6/15/2004 By Robert E. Wittes The Washington Post The cancer research community and the patients it serves took heart a few weeks ago from the Food and Drug Administration's approval of two new drugs -- Avastin and Erbitux. These are antibodies, similar in structure to the infection-fighting proteins that circulate in our blood. Neither is very effective when used alone, but in combination with other chemotherapy drugs, they can shrink tumors, restrain tumor growth and, in the case of Avastin, extend life by a few months in some patients with colon cancer that has already spread to other parts of the body. There is just one big problem: Both drugs have been marketed at such extraordinarily high prices that many people will simply not be able to afford them. Although the new drugs help only a minority of patients, they represent significant successes in translating new molecular knowledge about cancer into more effective treatment. In this respect they join other recent entries in the oncologist's medicine cabinet and are a sign of things to come. Most of us anticipate that truly successful treatment for disseminated cancers will be not with single drugs but with combinations of them, aided by precise molecular testing to guide selection of the most effective drugs for a particular patient. Now back to the economics. The average wholesale price (AWP, or the average price charged to hospitals and physician practices) of a month of treatment for a normal-size adult is roughly $4,800 for Avastin and $12,000 [...]

6/14/2004 Los Angeles, CA Valerie Reitman, Times Staff Writer The Los Angeles Times A growing number of anti-smoking researchers and public health advocates are adopting a tack that not long ago would have been considered heresy: suggesting that hard-core smokers who can't kick the habit would be better off switching to new smokeless tobacco products. With slogans such as "Spit-free" and "For when you can't smoke," these products differ markedly from the messy snuff and chewing tobacco stereotypes associated with your granddaddy's spittoon or certain pro baseball players' stuffed cheeks. They are clean, discreet, last about 30 minutes and come in mint, wintergreen and other flavors. Some go down easily, dissolving much like a breath mint, while others look like tiny tobacco-filled teabags, tucked into the side of the mouth and discarded like chewing gum. Though no one is calling the products "safe" — any tobacco that has been cured contains some carcinogens — numerous epidemiological studies have shown that smokeless tobacco is far less likely to cause any type of cancer, including oral cancer, than cigarettes. "If someone can't quit smoking, there is no question that smokeless is much safer. It doesn't cause heart or lung disease, and if it does cause cancer, it does so at a much lower rate," said Dr. Neal Benowitz, a professor of medicine at UC San Francisco and director of its cancer center's Tobacco Control Program. Gary Giovino, director of the Tobacco Control Research Program at the Roswell Park Cancer Institute in Buffalo, [...]

7/12/2004 New Orleans, LA By Marie Rosenthal Hem/Onc News Presidential advisory panel releases report aimed at improving outcomes for survivors. Although there are nearly 10 million Americans who are cancer survivors, a threefold increase over the number of survivors in 1971, many enter a world that is ill equipped to handle their special needs, ranging from psychological to medical, says a new report from the President’s Cancer Panel. “In 1971, there were 3 million cancer survivors in the United States; in 1986, there were 6 million. In 2004, there are close to 10 million cancer survivors,” said LaSalle D. Leffall, Jr., MD, who is chair of the panel, which just issued a report that looks at the late effects of cancer treatment across a survivor’s life. The panel made recommendations about issues concerning four age groups: children, adolescents and young adults, adults and the elderly. After holding town meetings in four cities — Austin, Texas, Birmingham, Ala., Denver and Philadelphia — to talk with cancer survivors, their caregivers and health care givers, the panel found that patients reported problems during and after cancer treatment. Late effects Years after treatment, cancer survivors reported late effects, such as learning disabilities among children; infertility or complications with pregnancies; premature aging and heart disease; psychosocial effects and prejudicial treatment, including being denied life or health insurance. Survivors reported depression and anxiety rooted in their fight against cancer that later affects their quality of life and ability to work, panelists said. “There were overarching issues [...]

6/11/2004 CODY, WY By TIMOTHY EGAN The New York Times That Copenhagen Cowboy, as they called Kent Cooper, was a saddle bronc rider on the rodeo circuit, one of the best in the world at trying to keep his spurs high on a horse that wanted no part of him. When he died two years ago at 47, the throat cancer was so bad it wrapped around his jugular vein and got into his brain. His name lives on, here in the place that calls itself the rodeo capital of the world, and in every town where cowboys wrestle animals under starry skies. But Mr. Cooper's legacy may be something more unsettling than his many winning rides. The Cooper family has sued the nation's leading maker of chewing tobacco, which is also the oldest sponsor of rodeo, charging that the company addicted Mr. Cooper to a cancer-causing product without adequate warning about its hazards. Smokeless tobacco, known as chew or spit, is the drug of choice on the bull and bronc circuit, given away at sampling tents, promoted through banners and college scholarships and by charismatic champions who tell people it is part of Western culture. Mr. Cooper's ex-wife, Susan Smith, and a small but growing number of cowboys say smokeless tobacco has made tooth-stained addicts out of too many rodeo riders and has no place in a fast-growing sport that appeals to families. "Kent was a billboard for tobacco," Ms. Smith said. "They all are. But I wish people [...]

7/10/2004 Bethesda, MD Karen Antman, MD National Cancer Institute Since about 1990, cancer mortality per 100,000 population in the United States has been falling. This trend has been driven by decreasing mortality in the four most common malignancies: prostate, breast, lung, and colon cancers.1 Although many debate the impact of either cancer screening or treatment, the decrease in mortality for breast, colon, and prostate cancers is attributable to better treatment, to screening, or, probably, to both. The fall in lung cancer deaths almost certainly results from the fact that significant numbers of Americans quit smoking 15 to 20 years ago. Most of those who quit were men; consequently, lung cancer mortality in men peaked in about 1990 and is now falling, whereas mortality in women has only leveled off. Women have particular difficulty quitting smoking, perhaps because our society places great value on thinness, and women who quit tend to gain weight. Depression, which also decreases the success rate of quitting, is approximately twice as common in women as in men. Mortality per 100,000 is a clean statistical end point. Although 5-year survival rates have also improved, from about 40% in the 1950s to 62% today, these rates are subject to early detection bias; they can be inflated by the implementation of screening programs, which increase the detection of small lesions with a better prognosis or of premalignant lesions of uncertain clinical significance.1 Nevertheless, because large numbers of baby boomers are now entering their 50s—an age when the risk of [...]

6/10/2004 London, UK BBC News, (UK) The world's first clinical research centre devoted to facial surgery is opening in London on Thursday. The centre, set up by the Facial Surgery Research Foundation, will coordinate studies into oral cancers and facial injuries and deformities. It will bring together 40 UK surgeons, plus researchers and statisticians. Surgeon Iain Hutchison, who is leading the centre, says he hopes its research will mean better treatments can be developed for patients more quickly. Oral cancer is the sixth most common cancer in the world and a source of facial disfigurement for some after treatment. It is almost as common in the UK as leukemia and melanoma and its incidence is twice that of cervical cancer. Another significant part of the surgeons' work involves caring for patients injured after binge drinking, either by falling or by fighting. All these types of causative factors will be treated by the facility. We hope to eliminate the inconsistencies in treatment Around 125,000 teenagers in the UK are affected by severe facial injuries after drinking every year and surgery is needed to correct the facial disfigurement of over 4,000 young people. Specialists also plan to carry out research into the psychological effects of having a facial injury. Although the centre will start by focusing research studies in the UK, it is hoped it can take part in international research projects within two or three years. Dr. Hutchison, a consultant in oral and maxillofacial surgery at St Bartholomew's Hospital in London, [...]

6/9/2004 NEW ORLEANS , LA By Stacie Overton Ivanhoe Newswire Those anti-inflammatory drugs you’re taking may be doing more good than you thought, according to researchers presenting at this year’s annual meeting of the American Society of Clinical Oncology in New Orleans. They could provide protection against a deadly cancer. Oral cancer is often related to tobacco and has a high mortality rate. Available data suggest aspirin, a type of non-steroidal anti-inflammatory drug, has a protective effect on esophageal cancer, but only scattered data exist on whether or not it is useful in protecting against oral cancer. Jon Sudbø, from the Norwegian Radium Hospital in Oslo, presented results of a study to determine how protective NSAIDs were against oral cancer. More than 450 people with oral cancer were included in the study. They were compared to a closely matched set of people without oral cancer, but who were at high risk of the disease. Among those with oral cancer, less than 20 percent had a history of NSAID use. Comparatively, more than 40 percent of those who were at high risk -- but did not have cancer -- had a history of NSAID use. Overall, there was a 65-percent reduction in oral cancer risk with extended use of NSAIDs, and all types of NSAIDs had a protective effect. The NSAIDs used were one of the following: aspirin, ibuprofen, naproxen, indomethacin, piroxicam or ketoprofen. Sudbø says, “Clearly, there is a protective effect of NSAIDs against oral cancer.” Sudbø collaborated on the [...]

6/9/2004 Rebecca Camber Manchester News (UK) A cancer patient who endured a 12-hour operation to remove a tumour has made sure her fellow patients do not have to go through the same ordeal. Sue Slater, 54, raised thousands of pounds to supply Christie Hospital with one of the most advanced laser surgery instruments available on the market. The transoral laser surgery equipment allows surgeons to remove throat and mouth tumours in under four hours. Sue had the surgery three years ago to remove a tumour on her tongue. Along with her husband Stuart, she formed a local group, the Wilmslow Fundraisers for Christies, selling toys, jams and chutneys all year to raise the £10,500 needed to buy the life-saving equipment. The sophisticated piece of kit is the only one in the North to allow surgeons to remove mouth and throat tumours without having to cut the skin or resort to rebuilding the face. The gadget is equipped with a microscope to give surgeons the best view when they look for the tumour through the mouth. The equipment also gives patients a much higher chance of making a full recovery and they won't have to bear the same scars as Sue has across her neck. Stuart, who is chairman of the group, said: "Sue went through major surgery. It was very tough. Having had personal experience of this kind of cancer, we are delighted to see this new equipment in use and hope it will provide benefits for many years to [...]

6/8/2004 NEW ORLEANS, LA Matthew Herper Forbes After helping to develop some of the hottest new biotech drugs, Memorial Sloan-Kettering cancer doctor Leonard Saltz has come down with a bad case of sticker shock. The price tag for treating patients has increased 500-fold in the last decade. Ten years ago, doctors could extend the life of a patient who had failed to respond to chemotherapy several times by an average 11.5 months using a combination of drugs that cost $500 in today's dollars. Now, new medicines such as Genentech's (nyse: DNA ) Avastin and Sanofi-Synthelabo's (nyse: SNY ) Eloxatin can extend survival to 22.5 months, but at a total cost of $250,000. And that doesn't include pharmacy markups, salaries for doctors and nurses, and the cost of infusing the drugs into patients in the hospital. That kind of cost is unsustainable. "Sooner or later the bubble is going to pop," Saltz says. Fears about the high cost of new drugs and the changing financial environment for treating cancer are major concerns among doctors gathered here at the annual meeting of the American Society for Clinical Oncology. Doctors are beginning to discuss treating cancer as a chronic disease that could be kept in check with a cocktail of pills. But that puts cancer drug firms on a collision course with both the private sector's crackdown on high healthcare costs in the United States and the new Medicare law, which will go into effect in less than two years. As the government [...]

6/7/2004 New Oleans, LA Matthew Herper Forbes.com The annual meeting of the American Society for Clinical Oncology is a much-watched arena for biotech concerns, which get their first chance to present new data to investors. Here are four companies that have doctors talking about their drugs. ImClone Systems Erbitux Colon Cancer, Head-And-Neck Cancer For the first time, ImClone Systems' (nasdaq: IMCL ) Erbitux has been proven to extend patients' lives. (In previous studies, it shrank tumors.) The new results for the drug are in head-and-neck cancer, a kind of tumor in the throat and mouth that is difficult to treat. The results are seen as proof of the drug's efficacy. "It takes a monkey off the back of a drug that's taken some hits," says Leonard Saltz, an oncologist from Memorial Sloan-Kettering who played a role in Erbitux's development. For ImClone and partner Bristol-Myers Squibb (nyse: BMY), that's good news indeed. Millennium Pharmaceuticals Velcade Myeloma, Lung Cancer Some analysts are disappointed with the sales of Millennium's (nasdaq: MLNM) Velcade as a treatment for multiple myeloma, a cancer of the blood. Yet many are watching to see whether the drug can work in other cancers, particularly those that form big, solid tumors. Early evidence came from a presentation using Velcade in non-small-cell lung cancer in a mere 53 patients. Bruce Johnson, an oncologist at the Dana-Farber Cancer Institute, says the results look good, but very preliminary. Roman Perez-Soles, chairman of the department of oncology at the Albert Einstein College of Medicine, [...]