Adenoviral-p53 Gene Therapy Promising in NSCLC
July 1st 1998HOUSTON--Adenoviral-p53 gene therapy with Introgen Therapeutics’ INGN 201 was well tolerated and showed evidence of clinical activity both alone and with cisplatin (Platinol) in patients with advanced non-small-cell lung cancer (NSCLC) who had failed conventional therapy. Stephen Swisher, MD, of the M. D. Anderson Cancer Center, presented the completed phase I/II trial results at an ASCO poster session.
Liposomes a Workable Delivery System for E1A Gene Therapy
June 1st 1998NEW ORLEANS--After delivery with a cationic liposome complex, the tumor-suppressor gene E1A was expressed by cells in many places in the body, Naoto Ueno, MD, of the M.D. Anderson Cancer Center, reported at the 89th annual meeting of the American Association for Cancer Research (AACR).
ODAC Recommends Approval of Two New Taxol Indications
April 1st 1998BETHESDA, Md--Bristol-Myers Squibb went 2-for-2 before the FDA’s Oncologic Drugs Advisory Committee (ODAC). The panel recommended that the FDA approve injectable Taxol (pacli-taxel), in combination with cisplatin (Platinol), for both the first-line treatment of ovarian cancer and for the treatment of non-small-cell lung cancer (NSCLC) in patients who are not candidates for potentially curative surgery and/or radiation therapy.
Prophylactic Cranial Irradiation in Small-Cell Lung Cancer: Is It Ever Indicated?
January 2nd 1998Prophylactic cranial irradiation (PCI) is being reintroduced into multimodality treatment protocols of patients with small-cell lung cancer (SCLC). The history of its use brings interesting insights into clinical evaluations of treatment strategies and design of relevant and informative trials. The critical issues of effectiveness and overall health gains of prophylactic cranial irradiation have been addressed in a series of recently completed clinical trials. These trials tested prophylactic cranial irradiation in small-cell lung cancer patients achieving good response to induction therapy and confirmed the ability of standard prophylactic cranial irradiation schedules to significantly reduce the lifetime risk of brain metastases. A subset of these trials evaluated neurotoxicity in a formal and prospective manner. No sustained or significant detriment in neuropsychometric function could be linked to the use of prophylactic cranial irradiation. In addition, all the large trials have shown a consistent survival advantage in favor of the prophylactic cranial irradiation arm. None of the individual sample sizes were large enough to statistically confirm this survival benefit, but a meta-analysis is in progress and will report on this aspect of evidence shortly. Issues that remain to be answered are the optimal dose and schedule of prophylactic cranial irradiation as well as the timing of this administration. These questions form the nucleus of the next generation of collaborative trials that are being designed.[ONCOLOGY 12(Suppl 2):19-24, 1998]
Paclitaxel, Carboplatin, and Radiation Therapy for Non-Small-Cell Lung Cancer
January 2nd 1998Preclinically, the taxanes appear to potentiate radiation more effectively than do the platinum compounds. In our phase I trial (LUN-17) in patients with advanced non-small-cell lung cancer, we defined the maximum tolerated
Future Directions in Non-Small-Cell Lung Cancer: A Continuing Perspective
January 2nd 1998Non-small-cell lung cancer (NSCLC) will increasingly come under better control as the current approaches to therapy are more broadly employed and as new therapies are deployed against recently elucidated molecular
The Role of Carboplatin in the Treatment of Small-Cell Lung Cancer
January 2nd 1998Lung cancer is the leading cause of death due to cancer in the United States, and approximately 178,100 new cases were estimated to occur last year. Small-cell lung cancer (SCLC) accounts for approximately 17% to 25% of all lung cancers. Due to its aggressive nature and rapid proliferation rate, small-cell lung cancer is usually widespread at diagnosis. Therefore, chemotherapy is the cornerstone of therapy for this disease. Cisplatin (Platinol) is an active chemotherapeutic agent used to treat small-cell lung cancer, but its toxicity, including nausea and vomiting, nephrotoxicity, neurotoxicity, and ototoxicity, has led to the investigation of combination regimens with different toxicity profiles. Carboplatin (Paraplatin), a derivative of cisplatin, has far less nonhematologic toxicity, although myelosuppression may be slightly greater than that observed with cisplatin. The reduced toxicity and equivalent efficacy of carboplatin have resulted in the increased use of carboplatin-based regimens to treat small-cell lung cancer. Phase I and II trials of carboplatin as single-agent treatment for small-cell lung cancer resulted in overall response rates of approximately 60% for previously untreated patients and 17% for those who had received prior therapy. New combination chemotherapy regimens that include carboplatin may improve survival in patients with small-cell lung cancer and potentially cure those patients with limited disease. Further investigation of carboplatin and other new agents is warranted.[ONCOLOGY 12(Suppl 2):36-43, 1998]
One-Hour Paclitaxel Plus Carboplatin for Advanced Non-Small-Cell Lung Cancer
January 2nd 1998We report here the preliminary results of a large phase II multicenter study done in the community setting, using paclitaxel (Taxol) (given by 1-hour infusion) plus carboplatin (Paraplatin) to treat patients with advanced non-small-cell lung cancer (NSCLC). In this study, 155 chemotherapy-naive patients with stage IIIB, stage IV, or recurrent metastatic non-small-cell lung cancer received the two drugs in 21-day cycles. Paclitaxel 225 mg/m² was given by 1-hour intravenous infusion followed immediately by carboplatin at a targeted area under the concentration-time curve of 6.0 (calculated according to the Calvert formula). Colony-stimulating factors were not used routinely. Objective responses occurred in 53 of 155 patients (34%) (53 of 144 [36%] evaluable patients) including three complete responses and 50 partial responses. Fifty-two other patients had stable disease at initial reevaluation. The median survival among all 155 patients was 8 months; the 1-year survival rate was 42%, and the 2-year survival rate was 20%. Leukopenia and cumulative peripheral neuropathy occurred consistently but rarely were severe or affected the course of therapy. One patient died due to sepsis. Other grade 3 and grade 4 toxicities were uncommon. This paclitaxel-carboplatin combination chemotherapy appears to be a relatively convenient, safe, and active regimen in advanced non-small-cell lung cancer.[ONCOLOGY 12(Suppl 2):71-73, 1998]
Integrating Thoracic Radiotherapy in the Treatment of Limited Small-Cell Lung Cancer
January 2nd 1998Although the need to combine thoracic radiotherapy with systemic chemotherapy in the curative treatment of limited small-cell lung cancer is now widely acknowledged, there is substantial disagreement on how best to do this. This paper reviews radiotherapeutic factors but also highlights the important interactions that occur with some classes of chemotherapeutics. Studies examining variables like dose and volume are clearly in order. Concurrent therapy given early has been adopted throughout most of the world, except Europe. The reasons for this are explored. Multiple studies are now showing excellent results with fewer total cycles of chemotherapy. Integrationof newer drugs is another challenge for clinical investigators at the close of this century. [ONCOLOGY 12(Suppl 2):15-18, 1998]
New MoAb Receives FDA Clearance for Non-Hodgkin’s Lymphoma
January 1st 1998Rituximab (Rituxan) has been cleared for marketing by the FDA. Previously known as the C2B8 antibody, rituximab, is a single-agent monoclonal antibody therapy for relapsed or refractory, low-grade or follicular, CD20-positive, B-cell non-
Concomitant Cisplatin, Vinorelbine, and Radiation in Advanced Chest Malignancies
Newer chemotherapy drugs have shown encouraging activity in advanced non-small-cell lung cancer. Based on these improved outcomes, as well as the high rate of distant relapse in patients with locally advanced disease, several recent studies have evaluated the use of systemic therapy in patients with earlier-stage disease.
Topotecan Appears Effective for 2nd-Line SCLC Therapy
October 1st 1997DUBLIN-Preliminary results suggest that the use of single-agent topotecan (Hycamtin) as second-line therapy for small-cell lung cancer (SCLC) in patients who failed after an initial response to first-line therapy provides efficacy similar to that of the commonly used regimen of cyclophosphamide, doxorubicin (Adriamycin), and vincristine (CAV).
Gene Therapy Is Moving Toward Cancer Treatment
October 1st 1997SAN FRANCISCO-About 4,000 human diseases have a genetic cause, and many such diseases are untreatable or poorly treated by conventional medicine, said R. Michael Blaese, MD, chief of the Clinical Gene Therapy Branch at the NIH National Center for Human Genome Research. In theory, many of these diseases could be treated by adding, deleting, or altering genes.
Panel Recommends PDT Approval for Use in Superficial NSCLC
October 1st 1997BETHESDA, Md-The Food and Drug Administration’s Oncologic Drugs Advisory Committee (ODAC) has recommended approval of QLT Photo-Therapeutics’ Photofrin (porfimer sodium) for use as photodynamic therapy (PDT) of T1 stage endobronchial carcinoma in patients with non-small-cell lung cancer (NSCLC) for whom surgery and radiotherapy are not indicated.
This study compared the activity and toxicity of fluorouracil (5-FU)/cisplatin with the combination tegafur and uracil (UFT)/cisplatin in the neoadjuvant treatment of locally advanced-stage III or IV (M0)-head and neck
Future Directions in the Treatment of Squamous Cell Carcinoma of the Head and Neck: The Role of UFT
September 2nd 1997Squamous cell carcinoma of the head and neck is a potentially curable neoplasm. Historically, the standard approach to treatment has been either surgery or radiation therapy, or a combination of the two. Over the past
Combined-Modality Therapy of Locally Advanced Non-Small-Cell Lung Cancer
September 1st 1997Treatment of patients with unresectable stage IIIA and IIIB non-small-cell lung cancer with conventionally-fractionated radiation therapy (ie, total doses of 50 to 60 Gy, using one fraction per day), which was standard
Interleukin-2 May Enhance Gene Therapy of Melanoma
September 1st 1997SAN FRANCISCO-Investigations into the cellular basis of the anticancer activity of recombinant interleukin-2 (IL-2, Proleukin) may lead to immunization against some cancers. That was the prospect suggested by Steven A. Rosenberg, MD, head of the NCI’s Surgery Branch and professor of surgery at George Washington University School of Medicine and Health Sciences, and the Uniformed Services University of the Health Sciences, Bethesda, Md.
Commentary (Giles/Kantarjian): Biology and Treatment of Chronic Myelogenous Leukemia
September 1st 1997Drs. Enright and McGlave succinctly review the biology of chronic myelogenous leukemia (CML) and highlight the therapeutic role of allogeneic stem-cell transplantation. Two points, however, warrant further discussion. The first is that a regimen containing interferon-alfa (Intron A, Roferon-A) is optimal front-line therapy for the great majority of CML patients.[1] The second is that use of an interferon-alfa-based regimen prior to allogeneic stem-cell transplantation does not adversely affect post-transplant mortality, morbidity, or anti-CML efficacy.
Panel Recommends FDA Approve First MoAb for Cancer Rx
September 1st 1997BETHESDA, Md-The Biological Response Modifiers Advisory Committee has recommended that the FDA usher cancer therapy into a new era by approving IDEC Pharamceutical’s Rituxan (rituximab) for patients with relapsed or refractory low-grade or follicular B-cell non-Hodgkin’s lymphoma.
Photodynamic Therapy Used in Nonmelanoma Skin Cancer
August 1st 1997BETHESDA, Md--Delta-amino-levulinic acid (ALA), a compound found in cells throughout the body, holds potential as an active drug in photodynamic therapy and could provide an alternative to surgery for patients with basal and squamous cell carcinomas, R. Rox Anderson, MD, said at the General Motors Cancer Research Foundation conference.
BMT for Severe Autoimmune Diseases: An Idea Whose Time Has Come
July 1st 1997Studies of hematopoietic stem-cell transplantation as a treatment for severe autoimmune diseases (SADS) are currently in progress. Dr. Burt thoroughly reviews the rationale for these studies. It includes: (1) preclinical studies showing that marrow transplantation is an effective therapy in animal models of autoimmune disease; (2) observations of the effect of stem-cell grafts on SADS in patients transplanted for other indications; and (3) improvements in the safety of the transplant procedure.
Recent Progress in Radioimmunotherapy for Cancer
July 1st 1997Radioimmunotherapy allows for the delivery of systemically targeted radiation to areas of disease while relatively sparing normal tissues. Despite numerous challenges, considerable progress has been made in the application of radioimmunotherapy to a wide variety of human malignancies. The greatest successes have occurred in the treatment of hematologic malignancies. Radioimmunotherapy, with or without stem-cell transplant support, has produced substantial complete remission rates in chemotherapy-resistant B-cell lymphomas. Nonmyeloablative regimens have shown so much promise that they are now being tested as initial therapy for low-grade B-cell lymphomas. Although solid tumor malignancies have been less responsive to radioimmunotherapy, encouraging results have been obtained with locoregional routes of administration, especially when the tumor burden is small. Greater tumor-to-normal tissue ratios are achievable with regional administration. Even with intraperitoneal and intrathecal administration, bone marrow suppression remains the dose-limiting toxicity. Ongoing research into new targeting molecules, improved chelation chemistry, and novel isotope utilization is likely to extend the applications of this strategy to other tumor types. The potential for radioimmunotherapy will be enhanced if this modality can be optimally adapted for integration with other agents and if the administration method can be tailored to the type and distribution of malignancy. [ONCOLOGY 11(7):979-987, 1997]
Cell Cycling Research May Hold Key to Improving Cancer Therapy
June 1st 1997SAN DIEGO--So little is known about cell cycling that a new study on a possible mechanism for why cells fail to exit the cell cycle was termed the "most exciting presentation" of the American Association for Cancer Research's 88th annual meeting. Stephen H. Friend, MD, of the Fred Hutchinson Cancer Research Center, made the comment at a press briefing held at the meeting.
Bacterial Vectors Show Promise in Cancer Gene Therapy
June 1st 1997SAN DIEGO--Genetically engineered bacteria have the potential to deliver anticancer genes directly to a tumor site, according to four presentations of preclinical data at the American Association for Cancer Research (AACR) annual meeting.