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VANCOUVER, BC--The new understanding of the importance of viral dynamics in the progression of HIV infection (see "New Thinking on HIV Progression Leads to New Strategies") has led to new guidelines for deploying drugs now available to treat HIV (a list of available agents is on page 13). Experts now recommend reducing viral load to below detectable limits, as an indication that viral replication has been curtailed as much as possible.

By analyzing DNA from a strange mass of tissue found in a man's abdomen, researchers have discovered a previously unknown parasite that can infect and kill humans. The researchers have yet to name the parasite or determine what it looks

DALLAS--Fine-needle aspiration (FNA) breast biopsies in women with mammographically apparent, nonpal-pable breast lesions were deemed impractical due to the high rate of insufficient samples in a Radiologic Diagnostic Oncology Group (RDOG) study, and were stopped 19 months into the trial, Etta D. Pisano, MD, said at the American College of Radiology (ACR) National Conference on Breast Cancer.

VANCOUVER, BC--The new more aggressive approach to HIV infection, using antiviral drugs early and in combination, reflects not only the availability of new drugs but also the application of new thinking about HIV infection (see reports "Early Combination Treatment May Provide HIV Control" and "Researchers Propose New Treatment Guidlines for HIV"). Initial (primary) HIV infection causes an acute flu-like syndrome that is followed by years of relatively asymptomatic disease. This period of "clinical latency" had been thought to reflect viral latency, but work by David D. Ho, MD, and his colleagues at the Aaron Diamond AIDS Research Center, New York, has shown otherwise.

SAN DIEGO--There are many sound reasons why a medical center may want to capitate its oncology services and just as many wrong reasons, said Paul M. Kennelly, who recently assumed the position of president and CEO of the management services organization at the City of Hope Oncology Network in Southern California.

WASHINGTON--Although the chemical MTBE, added to gasoline in the winter to reduce the emission of carbon monoxide, does not pose a substantial human health risk, more study needs to be undertaken to assess both short- and long-term health effects, a National Research Council (NRC) committee said in its review of a draft of a federal report.

WASHINGTON--President Clin-ton has reappointed Barbara K. Rimer, DrPH, to a second 2-year term as chair of the National Cancer Advisory Board (NCAB) and appointed Richard J. Boxer, MD, professor of family and community medicine, Medical College of Wisconsin, Milwaukee, to a full 6-year term. Dr. Boxer had served on the board for a year to complete the term of Paul Calabresi, MD, who resigned to join the President's Cancer Panel.

The American Cancer Society (ACS) estimates that more than 8 million Americans alive today have a history of cancer, of whom 5 million were diagnosed 5 or more years ago. Most of these 5 million can be considered cured, while others still have evidence of cancer. In 1995, about 1,252,000 new cancer cases were diagnosed. This estimate does not include basal and squamous cell skin cancers and in situ carcinomas except bladder. The annual incidence of these skin cancers is estimated to be more than 800,000 cases. There has been a steady rise in cancer mortality in the United States in the last half-century. In 1995, about 547,000 people died of cancer--more than 1,500 people a day. One out of every five deaths in the United States is from cancer.

SAN DIEGO--Today when almost all payment and delivery models co-exist in every market, marketing approaches to cancer care services must respond to all payer models, including managed care and fee-for-service, said Karen M. Gilden, a senior consulting associate with Oncol-ogy Associates, Inc., Warrenton, Va, and the editor of Cancer Management.

BETHESDA, Md--Many people believe that the law under which the FDA regulates foods, drugs, devices, and cosmetics contains an exception for tobacco, but FDA Commissioner David A. Kessler, MD, told a symposium on tobacco addiction that this is not so, and that his agency plans to forge ahead with its proposed regulations.

ORLANDO--Impotence and incontinence, the radical prostatectomy complications that patients fear most, can be reduced through simple modifications in surgical technique without compromising cancer control, according to two reports presented at the American Urological Association's 91st annual meeting.

VANCOUVER, BC--Treatment for AIDS is beginning to resemble cancer therapy: Some studies suggest that best results occur when disease burden is reduced early by aggressive use of combination therapy. Previous thinking has been to hold effective antiviral agents in reserve until disease progression.Presentations at the 11th International Conference on AIDS showed that combination treatment, especially with regimens that include one of the new protease inhibitor drugs, can reduce the virus to undetectable levels in the blood. Reduced viral load decreases the risk of disease progression and is often followed by clinical and immunological improvement.Speaking at the meeting, Scott Hammer, MD, of New England Deaconess Hospital, Boston, pointed out that the ability of combination therapy to reduce viral load to undetectable levels means that "eradication of virus has become an acceptable hypothesis to be tested."Researchers at the Aaron Diamond AIDS Research Center are testing that hypothesis using aggressive combination treatment during primary infection.

Most antibodies do their work in the bloodstream. But others may be powerless to knock out their disease-causing foes unless the confrontation takes place inside an intestinal cell, researchers have found.

CHICAGO--Methylnaltrexone, an agent that blocks the side effects of morphine without interfering with pain relief, has been granted orphan drug status for use in patients with cancer pain.

SAN DIEGO--With more than 200 known hereditary cancers syndromes, there is a clear opportunity for medical centers in this field, said LeeAnne Vandegriff, RN, cancer risk assessment coordinator at Harris Methodist Hospital, Fort Worth.

BETHESDA, Md--The number of Americans infected with HIV is holding steady at about 650,000 to 900,000, according to CDC data. This may be because the number of new HIV infections each year is roughly equal to the annual number of AIDS-related deaths, the report said.

WILMINGTON, Del--Zeneca Inc. has received FDA clearance to market Kadian (morphine sulfate sustained release) capsules, a new single daily dose sustained-release (SR) morphine formulation, for the management of moderate to severe chronic pain when treatment with an opioid analgesic is indicated for more than a few days.

REDMOND, Wash--NeoPath Inc has signed an agreement with Kaiser Permanente to install AutoPap 300 QC Systems at its Northern California facility. Following a successful evaluation, Kaiser Permanente anticipates making the technology available to its nearly 2.5 million Northern California members.

In February 21, I presented testimony on behalf of the Society before the Senate Labor and Human Resources Committee during a hearing on Food and Drug

BETHESDA, Md--NCI research from the 1980s, in which scientists used crystallography to study the structure of the human immunodeficiency virus (HIV), paved the way for development of the current crop of HIV-specific protease inhibitors (see " Early Combination Treatment May Provide HIV Control" for a report on clinical trials of protease inhibitors).

LOS ANGELES, Calif--The Lym-phoma Research Foundation of America is now accepting requests for applications for medical grants for the fiscal year, July 1, 1997 to June 30, 1998.

DALLAS--A new study suggests that RODEO breast MRI can accurately determine the extent of DCIS (ductal carcinoma in situ) and identify characteristic patterns that can differentiate DCIS from more malignant breast cancers.

The Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute (NCI) has published a study reporting on patterns of cancer in a variety of racial and ethnic groups in the United States.

PISCATAWAY, NJ--Enzon, Inc. has begun a multidose, multicen-ter clinical trial of its hemoglobin-based oxygen carrier, PEG-hemoglobin, in cancer patients receiving radiation therapy. The agent was developed as a radiosensitizer to increase oxygenation of hypoxic tumors cells that may be resistant to irradiation. Patients will receive once-a-week infusions of PEG-hemoglobin followed by 5 days of radiation therapy, repeated weekly for 3 weeks.

SAN DIEGO--Hospitals are facing tremendous pressures from the insurance industry to standardize treatments by adopting clinical practice guidelines, panel members said at a conference sponsored by the Society for Ambulatory Care Professionals and Health Technology Assessment of the American Hospital Association.

TUSTIN, Ca--AMDL, Inc. has filed a 510(k) Premarket Notification with the FDA for PyloriProbe, its diagnostic test for the detection of Heli-cobacter pylori. This bacterium is associated with chronic gastritis and gastric and duodenal ulcers, and has been classified by WHO as a class I carcinogen that increases the risk of developing stomach cancer. Pylori-Probe is a direct enzyme immunoassay (EIA) that detects the presence of H pylori antibodies in serum samples.

RICHMOND, Ca--Onyx Pharmaceuticals has announced an extension and expansion of its research alliance with Eli Lilly focusing on BRCA1, the gene linked to increased risk of breast and ovarian cancer. Lilly has exclusive rights to the BRCA1 gene by license from Myriad Genetics, Inc.

SAN DIEGO--If a cancer patient dies because of a medical error, such as an incorrect dosage, it is only human nature to blame the tragedy on one incompetent person. But finger pointing is not a useful approach, says George Demetri, MD, since generally the problem has multiple causes, and a system overhaul may be in order.

Drs. Eulau and Corn comprehensively review the emerging use of combined androgen suppression and local therapies in locally advanced carcinoma of the prostate. These strategies have been developed since the recognition of the inadequacy of

More American men are living longer. An estimated 13,850,000 were over age 65 as of July 1, 1996 [1]. This total represents a 1.01% increase over that in 1995, a 10.3% increase over the 1990 total and more than a 34% increase over the