-fluorouracil (5-FU) in treating difficult cases of gastric and esophageal cancers. Developing more effective therapies has considerable public health importance because of the high incidence and mortality rates of these cancers, commented Eileen M. O’Reilly, MD, of Memorial Sloan-Kettering Cancer Center in New York.

ATLANTA-The CaverMap Surgical Aid to help surgeons protect the cavernous nerves during nerve-sparing prostatectomy appears not to be specific enough to be clinically useful at present, Patrick Walsh, MD, said at the 95th Annual Meeting of the American Urological Association (AUA).

HOUSTON-Early results of an ongoing phase II trial of irinotecan in relapsed or refractory non-Hodgkin’s lymphoma (NHL) show response rates of 33% to 45% in some NHL subtypes, reported Andreas H. Sarris, MD, PhD, at the clinical investigators’ workshop. For the most responsive subtypes (indolent lymphomas, relapsed aggressive lymphomas, and possibly refractory aggressive lymphomas), patient accrual will continue, reported Dr. Sarris, Associate Professor in the Department of Lymphoma and Myeloma at the M. D. Anderson Cancer Center in Houston. The workshop was sponsored by M. D. Anderson and Pharmacia Oncology.

In treating cancer, discovering new ways to use or modify old drugs can sometimes be as valuable as the identification of new drugs. This point is elegantly illustrated in Dr. Schilsky’s article about capecitabine (Xeloda), a prodrug that leads to high intratumoral levels of fluorouracil (5-FU).

Commonly used by cancer patients, unproven therapies are treatments that the practitioner claims can alter the disease process although there is no proof to support the claim. The reasons for the popularity of uproven

Commonly used by cancer patients, unproven therapies are treatments that the practitioner claims can alter the disease process although there is no proof to support the claim. The reasons for the popularity of uproven

Commonly used by cancer patients, unproven therapies are treatments that the practitioner claims can alter the disease process although there is no proof to support the claim. The reasons for the popularity of uproven

In this issue of Oncology, Dr. Schilsky has provided a comprehensive yet concise review of the pharmacology of the fluoropyrimidines and, in particular, capecitabine (Xeloda).

In order to derive maximum benefit from treatment with chemotherapeutic agents, adherence to the established chemotherapy dose and schedule is imperative.

Preclinical studies have shown that rhIL-11, also known as oprelvekin (Neumega), stimulates early and later stages of megakaryocytopoiesis (including proliferation and differentiation of megakaryocyte precursors and maturation of megakaryocytes), to

Safety data from two randomized phase II and one abbreviated phase III placebo-controlled, double-blind clinical studies in adult patients with nonmyeloid malignancies indicate that recombinant human interleukin-11 (rhIL-11, also known as oprelvekin [Neumega]) has an acceptable toxicity profile as therapy for the mitigation of chemotherapy-induced thrombocytopenia.

PHILADELPHIA-“Most people would agree that standard-of-care for frontline treatment of advanced colorectal cancer (CRCA) should now be irinotecan (Camptosar) plus 5-fluorouracil/leucovorin (5-FU/LV),” stated Daniel G. Haller, MD, at an investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology. As the basis for this assessment, Dr. Haller of the University of Pennsylvania Cancer Center in Philadelphia, cited presentations made earlier this year.

ROCHESTER, Minn-Standard adjuvant therapy for stage III colorectal cancer (CRCA) should be 6 months of 5-flourouracil (5-FU) plus either high-dose or low-dose leucovorin (LV), but new agents “offer the promise of less toxicity and possibly improved survival,” Henry C. Pitot, MD, reported. A consultant in the Division of Medical Oncology at the Mayo Clinic in Rochester, Minnesota, Dr. Pitot described several of these new regimens at a clinical investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology.

CHICAGO-No overall gain was seen with ranpirnase (Onconase) compared with doxorubicin in unresectable malignant mesothelioma, but there was a trend toward ranpirnase benefit in good-prognosis patients.

Ever since the first phase II study of paclitaxel (Taxol) began, there has been ongoing controversy about the optimal dose and schedule of administration of this drug. The initial reports of marked antitumor activity against metastatic breast cancer were obtained using 250 mg/m² administered by 24-hour continuous IV infusion. This schedule was originally developed in an attempt to reduce the incidence and severity of anaphylactic reactions. Subsequent to the determination that this dose and schedule was effective and safe, there were multiple attempts to develop more convenient schedules, and dose/schedules associated with an improved side-effect profile.

The Southwest Oncology Cooperative Group (SWOG) conducted a study in which single-agent docetaxel (Taxotere) was used as “consolidation” therapy following concurrent chemoradiotherapy (abstract #1916). A previous SWOG study (S90-19) (Proc Am Soc Clin Oncol 16: 446a [abstract 1600], 1997) established that chemotherapy with cisplatin (Platinol)/etoposide could be given concurrently with definitive thoracic irradiation both safely and effectively. In this earlier trial, following the completion of irradiation, two additional cycles of cisplatin/etoposide were given.

Gómez-Bernal et al (abstract #341) report the results of a docetaxel (Taxotere)/vinorelbine (Navelbine) combination as second-line therapy for metastatic breast cancer. Both agents were administered on the same day and repeated every 14 days. The 52% objective response rate is impressive, since vinorelbine alone would be expected to produce a 20%–30% response rate in this setting, with docetaxel projected to achieve a 40% complete and partial remission rate. Therefore, the results suggest an additive interaction between the two agents.

Over the past 5 years it has become evident that the administration of taxanes on a weekly schedule dramatically changes their toxicity profile, compared to the standard 3-weekly schedule. Weekly docetaxel (Taxotere) is markedly less

Evidence generated by controlled clinical trials over the past 4 decades indicated that combination chemotherapy produced superior results to single-agent cytotoxic therapy. Response rates and times to progression were superior with combination chemotherapy, and survival was also favorably altered by this approach. This paradigm has been recently challenged on the basis of the Norton-Simon hypothesis and by the development of more effective, new cytotoxic agents, specifically the taxanes.

Before the introduction of the taxanes into the management of breast cancer, the anthracyclines (and doxorubicin and epirubicin [Ellence] in particular) were considered the most active agents against this malignancy. The marked activity of single-agent taxanes suggested that their antitumor efficacy might match and perhaps exceed that of the anthracyclines. Several prospective randomized trials have confirmed these initial impressions. At intermediate doses (60 mg/m²), the activity of doxorubicin and paclitaxel (Taxol) was similar; at higher doses (75 mg/m²), doxorubicin appeared more effective. Conversely, docetaxel (Taxotere) was reported to be more active than doxorubicin in one trial.