IOM Committee Endorses Medicare Reimbursement for Clinical Trials
February 1st 2000here has been some private sector momentum on the issue of insurance company reimbursement of patient care costs in cancer clinical trials. Now the spotlight may shift to Medicare reimbursement, especially since the Institute of Medicine
C. Everett Koop Initiates Online Clinical Trials Info Center for Patients
February 1st 2000Former US surgeon general C. Everett Koop, MD, and Quintiles Transnational Corp. have launched an interactive, consumer Internet resource to enable interested individuals to sign up online for possible participation in clinical drug trials via the
Major Advance in Treating Relapsed Childhood Leukemia
February 1st 2000In a significant advance in the treatment of acute childhood lymphoblastic leukemia (ALL), researchers from the Pediatric Oncology Group have found that the use of drugs known to cross into the central nervous system results in high survival rates
Licorice Root Extract Shows Antitumor Activity
February 1st 2000A substance extracted from licorice root, Licochalcone-A, has been shown to have antitumor activity in acute leukemia, breast, and prostate cancer cell lines by lowering the amount of bcl-2, a drug-resistant protein. Excess amounts of this
Celecoxib Approved as Adjunct for Patients With Familial Adenomatous Polyposis
February 1st 2000The Food and Drug Administration (FDA) recently approved celecoxib (Celebrex) as an oral adjunct to the standard care (eg, endoscopic surveillance and surgery) of patients with familial adenomatous polyposis (FAP). Celecoxib, the only
New Anticancer Agent With Minimal Side Effects Has Unique Mechanism of Action
February 1st 2000An ongoing phase I clinical trial shows that a new anticancer agent, CCI-779, is well-tolerated and may have antitumor activity. CCI-779 is a derivative of rapamycin, an immunosuppressive agent. Results of the study were presented at the
New Breast Cancer Treatment Available for Women Who Do Not Respond to Tamoxifen
February 1st 2000The first oral aromatase inactivator for the treatment of postmenopausal women with advanced breast cancer whose tumors have stopped responding to tamoxifen (Nolvadex) therapy is now available in the United States. Pharmacia & Upjohn
Immediate Hormonal Therapy vs Observation in Node-Positive Prostate Cancer
February 1st 2000Immediate antiandrogen therapy after radical prostatectomy and pelvic lymphadenectomy improves survival and reduces the risk of recurrence in patients with node-positive prostate cancer, according to a study published in the December 9, 1999,
UICC International Union Against Cancer Familial Cancer and Prevention
February 1st 2000At the beginning of the 1997 International Union AgainstCancer (UICC) conference in Kobe, Japan, the speakers invoked Buddhist imagery to inspire the audience to embrace cancer genetics in the “battle” against “the enemy.” Asura, a figure with
Potential Role of Tumor Vaccines in GI Malignancies
February 1st 2000The article by Laheru and Jaffee offers an excellent summary of immunotherapies for gastrointestinal malignancies. Thoughtful descriptions of the antibody, cytokine, and cel- lular components of the immune system provide useful background information that facilitates an understanding of specific passive and active cancer immunotherapies. Immunotherapies that have demonstrated efficacy in colon cancer clinical trials, including levamisole (Ergamisol), passive monoclonal antibody vaccines, and bacillus Calmette- Guérin (BCG)–autologous tumor vaccines, are appropriately reviewed. In addition, novel approaches at varying stages of clinical testing are clearly summarized; these include the use of an anti-idiotypic antibody, genetically modified tumor and dendritic cells, recombinant protein, and viral and DNA vaccines. Some additional approaches, studies, and perspectives are also worthy of mention as a supplement to this review.
High-Dose Chemotherapy With Autologous Stem Cell Rescue in the Outpatient Setting
February 1st 2000The number of autologous periperal blood progenitor cell (PBPC) transplants performed annually has increased dramatically over the past decade. Autologous PBPC transplants have quickly moved from the exclusive province of the academic medical center to part of the armamentarium of the practicing community oncologist
Cancer and Male Sexual Dysfunction
February 1st 2000Dr. Costabile presents a thorough review of the biological causes of erectile dysfunction after cancer treatment and of our current range of medical treatments to restore erections. I believe, however, that despite the technical progress made in understanding and remediating erectile dysfunction during the last 20 years, the majority of men who develop such problems following cancer treatment still do not resume a satisfying sex life.
Cancer and Male Sexual Dysfunction
February 1st 2000Erectile dysfunction is a common occurrence as men age. Approximately 20% of men over the age of 50 years report difficulty in achieving or maintaining an erection, and as many as 60% of men age 70 and older suffer from erectile dysfunction.[1]
Potential Role of Tumor Vaccines in GI Malignancies
February 1st 2000Laheru and Jaffee review the potential role of tumor vaccines in the management of gastrointestinal (GI) malignancies, which represent the leading cause of cancer death and are believed to be poorly immunogenic. The authors carefully review the questions and controversies surrounding currently available immunotherapeutic strategies and describe ongoing clinical protocols using tumor vaccine therapy, a few of which deserve special comment.
High-Dose Chemotherapy With Autologous Stem Cell Rescue in the Outpatient Setting
February 1st 2000Intensive outpatient care is rapidly becoming the primary mode of care for selected patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell (PBSC) transplantation. Although the traditional inpatient model of care may still be necessary for high-risk patients, published data suggest that outpatient care is safe and feasible during or after administration of high-dose chemotherapy and autologous PBSC transplant. Blood and marrow transplant (BMT) centers have developed programs to provide more outpatient care under three basic models: an early discharge model, a delayed admission model, and a comprehensive, or total, outpatient model. This review will describe these models of care and address the elements necessary for the development of an outpatient BMT program, including patient selection, staff development, and patient and caregiver education. Available supportive care strategies to facilitate outpatient care will also be highlighted.
High-Dose Chemotherapy With Autologous Stem Cell Rescue in the Outpatient Setting
Outpatient bone marrow transplant (BMT) strategies, as reviewed by Dix and Geller, have evolved for various reasons—from social to medical. If high-dose approaches are to become a viable treatment for common cancers, such as breast cancer, the refinement of transplants to a “kinder and gentler” approach is essential.