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Despite advances in surgery, radiotherapy, and chemotherapy, survival of patients with squamous cell carcinoma of the head and neck has not significantly improved over the past 30 years. Locally recurrent or refractory disease is particularly difficult to treat. Repeat surgical resection and/or radiotherapy are often not possible, and long-term results for salvage chemotherapy are poor. Recent advances in gene therapy have been applied to recurrent squamous cell carcinoma of the head and neck. Many of these techniques are now in clinical trials and have shown some efficacy. This article discusses the techniques employed in gene therapy and summarizes the ongoing protocols that are currently being evaluated in clinical trials. [ONCOLOGY 15(3):303-314, 2001]

BOSTON-Investigators at Johns Hopkins University School of Medicine are testing a common cold virus as a vector for gene therapy against prostate cancer, Theodore L. DeWeese, MD, reported at the 42nd annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). The therapy was found to be safe, and the technique showed signs of antitumor activity in a phase I trial.

Patients with refractory/relapsed diffuse large B-cell non-Hodgkin’s lymphoma (NHL) who fail high-dose chemotherapy and stem cell transplant or are not suitable candidates for intensive therapy have limited therapeutic options. We have

This issue of Oncology features an excellent review of gene therapy for head and neck cancers. Lamont and colleagues have highlighted the principles of genetic intervention, the current state of available therapies, and the results of human trials in an organized and coherent manner.

High-dose therapy (HDT) with peripheral blood stem cell transplantation is a treatment option for patients with advanced follicular, marginal, and mantle cell lymphoma. In this setting, frequent contamination of peripheral blood stem cell harvests by

BALTIMORE-The B-cell directed monoclonal antibody rituximab (Rituxan) can produce durable complete remissions without the need for maintenance therapy in patients with cold agglutinin autoimmune hemolytic anemia (AIHA) and might also represent a treatment option in warm agglutinin AIHA, according to Edward Lee, MD. Dr. Lee is director of hematology and medical oncology at Sinai Hospital in Baltimore, and Director of the Bone Marrow Transplantation Program.

A new study presented at the Ninth World Congress on Lung Cancer demonstrated that topotecan (Hycamtin) in combination with carboplatin (Paraplatin) is active as a first-line treatment of advanced non-small-cell lung cancer. Topotecan

SAN FRANCISCO-Advances in gene therapy, cancer vaccines, and a variety of new antibody therapies for hematologic malignancies were the focus of a satellite symposium to the 42nd Annual Meeting of the American Society of Hematology titled Scientific and Technical Innovations in Biology: Initiating Advances in Therapeutic Approaches to Hematological Malignancies. The program was sponsored by Fox Chase Cancer Center through an unrestricted educational grant from Genentech BioOncology and IDEC Pharmaceuticals.

WASHINGTON-Gene therapy is unlikely to cure cancer on its own, but may enhance existing treatments when used in combination, said Chuan-Yuan Li, PhD, of Duke University Medical Center. "Combining gene therapy with radiation therapy produces a synergistic effect on tumors and merits further study," he said at the Susan G. Komen Breast Cancer Foundation grants conference "Reaching for the Cure."

SAN FRANCISCO-Interim results of a trial of the combination of rituximab (Rituxan) and fludarabine (Fludara), a novel approach for the treatment of low-grade or follicular B-cell lymphoma, suggest excellent antitumor activity. Rituximab, an anti-CD20 monoclonal antibody, is the only approved monoclonal antibody therapy for refractory or relapsed low-grade or follicular non-Hodgkin’s lymphoma (NHL).

The combination of docetaxel (Taxotere) and gemcitabine (Gemzar) is active as first-line therapy for advanced, metastatic non-small-cell lung cancer and appears to be generally well tolerated, according to the results of a phase II study published in

Cisplatin (Platinol)-based chemotherapy has been the standard systemic therapy for both non-small-cell and small-cell lung cancer for the past 2 decades, though the efficacy and benefit remain modest. Recently, several novel

The management of non-small-cell lung cancer is undergoing rapid evolution. Although the advent of combined-modality therapy has led to improved survival, most patients eventually succumb to the disease. The arrival of a

A pilot study was performed at The University of Texas M. D. Anderson Cancer Center to determine the feasibility of using thalidomide in a population of renal-cell carcinoma patients who had progressive disease despite chemotherapy and immunotherapy. Metastatic renal-cell carcinoma patients with adequate oral function were entered onto a study after signing an internal review board-approved informed consent. There were no exclusion criteria for prior therapy. Nineteen previously treated patients and one untreated patient with progressive renal-cell carcinoma received oral thalidomide as a single agent. The starting dose was 200 mg and the dose was increased by 100 to 200 mg every week until it reached 1,200 mg/d. Response was assessed on the basis of a radiographic reduction of the metastatic sites involved. A case report describing one of the patients involved in the pilot trial is included. [ONCOLOGY 14(Suppl 13):33-36, 2000]

TOKYO-Neoadjuvant therapy with the taxane docetaxel (Taxotere) is well tolerated and boosts survival over local treatment alone in patients with radically treatable, locally advanced non-small-cell lung cancer (NSCLC), investigators reported at the Ninth World Conference on Lung Cancer.

MADISON, Wisconsin-Although topotecan (Hycamtin) has clear activity in small-cell lung cancer, the optimal combinations, schedule, and route of administration for use of this topoisomerase-I inhibitor as first-line therapy are yet to be determined, according to Joan H. Schiller, MD, of the University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin.

NAGASAKI, Japan-The combination of irinotecan (Camptosar) 40 mg/m² and cisplatin (Platinol) 60 mg/m² with concurrent thoracic radiotherapy should be tested for its potential role in treating patients with limited-stage small-cell lung cancer (SCLC).The recommendation was made at the conclusion of a phase I trial that evaluated the combination of irinotecan and cisplatin in three dose schedules in patients with histologically or cytologically proven limited-stage SCLC who had not undergone prior therapy for their disease.

AMSTERDAM, The Netherlands-Cisplatin (Platinol), the cornerstone of chemotherapy for advanced non–small-cell lung cancer (NSCLC), continues to come under increased scrutiny, noted Pieter E. Postmus, MD, FCCP. Investigators are searching for chemotherapeutic strategies that are as effective as platinum-based therapy, but are better tolerated and more cost-effective, he explained. Dr. Postmus is with the Department of Pulmonology, Vrije Universiteit, University Hospital, in Amsterdam, The Netherlands.

The US Food and Drug Administration (FDA) has granted marketing clearance for bexarotene (Targretin) gel 1%, a novel therapy for the topical treatment of cutaneous lesions in patients with early-stage (IA and IB) cutaneous T-cell lymphoma (CTCL) who develop refractory or persistent disease after undergoing other therapies or who have not tolerated other therapies.

Patients with limited-stage small-cell carcinoma of the lung are treated with combined-modality therapy with the intent to cure. Standard therapy consists of platinum-based combination chemotherapy, thoracic irradiation, and

Patients with limited-stage small-cell carcinoma of the lung are treated with combined-modality therapy with the intent to cure. Standard therapy consists of platinum-based combination chemotherapy, thoracic irradiation, and

Testicular cancer is a highly curable cancer. However, 30% of patients are refractory to standard therapy and will need additional therapy. This article focuses on the use of high-dose chemotherapy in germ-cell tumors.

TOKYO-Weekly paclitaxel (Tax-ol) and carboplatin (Paraplatin) is an effective and well-tolerated second-line therapy in patients with non-small-cell lung cancer (NSCLC) who failed first-line therapy with the same agents, Mark A. Socinski, MD, said at the 9th World Conference on Lung Cancer. Dr. Socinski is director of the Multidisciplinary Thoracic Oncology Program, University of North Carolina, Chapel Hill.

Patients with limited-stage small-cell carcinoma of the lung are treated with combined-modality therapy with the intent to cure. Standard therapy consists of platinum-based combination chemotherapy, thoracic irradiation, and

NASHVILLE, Tennessee-Irinotecan (Camptosar) combined with radiation therapy is active in non–small-cell lung cancer (NSCLC) and is most effective when the chemotherapy and radiation therapy are given concurrently, Hak Choy, MD, reported at a clinical investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology. Dr. Choy is Professor and Vice Chairman of the Department of Radiation Oncology at the Vanderbilt Cancer Center in Nashville, Tennessee.

OSAKA, Japan-Irinotecan/cisplatin combination therapy improved survival compared to etoposide/cisplatin in extensive-stage small-cell lung cancer (SCLC), Masahiro Fukuoka, MD, reported at an investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology. Two-year survival in the Japan Clinical Oncology Group (JCOG)-9511 study was 19% with irinotecan/cisplatin vs 9% with etoposide/cisplatin, according to Dr. Fukuoka, who is professor of the 4th Department of Internal Medicine at Kinki University School of Medicine in Osaka, Japan.

In medically suitable patients with stage III (locally advanced) non–small-cell lung cancer, the use of cisplatin (Platinol)-based chemotherapy as induction therapy prior to definitive local therapy has been shown to improve survival (J Natl Cancer Inst 86:673-680, 1994; Ann Intern Med 125:723-729, 1996). This is true regardless of whether the local treatment modality used is surgery or thoracic irradiation. However, because cisplatin therapy is particularly toxic, there is interest in studying other agents in the induction setting. Given its activity in non–small-cell lung cancer, docetaxel (Taxotere) is one logical agent to investigate.

We previously reported the efficacy of concurrent cisplatin (Platinol)/etoposide (PE) and radiotherapy in stage IIIB non–small-cell lung cancer in which biopsy confirmation of T4 (noneffusion) or N3 status was required (S9019). In view of the activity of docetaxel (Taxotere) as second-line therapy and potential molecular mechanisms of action favoring taxane sequencing, we designed the present study to maintain a core of concurrent PE/radiotherapy, but to substitute docetaxel consolidation for the two additional cycles of PE.

One hundred centers from Europe, the Middle East, Asia, and South America participated in a non–small-cell lung cancer (NSCLC) study with broad inclusion criteria (first and second line) to establish the toxicity and efficacy profile of docetaxel (Taxotere) at 100 mg/m² in worldwide clinical practice.

NEW ORLEANS-Topotecan (Hycamtin) after standard therapy with etoposide/cisplatin (Platinol) improved progression-free survival but failed to improve overall survival in extensive-disease small-cell lung cancer (SCLC) when compared to observation, according to a randomized phase III trial presented at the 36th Annual Meeting of the American Society of Clinical Oncology (ASCO).