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MADISON, Wis--An anomaly of pain management is that patients generally report satisfaction with their pain management, even though they are still experiencing pain. The downside of this finding is that if patients are truly satisfied, institutions may see no need to improve pain management programs.

Pediatric cancer specialists at The University of Texas Southwestern Medical Center at Dallas plan to bring an old cancer-fighter off the bench and test its effectiveness in a new generation of children with leukemia.

AMSTERDAM--Innovative strategies for thwarting metastasis are now at the brink of clinical application, Lance Liotta, MD, of the National Cancer Institute, reported at the 9th NCI-EORTC Symposium on New Drugs in Cancer Therapy.

The article by Hambleton provides a compendium of the causes of hematopoietic defects in HIV-infected individuals. For the busy practicing physician who treats patients with HIV, these defects are not trivial. Cytopenias are a continuous problem that impact on most clinical decisions. For example, anemia and neutropenia are more common in patients with 100 CD4 cells/mcL or less. In general, these patients also have the highest titers of virus and are at greatest risk of developing symptomatic Mycobacterium avium or cytomegalovirus infection. Thus, physicians often find themselves trying to decide which patients should undergo a more extensive evaluation and which should receive "less" myelosuppressive therapy.

Benign and aggressive intracranial meningiomas, as the authors state, are seemingly simple tumors (even with benign histology) that can behave in a clinically malignant fashion solely by location. Clinicians with experience in the management of patients with aggressive, recurrent, or malignant meningiomas are all too well aware of the difficulties of recommending effective therapy beyond surgery and radiation therapy. Clearly, there is much room for improvement in the treatment of recurrent or malignant meningiomas with local or systemic chemotherapy and/or biologic therapies.

Drs. Dresler and Goldberg review the role of resection of metastatic tumors to the lung. It is a difficult topic, with the exception of osteosarcoma, for which the practice of secondary resection is common and clearly of benefit. For lung metastases from other tumors, however, the use of resection is based largely on sporadic and anecdotal reports.

Meningioma is a prime example of a tumor requiring a multimodality approach. This tumor is usually benign and often grows slowly. Under many circumstances, such a benign tumor would never attract the attention of the oncologist or even require treatment at all. However, a meningioma is a benign tumor in a malignant location. In the closed space of the skull, there is no room for expansion of even a benign lesion; thus, effective treatment of this potentially neurologically devastating lesion is necessary. Neurosurgeons, neuroradiologists, radiotherapists, and medical oncologists are all directly involved in treatment decisions. Rapidly expanding knowledge concerning the etiology and natural history of meningiomas may now also involve epidemiologists, molecular geneticists, and endocrinologists. Despite this concentration of expertise, numerous questions remain unanswered or incompletely answered.

Hematologic complications of HIV disease are commonly encountered by physicians and other health-care workers caring for patients infected with this virus. Ineffective hematopoiesis, infiltrative diseases of the bone

Usually considered benign tumors, meningiomas can display aggressive behavior characterized by multiple recurrences and invasion of the brain, dura, and adjacent bone. The aggressive or malignant phenotype is difficult

Lung parenchyma is the most common site of metastases from either carcinomas or sarcomas. Depending on the status of the original primary, resection of lung metastases may be curative. Multiple variables must be

BALTIMORE--A small study of HIV-infected patients conducted by researchers at the National Institute of Allergy and Infectious Disease (NIAID) shows that inoculation with a common vaccine can temporarily increase the amount of HIV that is circulating in the bloodstream.

FORT LAUDERDALE, Fla--There is a void of outcomes data in cancer that the National Comprehensive Cancer Network (NCCN) hopes to fill, said Jane Weeks, MD, at the NCCN's first annual conference.

Radiosurgery plus the radiation sensitizer etanidazole is being evaluated in a Radiation Therapy Oncology Group trial (RTOG 95-02) as a treatment for recurrent or persistent brain tumors or metastases.

PARIS--Worldwide, some 50 clinical trials involving up to 1,000 patients are now attempting to define the clinical utility of angiogenesis inhibitors in reining in micrometastases. The rationale for such "dormancy therapy" lies in a hypothesis formulated by Judah Folkman, MD, of Harvard.

During the 1980s, HIV infection emerged as a leading cause of death in the United States. In 1993, HIV infections became the most important cause of death among persons age 25 to 44 years. This report updates national trends in deaths caused by HIV infection in 1994.

BETHESDA, Md--The National Cancer Institute and the Department of Defense (DOD) have signed an in-teragency agreement that gives the 8.3 million beneficiaries of TRICARE/CHAMPUS, the DOD's health program, access to NCI-sponsored clinical treatment trials. About 12,000 of the DOD beneficiaries are diagnosed with cancer each year.

BETHESDA, Md--The number one priority for the NCI is to use its new budget for fiscal 1996 to "maintain the engine of discovery," by increasing funding for extramural, investigator-initiated research, NCI director Richard D. Klausner said at a meeting of the National Cancer Advisory Board (NCAB). The new $2.25 billion budget represents a 5.5% increase from 1995, he said.

The treatment of childhood leukemias and lymphomas is one of modern oncology's major success stories. Today, 80% to 85% of childhood cancer patients grow up free of their disease. But the very treatment that, in most cases, cured these young patients leaves many of them at risk for other problems later in life.

PHILADELPHIA--Two highlights of the 1996 American Society of Clinical Oncology (ASCO) meeting (to be held May 18-21 in Philadelphia) will be the integrated symposia, ASCO president John Glick said in an interview. Dr. Glick, of the University of Pennsylvania Cancer Center, said that the innovative symposia will integrate educational material and state-of-the-art abstracts.

For the oncology profession, the transition period to managed care will mean new relationships with other providers, some loss of control over patient care, and the need for practice and ethical guidelines, concluded panelists participating in a session on managed care at the Association of Community Cancer Centers' 1995 Oncology Symposium.

Graft-versus-host disease (GVHD) represents a significant, perhaps neglected, complication of unrelated bone marrow transplantation, stated Daniel Weisdorf, MD, Professor of Medicine at the University of Minnesota, and Associate Director of the Adult Bone Marrow Transplantation Program, at a symposium on "Clinical Issues in Unrelated Marrow Transplantation" held in association with the recent meeting of the American Society of Hematology. Prolonged immunocompromise is an additional hazard to recipients of unrelated bone marrow transplants.

FORT LAUDERDALE, Fla--The most difficult part of the guidelines process is implementation--getting physicians, nurses, and administrators to "buy in" to the process, Gale Katterhagen, MD, said at the first annual conference of the National Comprehensive Cancer Network (NCCN), a coalition of major cancer centers currently in the process of developing guidelines for its members.

Monoclonal antibodies (MoAbs) show promise as a prognostic as well as therapeutic tool in some minimal residual cancers, said Gert Riethmüller, MD, of the University of Munich's Institute for Immunology.

NEW YORK--Henry T. Lynch, MD, whose pioneering work during the 1960s and '70s helped establish the hereditary basis of certain gastrointestinal, breast, and ovarian cancers, is the recipient of the 19th annual Bristol-Myers Squibb Award for Distinguished Achievement in Cancer Research. Thanks in large part to Dr. Lynch, the specific genetic mutations responsible for a number of familial cancers have been identified.

BETHESDA, Md--The PDQ Adult Treatment Editorial Board held its March meeting in Milan, Italy, so that an international audience could observe how the board reviews recently published literature to determine if changes should be made in the information in PDQ. The experience is expected to aid the European oncology community in developing its own database, known as START (State-of-the-Art Oncology in Europe).

FORT LAUDERDALE, Fla--Unlike the piecemeal development of clinical practice guidelines in the United States--by individual institutions, networks, or managed care plans--in Canada, guidelines development is a provincial effort, with the resulting product applying to all oncologists in the province, Mark Levine, MD, said at the first annual conference of the National Comprehensive Cancer Network (NCCN).

FORT LAUDERDALE, Fla--Interest in neurotoxins derived from marine cone snails has led to development of a calcium-channel blocking agent that could potentially be used as an alternative to opioid analgesics for patients with cancer pain. Early clinical studies with the agent (SNX-111, being developed by Neurex Corporation, Menlo Park, Calif) have found it to be more potent than morphine and free of opioid side effects, Richard W. Tsien, DPhil, said at a conference on gene technology organized by the University Biochemistry & Molecular Biology Foundation, Inc. and Bio/Technology Magazine.

HOUSTON--The University of Texas M.D. Anderson Cancer Center will hold its second medical oncology conference in Spanish on May 22-24, 1996. The educational conference will bring together physicians from Spain and Latin American with the M.D. Anderson faculty, said Richard Pazdur, MD, associate professor of medicine and co-director of the conference along with Alejandro Preti, MD, assistant professor of medicine.

The use of antibodies as immunodelivery systems is still in its infancy, Sydney Welt, MD, said at a symposium on Monoclonal Antibodies and Cancer Therapy, sponsored by the Cancer Research Institute.

Efforts to improve the rate of remission and reduce the risk of relapse in patients with advanced hematologic malignancies are focusing on interleukin-2 (IL-2, aldesleukin, Proleukin), said Alexander Fefer, MD, of the University of Washington Medical School and Fred Hutchinson Cancer Research Center, Seattle.