ONCOLOGY Vol 12 No 1

For more than 25 years, chemotherapy has been the cornerstone of treatment for small-cell lung cancer. Many studies have tested a wide variety of drugs in different combinations, resulting in a number of standard

Management of disseminated non-small-cell lung cancer has changed over the past 10 years. Newer agents, such as vinorelbine (Navelbine) and paclitaxel (Taxol), have been shown to modestly improve survival in patients with

Anticancer drugs have been explored by means of random screening and demonstrated to be active against not only hematologic malignancies but also some solid tumors. Recent progress in the field of molecular biology has

Preclinically, the taxanes appear to potentiate radiation more effectively than do the platinum compounds. In our phase I trial (LUN-17) in patients with advanced non-small-cell lung cancer, we defined the maximum tolerated

We evaluated the feasibility and efficacy of combination paclitaxel (Taxol) (via 1-hour infusion), carboplatin (Paraplatin), and oral etoposide (VePesid) in the first-line treatment of patients with small-cell lung cancer.

Chemotherapeutic intervention in advanced and metastatic non-small-cell lung cancer (NSCLC) has changed over the past 2 decades. The improvements offered by cisplatin (Platinol)-based regimens, though significant in

Lung cancer is the leading cause of death due to cancer in the United States, and approximately 178,100 new cases were estimated to occur last year. Small-cell lung cancer (SCLC) accounts for approximately 17% to 25% of all lung cancers. Due to its aggressive nature and rapid proliferation rate, small-cell lung cancer is usually widespread at diagnosis. Therefore, chemotherapy is the cornerstone of therapy for this disease. Cisplatin (Platinol) is an active chemotherapeutic agent used to treat small-cell lung cancer, but its toxicity, including nausea and vomiting, nephrotoxicity, neurotoxicity, and ototoxicity, has led to the investigation of combination regimens with different toxicity profiles. Carboplatin (Paraplatin), a derivative of cisplatin, has far less nonhematologic toxicity, although myelosuppression may be slightly greater than that observed with cisplatin. The reduced toxicity and equivalent efficacy of carboplatin have resulted in the increased use of carboplatin-based regimens to treat small-cell lung cancer. Phase I and II trials of carboplatin as single-agent treatment for small-cell lung cancer resulted in overall response rates of approximately 60% for previously untreated patients and 17% for those who had received prior therapy. New combination chemotherapy regimens that include carboplatin may improve survival in patients with small-cell lung cancer and potentially cure those patients with limited disease. Further investigation of carboplatin and other new agents is warranted.[ONCOLOGY 12(Suppl 2):36-43, 1998]

The challenge for oncologists treating patients with stage III non-small-cell lung cancer (NSCLC) is to optimize a treatment strategy using nonsurgical therapies. The recognition that chemotherapy response rates for patients

Non-small-cell lung cancer (NSCLC) will increasingly come under better control as the current approaches to therapy are more broadly employed and as new therapies are deployed against recently elucidated molecular

Like other epithelial tumors, non-small-cell lung cancer (NSCLC) is a result of a series of genetic and epigenetic changes that eventually progress to invasive cancer. The order and timing of these changes, involving specific

Prophylactic cranial irradiation (PCI) is being reintroduced into multimodality treatment protocols of patients with small-cell lung cancer (SCLC). The history of its use brings interesting insights into clinical evaluations of treatment strategies and design of relevant and informative trials. The critical issues of effectiveness and overall health gains of prophylactic cranial irradiation have been addressed in a series of recently completed clinical trials. These trials tested prophylactic cranial irradiation in small-cell lung cancer patients achieving good response to induction therapy and confirmed the ability of standard prophylactic cranial irradiation schedules to significantly reduce the lifetime risk of brain metastases. A subset of these trials evaluated neurotoxicity in a formal and prospective manner. No sustained or significant detriment in neuropsychometric function could be linked to the use of prophylactic cranial irradiation. In addition, all the large trials have shown a consistent survival advantage in favor of the prophylactic cranial irradiation arm. None of the individual sample sizes were large enough to statistically confirm this survival benefit, but a meta-analysis is in progress and will report on this aspect of evidence shortly. Issues that remain to be answered are the optimal dose and schedule of prophylactic cranial irradiation as well as the timing of this administration. These questions form the nucleus of the next generation of collaborative trials that are being designed.[ONCOLOGY 12(Suppl 2):19-24, 1998]

The 1997 revision of the lung cancer staging system has added very little to disease staging, and many changes have been totally unnecessary. Before the next revision of the staging system, anticipated in the year 2007, a

Despite advances in the treatment of small-cell lung cancer during the 1970s, with the use of combination chemotherapy, and in the 1980s, with the combination of etoposide and cisplatin plus concurrent radiation

Although the need to combine thoracic radiotherapy with systemic chemotherapy in the curative treatment of limited small-cell lung cancer is now widely acknowledged, there is substantial disagreement on how best to do this. This paper reviews radiotherapeutic factors but also highlights the important interactions that occur with some classes of chemotherapeutics. Studies examining variables like dose and volume are clearly in order. Concurrent therapy given early has been adopted throughout most of the world, except Europe. The reasons for this are explored. Multiple studies are now showing excellent results with fewer total cycles of chemotherapy. Integrationof newer drugs is another challenge for clinical investigators at the close of this century. [ONCOLOGY 12(Suppl 2):15-18, 1998]

We report here the preliminary results of a large phase II multicenter study done in the community setting, using paclitaxel (Taxol) (given by 1-hour infusion) plus carboplatin (Paraplatin) to treat patients with advanced non-small-cell lung cancer (NSCLC). In this study, 155 chemotherapy-naive patients with stage IIIB, stage IV, or recurrent metastatic non-small-cell lung cancer received the two drugs in 21-day cycles. Paclitaxel 225 mg/m² was given by 1-hour intravenous infusion followed immediately by carboplatin at a targeted area under the concentration-time curve of 6.0 (calculated according to the Calvert formula). Colony-stimulating factors were not used routinely. Objective responses occurred in 53 of 155 patients (34%) (53 of 144 [36%] evaluable patients) including three complete responses and 50 partial responses. Fifty-two other patients had stable disease at initial reevaluation. The median survival among all 155 patients was 8 months; the 1-year survival rate was 42%, and the 2-year survival rate was 20%. Leukopenia and cumulative peripheral neuropathy occurred consistently but rarely were severe or affected the course of therapy. One patient died due to sepsis. Other grade 3 and grade 4 toxicities were uncommon. This paclitaxel-carboplatin combination chemotherapy appears to be a relatively convenient, safe, and active regimen in advanced non-small-cell lung cancer.[ONCOLOGY 12(Suppl 2):71-73, 1998]

Researchers from the National Surgical Adjuvant Breast and Bowel Project (NSABP) announced the results of a large-scale trial designed to determine a more effective treatment for women with breast cancer. Results from this study, published

A study presented at the 39th Annual American Society of Hematology (ASH) Meeting in San Diego offers the promise of an improved drug treatment, PSC833, for acute myeloid leukemia (AML).

In 1997, breast cancer will be diagnosed in an estimated 180,200 women, and 43,900 women will die from the disease. Early detection combined with timely and appropriate treatment can alter the progress of and reduce mortality from this

Genetics Institute, Inc., a subsidiary of American Home Products Corporation, has received FDA approval to market oprelvekin (recombinant interleukin-11 [Neumega]), a platelet growth factor that stimulates the production of blood platelets

The widespread impression that breast implants increase the risk of developing breast cancer has little supportive evidence, according to a recent report in the Journal of the National Cancer Institute. Authors Louise A. Brinton and S. Lori Brown

Rituximab (Rituxan) has been cleared for marketing by the FDA. Previously known as the C2B8 antibody, rituximab, is a single-agent monoclonal antibody therapy for relapsed or refractory, low-grade or follicular, CD20-positive, B-cell non-

Cinical practice guidelines for gynecologic oncology were developed under the direction of the Medical Practice and Ethics Committee of the Society of Gynecologic Oncologists (SGO) in concert with national trends in medical care in the United

The Oncology Nursing Society (ONS) has begun a public education campaign, entitled “Wake Up to Cancer Fatigue,” which will feature the first Cancer Fatigue Awareness Day on April 2, 1998. The purpose of the campaign is to educate

A genetic mutation in the adenomatous polyposis (APC) gene found in 7% of Ashkenazi Jewish families in the United States does not necessarily lead to colon cancer, according to a study in the December 15, 1997, issue of Cancer Research.

Researchers from the University of Wurzburg in Germany have determined that a simple antibody test may be as effective in detecting Helicobacter pylori infection as the more invasive procedures that are currently used. They reported their findings

In 1991, approximately 13.8 million adults in the United States met diagnostic criteria for alcohol abuse, alcohol dependence, or both. In addition, at least 80% of persons in this group were likely to be daily tobacco smokers and,

Speakers at this international workshop, which was held in Lisbon, Portugal, on June 28, 1997, addressed the integration of new treatment strategies, including paclitaxel (Taxol), into the management of women with breast cancer.

There is certainly no good place to get a brain tumor, but one of the worst is in the lower portion of the brain along the base of the skull. Skull-base tumors are often intimately entwined with critical arteries and cranial nerves that emerge from the base of the brain, making surgical removal challenging and risky.

Researchers found that men who use cocaine are twice as likely as abstainers to develop intermediate- or high-grade non-Hodgkin’s lymphoma (NHL). For those who use cocaine more frequently, ie, on at least nine occasions, the risk is more than triple what nonusers face, says Rebecca Nelson, a doctoral student in the preventive medicine department at the University of Southern California (USC) School of Medicine, in an article published recently in the British Journal of Cancer.

Long-term follow-up data on patients treated with pentostatin (Nipent) were presented at the 39th Annual Meeting of the American Society of Hematology in San Diego, California. Pentostatin is currently indicated in the United States for first-line treatment of hairy cell leukemia.