ONCOLOGY Vol 12 No 11

Researchers at Duke University Medical Center report animal studies that may explain, for the first time, why oral contraceptives offer protection against ovarian cancer. Their findings suggest that the progestin in birth control pills induces

Phase III clinical trial data for the human immunodeficiency virus (HIV) protease inhibitor amprenavir (Agenerase) suggest that the drug may be potent and generally well-tolerated in combination with lamivudine (Epivir) and zidovudine (AZT [Retrovir]). These data, presented at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), support the role of amprenavir in front-line combination antiretroviral therapy.

The January issue of Science reported that researchers had successfully extended the lifespan of normal human cells using the enzyme telomerase to lengthen telomeres. Reaction to these initial findings was guarded. Oncologists were concerned that the

Two of the most distressing side effects of cancer treatment, nausea and vomiting, cause enough fear in some patients to induce them to delay or abandon potentially curative treatment. Some studies of surgical patients suggest that the fear of

During the past decade, federal health agencies have focused on reducing the incidence of oral and pharyngeal cancer and increasing the 5-year survival rate from these cancers in the United States. Beginning with a consortium of health agencies in

The January issue of Science reported that researchers had successfully extended the lifespan of normal human cells using the enzyme telomerase to lengthen telomeres. Reaction to these initial findings was guarded. Oncologists were concerned that the process could be cancerous. Now, new research presented at the annual meeting of the American Association for Cancer Research (AACR) demonstrated that these cells continue to divide and maintain normal structure and function and do not progress toward cancer.

Renal cancer occurs in nearly 10 of every 100,000 people in the United States and in approximately 45 of every 100,000 of those over 65 years of age. Standard treatment is open surgery, often involving total removal of the tumor along with the kidney. However, a study in the September issue of the Journal of Ultrasound in Medicine reports that ultrasound-guided renal cryoablation is a feasible technique for treating renal malignancies while still preserving the renal parenchyma.

Over the past decade, knowledge of the way in which the immune system can be used to fight cancer has greatly increased.

The Doris Duke Charitable Foundation announced recently its first grant awards, totaling more than $4.2 million, under the Doris Duke Clinical Scientist Award Program. The program was developed to enable promising young scientists conducting

Phase III clinical trial data for the human immunodeficiency virus (HIV) protease inhibitor amprenavir (Agenerase) suggest

Researchers at Duke University Medical Center report animal studies that may explain, for the first time, why oral contraceptives offer protection against ovarian cancer. Their findings suggest that the progestin in birth control pills induces damaged ovarian cells to die before they turn malignant.

Renal cancer occurs in nearly 10 of every 100,000 people in the United States and in approximately 45 of every 100,000 of those over 65 years of age. Standard treatment is open surgery, often involving total removal of the tumor along with the

One in 20 Americans will require a blood transfusion at some point in their lives. Yet, many remain uninformed about the reason for transfusions, the risks associated with them, and ways to avoid or minimize them. Pall Corporation has launched a

The University of Minnesota Cancer Center has been designated a "comprehensive cancer center" by the National Cancer Institute. To quality for the title "comprehensive," a center must conduct basic and clinical research, as well as prevention, control, and population studies; exhibit a strong body of interactive research bridging these key areas; and have outreach, education, and information programs in place. Only 35 of the 58 NCI-designated cancer centers meet the requirements for the "comprehensive" designation.

In a study of the protein p27, researchers at Memorial Sloan-Kettering Cancer Center have confirmed the existence of at

The patient’s medical history is remarkable only for asthma and mild emphysema. The family history included a grandmother with gastric cancer. The patient had been taking estrogen replacement therapy since menopause 3 years earlier, and she was

The University of Minnesota Cancer Center has been designated a "comprehensive cancer center" by the National Cancer Institute. To quality for the title "comprehensive," a center must conduct basic and clinical research, as well as prevention,

Given the clinical utility of myeloid growth factors and erythropoietin (Epogen, Procrit) in the management of many cancer patients, it is understandable that the cloning and introduction into clinical trials of thrombopoietin was greeted with great expectations for the future utilization of this molecule in oncology. Drs. Prow and Vadhan-Raj have written a well-referenced review that summarizes the preclinical biology of thrombopoietin and the evidence that it is the physiologic regulator of thrombopoiesis in animals and humans. The authors also synopsize some of the data from early clinical trials. My own interpretation of the clinical data obtained to date with both the full-length clone (recombinant human thrombopoietin [rhTPO]) and the pegylated, truncated molecule (pegylated recombinant human megakaryocyte growth and development factor [PEG-rHuMGDF]) differs somewhat from both our initial expectations and the perspective provided by the authors.

The bisphosphonates have now joined an elite group of drugs that have annual sales greater than $1 billion. Although the major therapeutic target of these agents is osteoporosis, their use in cancer, particularly in osteolytic bone disease due to breast cancer and myeloma, is growing very rapidly. Pamidronate (Aredia), the only bisphosphonate currently approved for this indication in the United States, is now prescribed for the majority of patients with myeloma, as well as a substantial number of patients with breast cancer.

In the first of a two part series on cancer chemoprevention, Drs. Singh and Lippman provide a concise, yet complete overview of the principles of chemoprevention. They discuss issues most pertinent to the design and conduct of cancer chemoprevention trials: tolerance of drug toxicities among healthy and high-risk populations, study designs used to test chemopreventive agent toxicity and efficacy, and the mechanism of action of chemopreventive agents (eg, blocking and suppressing agents).

As comprehensively described by Drs. Prow and Vadhan-Raj, lineage-specific preparations of thrombopoietin are now in clinical development: pegylated recombinant human megakaryocyte growth and develop- ment factor (PEG-rHuMGDF) and recombinant human thrombopoietin (rhTPO). These preparations produce marked increases in megakaryocyte mass and platelet count after SC dosing.

The urge to control the manifestations of incurable chronic diseases, such as the anemia, renal failure, and bony disease of myeloma and the bone disease of breast cancer, is understandable. Successful control of these disease manifestations greatly improves a patient’s quality of life. This is especially important since patients with either of these malignancies may live with the disease for 20 years or more. Considerable success has been achieved in the correction of anemia with erythopoietin (Epogen, Procrit), and simple hydration has reversed renal failure and improved the survival of patients with myeloma.[1] Anyone who has witnessed the frightening spasms of back pain in myeloma patients, precipitated by a sneeze or an attempt to turn over in bed, understands the dreadful fear that patients have of uncontrolled bone pain.

After an almost 40-year search for a primary regulatory of platelet production, thrombopoietin has recently been purified and cloned. Thrombopoietin regulates all stages in the production of platelets by promoting both the

Tumor-induced osteolysis or lytic bone disease is mediated by osteoclast activation. Osteoclasts can be activated directly by products produced by tumors or indirectly through other nonmalignant cells. By reducing

Cancer chemoprevention is the use of specific natural or synthetic substances with the objective of reversing, suppressing, or preventing carcinogenic progression to invasive cancer. Currently, numerous chemopreventive agents are in various stages of development and testing. Part 1 of this two-part series provides an overview of issues unique to chemoprevention trials, including the use of surrogate biomarkers as end points. This is followed by a discussion of the retinoids, such as all-trans-retinoic acid (ATRA [Vesanoid]), 9-cis-retinoic acid (9cRA), and isotretinoin (Accutane), and the carotenoids (eg, beta-carotene and lycopene) and other "classic" antioxidants (eg, vitamins E and C and selenium). Research on these agents will be delineated by disease site when applicable. Part 2, which will appear in next month’s issue, will focus on hormonally mediated chemopreventive agents, such as tamoxifen (Nolvadex), finasteride (Proscar), oral contraceptives, and dehydroepiandrosterone (DHEA). Part 2 also will cover nonantioxidant natural agents, such as calcium, the polyphenols, the isothiocyanates, and genistein; nonsteroidal anti-inflammatory drugs (NSAIDS), such as celecoxib, sulindac sulfone, and aspirin; difluro-methylornithine (DFMO [Eflornithine]); oltipraz; and N-acetylcysteine. [ONCOLOGY(11):1643-1658, 1998]

As tobacco companies settle lawsuits filed by states seeking to recover money spent treating smoking-related illnesses, the