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SAN DIEGO-“When do you start HIV therapy and what do you start with?” Michael S. Saag, MD, asked to open a seminar on retroviral therapy at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). As simplistic as it sounds, he said, it is a question that initiates the process of strategic thinking on the use of antiretroviral therapy.

HOUSTON-The University of Texas M.D. Anderson Cancer Center has unveiled its new 13-story Albert B. and Margaret M. Alkek Hospital (Figure 1). At the dedication ceremony, the Center’s president John Mendelsohn, MD, called Alkek “an incredible modern facility.” It is, he said, a hospital for the future, one that can help bring into reality Dr. Mendelsohn’s vision of cancer care in the 21st century. “We’re optimistic that we will be able to turn cancer into a chronic disease that we can control,” he said.

OMAHA, Nebraska-The Lied Transplant Center, located on the University of Nebraska Medical Center campus, recently had its grand opening and is expected to begin admitting patients this month for solid organ or bone marrow transplants. Its 14 levels include clinics and treatment rooms, 44 cooperative care suites, 44 Nebraska House guest suites, and four floors devoted to research. The Center takes its name from the Lied Foundation Trust, which donated $15 million toward construction.

WASHINGTON-Daily cigarette smoking among high school seniors declined in 1998, down to 22.4% from 24.6% in 1997. However, the 1998 rate remains significantly higher than the 17.2% recorded in 1992 and not far removed from the 25.4% found in 1979, according to a survey conducted for the National Institute on Drug Abuse.

WASHINGTON-The growth in health care spending in the United States hit a nearly 40-year low in 1997, but the Health Care Financing Administration (HCFA) predicts a strong growth spurt in the coming decade. Health care spending reached $1.1 trillion in 1997, the agency reported, an average per person of just under $4,000, and will nearly double by 2007, reaching a total of $2.1 trillion.

ROCKVILLE, Md-The explosive overall growth of enrollees in Medicaid managed care is not occurring in rural America, according to a study conducted for the Agency for Health Care Policy and Research (AHCPR).

NEW YORK-The Doris Duke Charitable Foundation has established the Doris Duke Distinguished Clinical Scientist Award Program, a $12 million initiative to fund the research teams of four eminent scientists studying cancer, AIDS, heart disease, and sickle cell anemia and related blood disorders. Recipients of the first awards are expected to be named in late 1999.

WASHINGTON-Whether you call it the Year 2000 Problem (Y2K) or the Millennium Bug, it could bite the Department of Health and Human Services (HHS) quite badly, a congressional report warns. The Y2K problem stems from the fact that most computers still use only two digits to represent the year. Come the year 2000, unless this flaw is corrected, these computers will read 00 as the year 1900, and chaos will occur in their calculations.

SAN DIEGO-With a survival rate of only 5%, invasive aspergillosis remains a devastating problem that is difficult to prevent, tricky to diagnose, and complicated to treat, according to presenters at a symposium aptly named “Uncertainties in Invasive Aspergillosis,” held at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy.

BETHESDA, Md-Far-reaching changes in the National Cancer Institute’s 43-year-old Developmental Therapeutics Program (DTP) would “enhance the ability to discover new and useful antitumor drugs during the next decade,” according to the report of an NCI committee, which offered a series of recommendations to ensure its vision.

WASHINGTON-As part of World AIDS Day 1998 (December1), President Clinton announced that the federal government will spend $200 million to fund research aimed at developing an effective HIV vaccine during fiscal year 1999. The money represents a 33% increase in AIDS vaccine funding over fiscal year 1998.

BETHESDA, Md-“I went into community oncology to treat patients,” said Richard Kosierowski, MD, an oncologist in private practice outside Philadelphia, “but I have a responsibility to the community as well.”

PHOENIX-Five-year results of a pilot study at the Ochsner Clinic, New Orleans, suggests that a 4-day course of brachytherapy may be just as effective as a 6-week course of external beam radiation therapy in breast cancer patients who have undergone breast-conserving surgery.

MIAMI BEACH-Long-term follow-up of the pivotal trial of rituximab (Rituxan) in patients with relapsed or refractory low-grade or follicular B-cell non-Hodgkin’s lymphoma (NHL), shows a median duration of response of nearly 1 year (11.6 months), Peter McLaughlin, MD, reported at a poster session of the American Society of Hematology (ASH) meeting.

BETHESDA, Md-The National Cancer Institute plans a major restructuring of its clinical trials program, intended to broaden participation by physicians and patients and shorten the time between the initial idea for a treatment study and its conclusion.

WASHINGTON-The new tobacco settlement has left tobacco-control advocates fearing that the $206 billion dollar agreement may have blunted their efforts to reduce smoking and the death and disability it causes.

An important, though as yet elusive, goal of cancer chemotherapy is the development of agents that are selectively toxic to tumor cells and, thus, permit effective cancer treatment to be administered without severe, often life-threatening toxicity to normal tissues. Until such agents are available, an alternative strategy to improve the therapeutic index of cancer chemotherapy is the administration of cytoprotective agents to selectively protect normal tissues from injury by cytotoxic drugs.

HYATTSVILLE, Md-The number of teenagers who smoke while pregnant is on the rise again. Data from a new National Center for Health Statistics (NCHS) study show that smoking among pregnant women between the ages of 15 and 19 increased to 17.2% in 1995 and 1996 after declining for several years. Non-Hispanic whites, at 29%, had the highest rate of smoking among pregnant teenagers. The study found a significant decline overall in smoking by pregnant women, from almost 20% in 1990 to 14% in 1996.

FLORENCE, Italy-Radiotherapy reduces the odds of local recurrence in women with ductal carcinoma in situ (DCIS) who have undergone breast-conserving surgery, according to 4-year follow-up evidence from a trial conducted by the European Organization for Research and Treatment of Cancer (EORTC).

Tobacco use, particularly cigarette smoking, remains the leading cause of preventable illness and death in the United States. Studies have shown that increases in the price of cigarettes will decrease the prevalence of smoking and the number of

BUFFALO, NY-Cancer care services vary widely among health care plans in the United States, speakers told the President’s Cancer Panel at a meeting hosted by Roswell Park Cancer Institute. Suggestions for helping standardize care included use of outside accreditation centers and adoption of national practice guidelines, although the methodology to be used to develop such guidelines remains open to debate.

WASHINGTON-Forget those smoke-filled cocktail lounges, tobacco addicts, and head for a local tea room. “Drinking tea after smoking reduces levels of oxidative stress,” reported James E. Klaunig, PhD, professor of pharmacology and toxicology, Indiana University School of Medicine. Oxidative stress has been linked to cancer and other diseases .

PHOENIX-A single dose of a radiolabeled anti-CD20 monoclonal antibody (MoAB), given following rituximab (Rituxan) dosing, produced responses in two thirds of patients with relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL), Gregory Wiseman, MD, of the Mayo Clinic, said at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting.

WASHINGTON-As Oncology News International went to press, the tobacco industry and more than 40 state attorneys general were in final negotiations of a settlement worth approximately $206 over 25 years. The settlement will reimburse the states for Medicare spending on smoking-related illnesses, place some limits on cigarette advertising, and result in a substantial increase in cigarette prices. Look for a full analysis of the settlement in the January issue.

ROCKVILLE, Md-The FDA has granted full approval to Pharmacia & Upjohn’s Camptosar (irinotecan), based on survival data. Camptosar is indicated for use in patients with metastatic colorectal cancer whose disease has recurred or spread after treatment with the current standard chemotherapy. The agent received accelerated FDA approval in June 1996.

SILVER SPRING, Md-Depo-Tech’s DepoCyt (cytarabine liposome injection) has won the backing of the Oncology Drug Advisory Committee (ODAC), which recommended that the FDA grant the drug accelerated approval for the intrathecal treatment of lympho-matous meningitis. The 6-to-1 vote came about 1 year after ODAC declined to recommend the drug for intrathecal treatment of neoplastic meningitis in patients with solid tumors.

GALVESTON, Tex-Last October, radiation oncologists at the University of Texas Medical Branch in Galveston treated their first patient with intensity modulated radiation therapy (IMRT). The patient received a computer-planned prostate boost involving seven beam angles and 25 beam segments (see Figure). This complex plan allowed for maximum targeting of the tumor while minimizing radiation to the urethra, rectum, and bladder.

WASHINGTON-Can the humble cup of tea ward off chronic diseases like cancer? Hints of the potential health benefits of tea are intriguing, but the emphasis remains on the “potential,” said Jeffrey B. Blumberg, PhD, chief of the Antioxidants Research Laboratory, Tufts University. He spoke at the Second International Scientific Symposium on Tea and Human Health.

SAN FRANCISCO-In an era of increasing fragmentation and specialization in cancer care, and a trend toward ambulatory care, the family physician’s role as a coordinator of care is more important than ever-for both patients and cancer specialists, David Rosenthal, MD, president of the American Cancer Society (ACS), said at the American Academy of Family Physicians meeting.

BUFFALO, NY-Evidence-based practice guidelines are needed to improve the quality of cancer care, several representatives from the professional cancer societies told the President’s Cancer Panel at a meeting hosted by Roswell Park Cancer Institute . But expert physicians also play a critical role in the creation of practice guidelines, particularly in situations where evidence is lacking or controversial.