ONCOLOGY Vol 10 No 1

Topotecan HCl, an investigational anticancer drug, has demonstrated significant antitumor activity in previously treated small-cell lung cancer (SCLC) patients, according to European Organization for Research and Treatment of Cancer (EORTC) researchers, who presented phase II trial data at the Eighth European Conference on Clinical Oncology, Cancer Research and Cancer Nursing (ECCO-8) in Paris.

New research suggests that the reason aspirin may protect against certain cancers is its ability to inhibit prostaglandins, chemicals naturally produced by the body that are suspected of playing a role in colorectal and lung cancer.

DNA sequence analysis of the complete p53 tumor-suppressor gene provides predictive information about breast cancer patients' response to therapy, according to a study published in the October 1995 issue of Nature Medicine. The study analyzes the associations between tumor mutations and patient outcome--especially in relation to therapy--using Sequence-Based Diagnosis, (SBD), a new concept for complete DNA sequencing. Although previous studies have examined p53 using various molecular biologic methods, this study represents the first complete sequencing of the p53 gene in a large retrospective study of a population-based cohort. The study also confirms that since mutations are found over the entire coding sequence, some could be missed using traditional DNA analysis protocols.

The following recommendations have been developed to provide guidance to healthcare workers when educating women

Acquired susceptibility mutation--A mutation in a gene that occurs after birth from a carcinogenic insult. Allele--One of several mutational forms of a specific gene.

The 1995 Cancer Treatment edited by Dr. Charles Haskell is the fourth edition of his original textbook published in 1980. Cancer Treatment has kept pace with advances in oncology over these 15 years, and the fourth edition includes new

Recent dramatic advances in the understanding of inherited susceptibility to several common adult-onset cancers have made possible the identification of individuals who may be at significantly increased risk of developing malignant disease. These advances may translate into some of the first opportunities for cancer prevention.

Potent immune cells that have been pretreated with peptides taken from the surface of tumor cells are effective in curing established cancers and in preventing cancers from developing in mice, according to research published in the December 1995 issue of Nature Medicine. Clinical trials of this therapeutic approach will begin soon, according to study investigators.

A malfunctioning "traffic cop" gene apparently plays an important role in the formation of liver cancer, according to researchers from the Duke University Comprehensive Cancer Center and Zeneca Pharmaceuticals of Chesire, United Kingdom.

Corticosteroids have not been approved by the FDA for use as antiemetic agents. However, the efficacy of these agents (primarily dexamethasone) when used as single agents for control of emesis has been extensively documented. In addition,

Menko and colleagues review the genetic counseling that occurs after the presymptomatic diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC) is made. The discovery of the mechanism by which tumors develop in this setting and the cloning of the genes responsible for the disease have made possible the DNA-based diagnosis of a disease, which, less than 5 years ago, was a controversial entity. In a remarkably short period, the nature of HNPCC has been greatly elucidated, its relationship to defective DNA mismatch repair has become manifest, and the means to diagnose it in a presymptomatic state has been developed [1].

The authors provide a timely introduction to the use of predictive testing as an adjunctive service in the management of a precancerous chronic disease, familial adenomatous polyposis (FAP). As they point out, this new technology carries a significant burden for both the caregiver and affected family since it will alter the genetic counseling process, as well as the clinical recommendations for managing FAP. The unique perspective of registry-based research illustrates the value of generational study of a genetic anomaly over a 22-year-period.

This special reference on genetic counseling in cancer is timely, given the explosive progress that has been made in cancer

Recent identification of gene mutations responsible for hereditary nonpolyposis colorectal cancer (HNPCC) has made possible the presymptomatic diagnosis of at-risk family members. If DNA testing shows that a family member is a gene carrier, that individual's lifetime cancer risk is approximately 90%. If the test is negative, the family member's cancer risk drops to that of the general population.

The doctor-hospital integrated practice is one possible strategy oncologists may wish to employ in order to stay financially solvent in the current unstable health-care environment. Before entering into an arrangement with a

Testing for adenomatous polyposis coli (APC), the gene responsible for familial adenomatous polyposis (FAP), can now be offered to family members in FAP kindreds. With the availability of this test, genetic counseling has become a crucial tool for helping FAP patients and their relatives understand the syndrome and its implications and for assisting at-risk individuals in making informed decisions about whether or not to undergo genetic testing. Genetic counseling can occur at several time points: when FAP is diagnosed, when an FAP patient is considering reproductive options, when a patient is deciding whether to have his or her children screened, and when an at-risk person is considering genetic testing.

The discovery of inherited gene mutations that increase the risk of certain cancers could greatly expand the use of predictive genetic testing in healthy individuals. In families with hereditary forms of cancer, the use of genetic tests to determine whether family members have inherited suseptibility mutations (ISMs} may improve out come.

This paper provides an overview of the current approach to genetic counseling for cancer, using hereditary