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The Clinton administration memorandum on coverage of Medicare patient costs in clinical trials, which drew concern from ASCO when the White House published its incipient statement last June, has apparently morphed into a “final national coverage decision”-announced in late September-that most groups are quite happy with. Ellen Stovall, president and CEO of the National Coalition for Cancer Survivorship, says her group is very happy with the coverage document published by HCFA. She does note, however, that there is a need to monitor the new rules HCFA will be developing for coverage of a subgroup of trials-so-called IND-exempt trials run by cancer centers and pharmaceutical companies-that are testing existing drugs for new uses. Some of these trials are extremely legitimate. Some are not. No one in the cancer community wants to see Medicare pay for clinical trials involving the use of tea leaves to cure colon cancer. However, in writing rules meant to exclude Medicare coverage of those kinds of questionable trials, Stovall indicates that it will be important to ensure that those rules, based on imprecise wording, don’t exclude Medicare coverage for legitimate trials.” We will be concerned with how the language develops,” she explained. One other area of possible concern is Medicare’s intention to pay only for trials that have a “therapeutic” objective. That would rule out some phase I trials designed to test the toxicity of a new medication.

Seventeen patients with myeloma (13) or Waldenstrom’s macroglobulinemia (4) have been treated at our center with a nonmyelosuppressive combination of oral clarithromycin (Biaxin) at 500 mg twice daily, low-dose oral thalidomide

Research suggests that a drug used to relieve nausea in cancer patients can help the most difficult-to-treat alcoholics significantly reduce their drinking. Success with the drug ondansetron (Zofran) comes amid growing search for new medications to help treat a disease that affects some 14 million Americans.

WASHINGTON-Two effective advocates for biomedical research who are retiring from Congress were honored by two advocacy groups for their support of increased funding for the National Institutes of Health (NIH) and the National Cancer Institute (NCI).

This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house

Technological ad-vances in cancer prevention and therapy have dramatically reduced cancer mortality, yet literacy continues to be a formidable obstacle to the treatment and prevention of cancer. Patients with low literacy skills who are unable to read and comprehend medical information vital to their health cannot take advantage of these innovative early detection programs and treatments.

Interest in thalidomide (Thalomid) has intensified in recent years as research has identified and elucidated its immunomodulatory, anti-inflammatory, and antiangiogenic properties. In this supplement, we present a selection of abstracts

This year, approximately 40% of the 28,300 patients diagnosed with pancreatic carcinoma in the United States will present with locally advanced disease. Radiotherapeutic approaches are often employed, as these patients

In the phase II study of thalidomide (Thalomid) in the treatment of recurrent glioblastoma multiforme, Marx et al (abstract #613) concluded that there was no correlation with vascular endothelial growth factor (VEGF) levels and response or

These four studies further establish the remarkable antitumor activity of thalidomide (Thalomid) in a variety of hematologic disorders. This drug was initially used as a nonbarbiturate sedative/hypnotic and antiemetic during pregnancy in the 1950s.

This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house

Myelodysplastic syndrome patients present with variable cytopenias even though their bone marrows are generally hypercellular. Excessive cytokine-induced apoptosis of hematopoietic cells in the marrows has been proposed as a possible

This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house

ALBANY, NY-A team of leading oncologists and hematologists has begun a study designed to help physicians more accurately predict and manage neutropenia. The Awareness of Neutropenia in Chemotherapy (ANC) Study Group was formed to develop more accurate prediction models for neutropenia.

NEW YORK-In an age when hospital stays are shorter and acute diseases more chronic, family caregivers are increasingly seen as extensions of the health care system. Yet often they receive scant preparation from health care providers and little support or understanding from their employers. Establishing programs to help caregivers was the subject of a Cancer Care, Inc. teleconference.

SAN DIEGO-Hepatocellular carcinoma (HCC) is increasing in the United States, while survival rates have not improved substantially, Andrew Mason, MD, of the University of New Mexico Health Sciences Center, Albuquerque, said at the annual meeting of the American Gastroenterological Association (AGA), held during the Digestive Disease Week conference.

WASHINGTON-Mutations of the BRCA1 gene occur in a different region of the gene among black and Hispanic carriers than in whites and Ash-kenazi Jews, researchers said at the Intercultural Cancer Council’s 7th Biennial Symposium on Minorities, the Medically Underserved, and Cancer.

CHICAGO-Although the addictive nature of nicotine appears obvious, it is only in the last few years that studies have provided a scientific understanding of nicotine addiction, Alan Leshner, PhD, said at the Eleventh International Conference on Tobacco or Health. Such information provides a firm scientific basis for smoking prevention campaigns, treatment strategies, and tobacco policy development.

WASHINGTON-Two new government surveys present a portrait of tobacco use in the United States in 1999 in which cigarette smoking by high school males appears to be declining but more than 30% of the population age 12 or older still smokes, chews, or sniffs tobacco products.

NEW YORK-The markedly improved safety profile of selective COX-2 inhibitors over conventional nonsteroidal anti-inflammatory drugs (NSAIDs) has spurred a number of new studies aimed at demonstrating their value as preventive agents among populations at high and moderate risk for a variety of cancers, Andrew J. Dannenberg, MD, said at a media briefing. Dr. Dannenberg is professor of medicine and surgery, Weill Medical College of Cornell University.

Surviving cancer is in itself a joyous thing. A new awards program will spotlight that joy and share the stories of 12 survivors who are “everyday heroes,” in an effort to help others who are struggling with the disease.

BETHESDA, Md-An independent committee studying the status of the National Cancer Program plans to release its report in January, the month that a new Congress and a new President take office. It will likely recommend legislative changes to revise the National Cancer Act of 1971 and restructure parts of the program.

WASHINGTON-Under proposed new Medicare rules, routine care costs for beneficiaries participating in clinical trials funded by a number of federal agencies would be automatically covered. Trials conducted under investigational new drug applications (INDs) or that are exempt from an IND would also receive automatic coverage status. Other trials that meet eligibility requirements (to be established) would also be covered.

WASHINGTON-Size matters, especially in epidemiologic studies. The European Prospective Investigations into Cancer and Nutrition (EPIC) was founded on that principle in 1992, said Elio Riboli, MD, ScM, MPH.

A study of smoking habits in 681 seventh graders (12 to 13 years old) in Massachusetts suggests that addiction to nicotine can occur very fast. The study was published in the British Medical Association journal Tobacco Control (9:313-315, 2000).

MINNEAPOLIS-The National Marrow Donor Program (NMDP) has reached a new milestone: 10,000 unrelated donor transplants. “At our 10-year anniversary in 1997, we celebrated 6,000 unrelated transplants, but in just 3 years, we have increased that number to 10,000,” Dr. Dennis Confer, chief medical office, said in a news release. The program, which has a volunteer registry of more than 4 million potential donors, facilitates transplants for more than 120 patients each month, he said.

Serial dynamic RODEO (Rotating Delivery of Excitation Off-resonance) magnetic resonance images (top left to bottom right) generated at approximately 1- to 2-minute intervals during the course of interstitial laser photocoagulation treatment of a small breast cancer. Prior to laser treatment, pre- and post-gadolinium contrast RODEO images were generated to allow accurate placement of a needle tip into the lesion. A bare-tip laser fiber was then inserted into the needle and connected to the laser. The laser tip was pre-charred; then 3 watts of continuous power were applied for 10 minutes. The top left image is before initiation of laser treatment. The next image (to the right of the top left image) depicts the zone of pre-charring. As the laser ablation progresses, the hypointense zone increases in size. The final dynamic image on the bottom right shows an approximately 1.4 cm zone of ablation. Images courtesy of Dr. Steven E. Harms, professor of radiology, University of Arkansas for Medical Sciences.

NEW YORK-For the bereaved caregiver, the workplace can be a distraction from worries, a structure amidst chaos, and a place for healing. During a Cancer Care, Inc. teleconference for employers, managers, and medical and human resource departments, Amanda L. Sutton, CSW, program coordinator of bereavement services at Cancer Care, outlined some steps a supervisor can take to promote a grieving employee’s healing.

BETHESDA, Md-Less than 3% of adult cancer patients take part in clinical trials. In an effort to increase patient enrollment in phase III studies, the National Cancer Institute (NCI) launched a pilot program last year-called the Expanded Participation Project (EPP)-to allow greater physician participation in its cooperative research groups.

PAVIA, Italy-In a retrospective study of children with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL), bone marrow transplantation from an HLA-matched related donor proved superior to other types of transplantation and to intensive chemotherapy alone in prolonging initial complete remissions.