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NEW YORK--Despite its aim of cost containment, health-care reform threatens to increase the economic toll of pain because it may encourage undertreatment, Daniel Carr, MD, said at a media briefing on pain, sponsored by the American Medical Association and Ortho-McNeil Pharmaceutical Corp.

WASHINGTON--Samuel Broder, MD, head of the National Cancer Institute (NCI) for the past 5 years, says that he will resign his post in April of this year. He will join IVAX Corporation (Miami), a manufacturer of generic drugs and IV drug delivery devices, where he plans to work on developing new drugs.

LISBON, Portugal--Doxorubicin coupled with cisplatin (Platinol) confers a distinct survival edge over the anthracycline alone in women with advanced inoperable or recurrent endometrial carcinoma, according to the latest findings of the Gynaecological Cancer Cooperative Group (GCCG) of the European Organization for Research and Treatment of Cancer (EORTC).

BETHESDA, Md--As expected, the number of reported AIDS cases increased substantially in 1993 due to the expansion of the surveillance case definition in January of that year, but an adjusted analysis shows only a slight overall increase.

LISBON, Portugal--Recent evidence linking low-grade gastric lymphoma with chronic Helicobacter pylori infection, which is said to trigger antigenic stimulation and lymphoid cell invasion of the stomach mucosa, has raised the provocative question of whether eradication of H. pylori infection can cure gastric lymphoma.

WASHINGTON--The US Court of Appeals for the Federal Circuit has ruled in favor of Burroughs-Wellcome, the manufacturer of zidovudine (Retrovir or AZT), on five of six patents that had been challenged by two pharmaceutical companies hoping to win the right to produce a generic version of the drug. The ruling should provide the company with a monopoly on zidovudine until the year 2005.

Physicians need to find more effective ways to determine their patients' preferences about cancer treatment, according to an editorial in the November 7, 1994 issue of the Journal of the National Cancer Institute.

Investigators at the University of California, San Diego (UCSD) School of Medicine have discovered a second pathway that the Ras proto-oncogene uses to cause cancer. The work sets the stage to develop new approaches for cancer treatment by

LONDON, UK--As Oncology News International (ONI) went to press, we received news that Zeneca Group PLC has agreed to buy a 50% interest in Salick Health Care, Inc (Los Angeles). The agreement is subject to shareholder approval and US regulatory review, the company said.

NASHVILLE--Using a "hairpin ribozyme" gene, researchers at the University of California, San Diego, School of Medicine have managed to stop HIV infection in its tracks by dismantling the virus's RNA.

GENEVA, Switzerland--A newly established United Nations AIDS program based in Geneva has announced plans to initiate large-scale clinical trials of two HIV vaccines as early as mid-1996, probably in Brazil and Thailand. Dr. Peter Piot, chief of research at the World Health Organization's Global Program on AIDS, will head the new group, which will involve six UN agencies.

SAN FRANCISCO--Delays for radiation treatment are longer in Ontario than in the United States, Canadian researchers reported in a poster presentation at the annual meeting of the American Society of Therapeutic Radiology and Oncology (ASTRO).

HANOVER, NH--Results of a multicenter study debunk the view that limiting 'futile' life-sustaining treatments for terminally ill patients will produce significant health-care savings. "Cutting off care through strict 'futility guidelines' will save few dollars and not much suffering," said Joanne Lynn, MD, of Dartmouth-Hitchcock Medical Center.

LISBON, Portugal--Combining granisetron (Kytril), a 5-HT3 antagonist, with high and repeated doses of dexamethasone yields superior protection against nausea and vomiting than either agent alone in cancer patients receiving moderately emetogenic antineoplastic agents, Dr. Maurizio Tonato reported on behalf of the Italian Group for Antiemetic Research.

Neutrophil counts drop less and recover faster in chemotherapy patients who take colony-stimulating factors (CSFs), said George Demetri, MD, at the 6th International Symposium on Supportive Care in Cancer. Agents such as G-CSF [granulocyte

ROCKVILLE, Md--The Food and Drug Administration has approved a semisynthetic source of Bristol-Myers Squibb Company's anticancer agent Taxol (paclitaxel), produced from renewable Taxus baccata plant sources.

WASHINGTON--The National Institutes of Health (NIH) is disputing the commercial rights to the newly discovered breast cancer gene BRCA1. In a move that could affect how much women pay for screening when such a test becomes available, scientists at the University of Utah and Myriad Genetics, Inc. failed to include NIH as a collaborator when it applied to patent the gene. The NIH has filed a counter application.

This article launches a three-part series on Medicare fraud and abuse laws. It reviews the laws prohibiting self-referrals, which were expanded this month. Part 2, which will appear in an upcoming issue of Oncology News International reviews the federal statutes regarding false claims and offers advice to physicians on how to avoid any conflicts with the fraud and abuse laws. Part 3 will discuss the Medicare and Medicaid anti-kickback statute.

COLLEGEVILLE, Pa--Rhône-Poulenc Rorer Inc. (Paris, France) has formed a new division, RPR Gencell, dedicated to the discovery, development, and commercialization of cell and gene therapy products. To accelerate such discoveries, the company has also created a biotechnology network comprising 14 biotech companies and academic research centers.

TARRYTOWN, NY--A nationwide study to test whether a multidimensional approach can change schoolchildren's nutritional habits and behavior for the better is nearing its final stage, Elaine Stone, PhD, of the National Heart, Lung and Blood Institute said at a symposium marking the 25th anniversary of the American Health Foundation.

The following are excerpts from a speech given by Bernard Fisher, MD, Distinguished Service Professor of Surgery, University of Pittsburgh, School of Medicine, at the American Society of Clinical Oncology's Fall 1994 Educational Conference in Atlanta, Georgia.

Carcinoma of the gallbladder is a rare malignancy, with an incidence rate in the United States of 2.2 to 4.4 per 100,000 persons. Its clinical presentation is nonspecific, and the majority of patients have advanced disease at

Although generally benign tumors, meningiomas can cause serious neurological injury and, at times, vexatious management difficulties. Currently, the accepted management of these tumors is attempted total surgical excision when technically possible and associated with an acceptable risk. However, even with innovations in instrumentation and refinements in surgical technique, the goal of total resection may not be achievable. For these patients, and for those with recurrent tumors, options for treatment include reoperation, radiation therapy, and chemotherapy. Recent developments in surgical technique and instrumentation, radiosurgery, and brachytherapy have increased the treatment options, while clinical trials with tamoxifen and mifepristone (RU486) are adding information on the effectiveness of these drugs as chemotherapeutic agents. While the search continues for a uniformly successful management plan, physicians must be aware of the available options and try to help the patient decide which treatment is appropriate, based on current medical knowledge. [ONCOLOGY 9(1):83-100]

Primary CNS lymphoma is rising in incidence in both the AIDS and non-AIDS populations. It is a non-Hodgkin's lymphoma that usually presents as a brain tumor, but the leptomeninges, eyes, and spinal cord also are

Dr. DeAngelis has written a succinct and accurate assessment of management of primary central nervous system lymphoma. Non-AIDS-related primary central nervous system lymphoma is a rare, highly malignant primary brain tumor. However, its incidence is increasing, as are AIDS-related tumors of this type. Patients with primary central nervous system lymphoma usually have widespread infiltration throughout the brain, rendering aggressive resection of no benefit. There is a significant incidence of leptomeningeal and ocular involvement (the latter a "sanctuary site," thus posing a particular therapeutic dilemma).

Drs. Abi-Rached and Neugut have presented a comprehensive review of the natural history and epidemiologic characteristics of patients who develop carcinoma of the gallbladder. They correctly point out that this tumor is a rare neoplasm, with the annual incidence in the United States being quite low; the number of patients dying from gallbladder cancer in 1978 was estimated to be 2,469, representing only .3% to 1.0% of total cancer deaths in the United States [1]. Since incidence rates vary significantly by geographical area, the risk factors associated with this tumor are of interest. For example, in Chile, cancer of the gallbladder and bile ducts accounts for 5.25% of cancer deaths [2]. Among Jews in Israel, the incidence appears to be higher in patients of European birth compared with those born in Asia [3]. Incidence also appears to be higher in Native Americans and Mexican-Americans born in the United States than in other population groups in the United States [4]. For instance, gallbladder cancer is the most common gastrointestinal malignancy among Southwestern Native Americans [5].

DENVER, Colo--Although oncologists have long been concerned about cachexia and other nutritional problems in cancer patients, nutritional oncology, which includes nutritional assessment and intervention for cancer patients, is just beginning to emerge as a recognized medical discipline and as an important adjunct to standard cancer therapy.

WASHINGTON--John Durant, MD, has been named to the newly created position of executive vice president of the American Society of Clinical Oncology (ASCO). Formerly president of ASCO and a member of its board of directors, Dr. Durant will become the society's leading spokesman and advocate in Washington on April 1. He is currently vice president for health affairs and director of the medical school at the University of Alabama at Birmingham.

Neuroendocrine differentiation has been foundin 50% to 100% of prostate neoplasms of all stages. Furthermore,10% of prostatic tumors are extensively or fully differentiated.Thus, neuroendocrine-specific

PARIS-Physicians need to make a more concerted effort to consider quality of life issues when devising a management strategy for patients with HIV-infection, an infectious diseases specialist said at a conference on cancer, AIDS, and quality of life, sponsored by UNESCO.