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CLEVELAND, Ohio-Nearly half of the symptoms associated with cancer are gastrointestinal (GI), including anorexia, weight loss, dry mouth, constipation, early satiety, nausea and vomiting, taste change, and dysphagia. Yet these symptoms are among the most difficult to treat because their pathophysiology is not well understood, available drugs are not always effective, and multiple symptoms may occur together, Kristine A. Nelson, MD, said at a symposium on palliative medicine held at the Cleveland Clinic Foundation.

BALTIMORE-Fludarabine (Fludara) and cyclophosphamide are highly active agents for indolent lymphomas, but when given in combination, opportunistic infections such as Pneumocystis carinii pneumonia (PCP) and herpes zoster may be dose limiting.

NEW YORK-The addition of G-CSF (Neupogen) to standard CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) may improve disease outcome in elderly patients with large-cell lymphoma by allowing optimal drug dosing, Gerard Donnelly, MD, said at the Fortieth Annual Meeting of the American Society of Hematology (ASH).

WASHINGTON-One major problem in the adjuvant treatment of breast cancer is that tumors may become resistant to endocrine therapy, even if estrogen/progesterone (ER/PR) receptors remain. Furthermore, some tumor cells appear to be stimulated by the treatment itself. “An antagonist can act as an agonist,” Kathryn B. Horwitz, PhD, said at a basic science symposium sponsored by the National Foundation for Cancer Research.

SAN DIEGO-With several new ultrasensitive HIV viral load assays soon to be available, Jonathan Schapiro, MD, questioned to what degree they will be able to predict or help physicians manage clinical HIV resistance. “We will be seeing both genotypic and phenotypic resistance assays for use with zidovudine [Retrovir], abacavir [investigational], and protease inhibitor resistance,” he said at ICAAC.

GAITHERSBURG, Md-The Food and Drug Administration’s Oncologic Drugs Advisory Committee (ODAC) has advised Zila, Inc., to take OraTest (tolonium chloride) back to the clinic for further testing. But members disagreed whether continuation of an ongoing clinical trial could provide the data necessary for the group to recommend approval of the test for detecting oral cancer, or if the company needs to undertake an entirely new study.

HOUSTON-The anti-CD20 monoclonal antibody rituximab (Rituxan) is approved for treatment of relapsed or refractory low-grade or follicular B-cell non-Hodgkin’s lymphoma but is less effective in small lymphocytic lymphoma (SLL), the tissue equivalent of chronic lymphocytic leukemia (CLL). In the pivotal trial, the response rate for SLL patients was 13% vs 60% for those with follicular lymphoma.

SOUTHAMPTON, UK-New immunotherapeutic agents often come with big price tags, but the costs of treating relapsed non-Hodgkin’s lymphoma (NHL) with a new anti-CD20 monoclonal antibody may be lower than the costs of conventional therapy, according to an economic analysis by UK researchers. This was because the antibody (rituximab, Rituxan) caused fewer side effects and thus had lower costs related to adverse events, John Sweetenham, MD, reported at an ASH poster session.

SAN FRANCISCO-“The onset of highly active antiretroviral treatment (HAART) has dramatically changed the epidemiology of cytomegalovirus (CMV) retinitis, leading to a 90% to 95% reduction in incidence among patients with AIDS,” W. Lawrence Drew, MD, PhD, of the University of California, San Francisco, said at a conference on globally emerging viral infections.

SAN FRANCISCO-Recombinant human thrombopoietin (TPO) plus G-CSF (Neupogen) helps mobilize stem cells for collection better than G-CSF alone, Charles Linker, MD, said at the Fortieth Annual Meeting of the American Society of Hematology (ASH). In addition to showing efficacy in stem cell mobilization, the trial had a number of secondary objectives.

ROCHESTER, Minnesota-IDEC-Y2B8, an anti-CD20 murine monoclonal antibody (MoAB) conjugated to the radioisotope yttrium-90, appears to be effective in non-Hodgkin’s lymphoma (NHL) patients with splenomegaly, Thomas Witzig, MD, said at an ASH poster session. Some have considered splenomegaly a contraindication to MoAB therapy because of theoretical concerns about the spleen acting as an “antibody sink,” limiting efficacy.

MIAMI BEACH-Bone marrow and peripheral blood stem cell transplants after high-dose chemotherapy are becoming more widely used, but there is no standard method of purging graft material to remove tumor cells prior to transplant.

WASHINGTON-Walden-ström’s macroglobulinemia is a rare low-grade B-cell lymphoproliferative disorder. Patients with Waldenström’s also often have small lymphocytic lymphoma (SLL). Hyperviscosity in Waldenström’s responds temporarily to plasmapheresis. Alkylator therapy, fludarabine (Fludara), and cladribine (Leustatin) are effective in many cases, but there are no good options for patients refractory to purine analogs.

PORTLAND, Oregon-A phase III study presented at the ASH meeting shows that oprel-vekin (rhIL-11, Neumega) effectively prevents severe chemotherapy-induced thrombocytopenia. Additional benefits included accelerated neutrophil recovery and fewer cases of neutropenic fever.

RESTON, Virginia-A new Radiation Therapy Oncology Group (RTOG) study will determine if the drug thalidomide combined with radiation therapy will lengthen the survival time and time to recurrence in adults with glioblastoma multiforme, the most malignant type of brain tumor.

Administering cytarabine at levels substantially higher than the standard dose can cure nearly five times as many patients who have a certain type of acute myeloid leukemia (AML), according to a recent study.

In a session targeting novice bone marrow transplant (BMT) nurses, the Oncology Nursing Society (ONS) outlined what nurses should expect in treating BMT cases, from pretransplant to posttransplant, as well as related insurance and

PHOENIX-The poor hematopoiesis that occurs in myelodysplastic syndromes (MDS) is due to a reduced ability to respond to growth factor stimulation. The result is that hematopoietic progenitor cells are lost faster than blood cells can be produced.

GAITHERSBURG, Md-The Oncologic Drugs Advisory Committee (ODAC) has unanimously recommended the accelerated approval of Temodal Capsules (temozolomide, Schering-Plough) for the treatment of anaplastic astrocytoma at first relapse following treatment with a nitrosourea and procarbazine. Accelerated approval requires the company to conduct further research to demonstrate the drug’s safety and efficacy.

Bone marrow transplantation (BMT) nurses need to educate themselves about their patients’ insurance coverage, said the Oncology Nursing Society (ONS) at its Eighth Annual Fall Institute. First, nurses must verify that patients have coverage and

MIAMI BEACH-Ultimately, historians may call the sequencing of the human genome the “defining event of our age,” Barry S. Coller, MD, of Mt. Sinai School of Medicine, New York, said at the annual meeting of the American Society of Hematology (ASH). Dr. Coller, the outgoing president of ASH, chaired a policy symposium on the post-genome world.

HOUSTON-A novel nucleoside analog, known as compound 506U78, has significant activity in mature B-cell and T-cell leukemias, producing responses in patients whose disease is refractory to fludarabine (Fludara) and alkylating agents, investigators from M.D. Anderson Cancer Center and Glaxo Wellcome, Inc. reported at the ASH meeting.

Due to the psychosexual consequences and significant morbidity associated with the standard radical vulvectomy procedure, there has been a trend toward vulvar conservation in the management of women with vulvar cancer.

BETHESDA, Md-It is widely assumed that monoclonal antibodies will not work in bulky non-Hodgkin’s lymphoma (NHL) because such agents require direct contact with target antigens expressed on tumor cell surfaces and cannot reach antigens inside tumor masses. Phase II data reported at ASH indicate this may not be true for rituximab (Rituxan).

MIAMI BEACH-As more cancer patients undergo allogeneic and autologous peripheral blood stem cell (PBSC) and bone marrow transplants, more long-term complications crop up. Two papers presented at the ASH meeting addressed the late effects of reduced bone density and development of therapy-related leukemia.

During the Oncology Nursing Society’s (ONS) Eighth Annual Fall Institute Meeting, oncology nurses discussed guidelines for implementing clinical trials within office-based community practices.

ANGERS, France-Fludarbine (Fludara) and mitoxantrone (Novantrone) increased the 1-year complete remission rate in indolent lymphomas to 55%, compared with 11% using CHEP (doxorubicin, cyclophosphamide, vindesine, prednisone) in a multicenter European study reported at the ASH meeting.

CHICAGO-A new regimen that includes an anthracycline plus interferon-alfa-2b (Intron A) as induction chemotherapy of patients with low- or intermediate-grade non-Hodgkin’s lymphoma (NHL) appears to be as effective as CHOP, Sari Enschede, MD, of Rush Presbyterian-St. Luke Medical Center, said at an ASH poster session.

SAN DIEGO-“Currently, there are no standard response criteria for non-Hodgkin’s lymphoma, as there are for solid tumors, chronic lymphocytic leukemia, and Hodgkin’s disease,” Anonio J. Grillo-López, MD, said at the annual meeting of the American Society of Hematology.

HOUSTON-Treatment with topotecan (Hycamtin) and high-dose cytarabine can produce high complete remission rates in patients with myelodysplastic syndromes (MDS) or chronic myelomonocytic leukemia (CMML), even in patients with poor-prognosis cytogenetic features and secondary MDS, Miloslav Beran, MD, PhD, DVM, of M. D. Anderson Cancer Center, said at ASH.