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Dr. Paulino and his coauthors present a thoughtful, comprehensive survey of the literature regarding the evolving management of intracranial germinoma. They review promising areas of clinical research and acknowledge an increasing

Paulino et al provide an excellent summary of the literature on primary germinoma of the central nervous system (CNS). As the authors note, germ-cell tumors of the CNS are rare, comprising about 1% of all brain tumors in patients in the Western

Vicini and colleagues present an informative, compelling review of both past and recent clinical investigations of the use of brachytherapy in patients with prostate cancer, particularly those with locally advanced disease. The tables presented at the

Increasingly, oncologists are recognizing the importance of understanding the patient’s perception of anticancer treatment. Supportive care for cancer has improved to the point that patients no longer need fear overwhelming nausea, uncontrolled

The Internet is rapidly becoming a third party in the doctor-patient relationship. The World Wide Web, electronic mail (e-mail), and discussion groups have dramatically increased the quantity of medical and health

Brachytherapy boosts in combination with external-beam radiation therapy allow a highly conformal dose of radiation to be delivered to the prostate in a safe, efficient manner. Several types of brachytherapy boost

The explosion of medical information readily available on the Internet has already changed doctors’ conversations with patients. Ten years ago, patients might have come to a clinic visit with a newspaper or magazine article, but it would have

ANAHEIM, California-Even as the use of combination regimens including protease inhibitors is becoming more routine among individuals infected with HIV, research is starting to highlight the growing problem of drug resistance,

BETHESDA, Md-The National Cancer Advisory Board (NCAB) has urged Congress to repeal legacislation that some scientists fear will have a paralyzing impact on clinical research. NCAB also made recommendations to the White House Office of Management and Budget (OMB) aimed at reducing the feared threats posed by the legislation.

A 60-patient phase II study was conducted to determine the safety and efficacy of retreatment with the anti-CD20 monoclonal antibody (MoAb) rituximab (Rituxan) in patients with low-grade or follicular non-Hodgkin’s lymphoma (NHL). Patients were relapsed or refractory to prior chemotherapy but had previously responded to rituximab. Upon progression of disease, patients received IV infusions of rituximab at 375 mg/m² weekly × 4. Patient characteristics were 55% males with medians of: age, 56 years; three prior therapies; 14.2 months since last treatment; and 4.7 years since diagnosis.

MIAMI BEACH-Patients with hematologic malignancies and high circulating lymphocyte counts are at increased risk for infusion-related side effects after the initial infusion of the anti-CD20 mo-noclonal antibody rituximab (Rituxan), but this problem can be prevented by a stepped-dosing scheme.

There are standard response criteria for solid tumors, chronic lymphocytic leukemia, Hodgkin’s disease, and acute myelogenous

WASHINGTON-Medicare will phase in a new payment method for managed care groups, known as risk adjustment, over the first 5 years of the new century. The payment plan, required under the Balanced Budget Act of 1997, is intended to encourage managed care organizations to enroll the sickest Medicare beneficiaries.

To establish the role of fludarabine (Fludara) in previously untreated patients with low-grade malignant non-Hodgkin’s

WASHINGTON-A new Internet library of clinical practice guidelines enables physicians to quickly examine hundreds of sets of treatment recommendations and to compare and contrast different guidelines. The National Guideline Clearinghouse (www.guideline.gov) went on-line in mid-January. The website was developed by HHS’ Agency for Health Care Policy Research, the American Medical Association, and the American Association for Health Plans. More than 500 clinical practice guidelines were put into the database initially, and others will be added.

ANAHEIM, California-The inefficient burning of fossil fuel, now practiced on a mammoth scale in developing countries worldwide, puts millions of children around the world at risk for the diseases caused by this form of pollution, which include several forms of cancer. In addition, it worsens climate conditions that carry severe health threats for the future.

WASHINGTON-The National Institutes of Health should greatly expand its efforts to determine why minorities and medically underserved populations, including Appalachian whites, have widely varying cancer burdens, compared with the overall US incidence and mortality, a new Institute of Medicine (IOM) report says.

Iodine-131 tositumomab (Bexxar) is a radiolabeled murine IgG2a monoclonal antibody directed against the CD20 antigen on

The role of allogeneic bone marrow transplant (BMT) as a treatment for advanced non-Hodgkin’s lymphoma (NHL) has not been established. Historical limitations tothis approach have included the relatively advanced age of these patients, as well as their extensive treatment prior to BMT. Accordingly, only limited data have been reported about overall and/or disease-free survival in these patients. Depletion of T-cells offers the potential for older patients to undergo allogeneic BMT by reducing complications related to graft-vs-host disease (GVHD), but whether the graft-vs-lymphoma effect would be correspondingly reduced is unknown.

Contamination of the peripheral blood stem-cell (PBSC) graft with lymphoma and residual disease remaining in the patient after high-dose therapy are two potential causes of relapse after autologous transplantation. Using a tumor-specific monoclonal antibody may be one way to purge the stem-cell graft in vivo and increase the efficacy of the preparative regimen. Rituximab (Rituxan) is an IgG1 kappa chimeric mouse/human antibody containing murine light- and heavy-chain variable regions and human gamma 1 heavy-chain and light-chain constant regions. The antibody reacts specifically with the CD20 antigen found on the surface of malignant and normal B-cells.

Fludarabine (Fludara) and cyclophosphamide (Cytoxan, Neosar) are two highly active agents in the treatment of indolent

Campath-1H is a humanized anti-CD52 monoclonal antibody (MoAb) that binds to nearly all B-cell and T-cell lymphomas. We report here the results of a multicenter phase II trial of Campath-1H in patients with low-grade NHL. Fifty patients with advanced, heavily pretreated, low-grade NHL were treated with Campath-1H (30 mg administered as a 2-hour intravenous (IV) infusion 3 times weekly for up to 12 weeks).

HAMBURG, Germany-“The next goal for psychooncology is to stamp out distress,” said Jimmie Holland, MD, chair of the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center.

BETHESDA, Md-National Cancer Institute director Richard D. Klausner, MD, has taken strong exception to two criticisms leveled at NCI in a recent Institute of Medicine (IOM) report on NIH research programs for minorities and the medically underserved . Dr. Klausner told the National Cancer Advisory Board (NCAB), “there are clearly either misunderstandings or profound philosophical differences.”

Protease inhibitors, routinely used to treat the human immunodeficiency virus (HIV) in the United States, are highly effective against the subtype C viral strain thought to be most prevalent worldwide, report Stanford researchers.

Waldenström’s macroglobulinemia is a rare, low-grade lymphoproliferative disorder for which few therapies are effective. Although patients with Waldenström’s macroglobulinemia often are reported with cases of small lymphocytic lymphoma, this disease has characteristic lymphoplasmacytic histology, bright CD20 expression, and IgM paraproteinemia. Rituximab (Rituxan) is a chimeric anti-CD20 monoclonal antibody that produces a 50% response rate in previously treated low-grade lymphoma, but has no previously described efficacy in the Waldenström’s macroglobulinemia subtype. We report 7 patients with Waldenström’s macroglobulinemia treated on clinical trials performed by IDEC Pharmaceuticals (N = 6) or at our institution (N = 1). Characteristics of these patients included a median age of 60 years (range, 50-75 years) with 5 being female. All patients were symptomatic, with a median performance status of 1 (range, 1-3), with all having measurable disease independent of paraproteinemia.

Our studies have shown that unconjugated antibody therapy targeted to the B-cell marker CD20 by the anti-CD20 antibody, C2B8, inhibits the growth of B-cell lymphomas in vitro. We have also demonstrated that B-lymphoma tumor cells can be sensitized to subtoxic doses of therapeutic drugs by the same antibody.

Several published reports have suggested that although there is a lesser relapse rate for allogeneic bone marrow transplantation (BMT) compared to autologous BMT in patients with low-grade lymphoma, no survival advantage was evident because of higher toxicity associated with allogeneic BMT. To address this issue, we compared outcome in 38 patients with low-grade lymphoma who received allogeneic BMT to 72 patients who underwent autologous BMT at our institution.

Splenomegaly has been considered by some to be a contraindication to monoclonal antibody immunotherapy or

Dr. Nag and colleagues present an excellent review of several of the techniques of brachytherapy used in both the pediatric and adult populations. The authors are to be commended for their comprehensive summary of the results of the major trials of pediatric brachytherapy in the management of soft-tissue sarcomas.