9/20/2005 Boston, MA Lori J. Wirth et al. Journal of Clinical Oncology, 10.1200/JCO.2005.02.4182 Purpose: Effective and tolerable palliative treatments are needed for patients with incurable squamous cell carcinoma of the head and neck (SCCHN). Single-agent targeted therapies have limited activity in this setting. The feasibility of adding celecoxib to gefitinib for the treatment of incurable SCCHN is unknown. Patients and Methods: Nineteen patients with unresectable recurrent locoregional and/or distant metastatic SCCHN with progressive disease after at least one prior chemotherapy or chemoradiotherapy regimen were enrolled onto this single-institution phase I study. Three dose levels were explored: (1) celecoxib 200 mg twice daily plus gefitinib 250 mg daily; (2) celecoxib 400 mg twice daily plus gefitinib 250 mg daily; and (3) celecoxib 400 mg twice daily plus gefitinib 500 mg daily. Results: No dose-limiting toxicities were encountered at any dose level. The most common toxicities were acneiform rash, diarrhea, hand reaction, dyspepsia, and anemia. Four of 18 patients assessable for response (22%; 95% CI, 2% to 42%) achieved a confirmed partial response. Conclusion: The combination of gefitinib 500 mg daily plus celecoxib 400 mg twice daily is well-tolerated. The encouraging responses seen in this early study suggest further evaluation of epidermal growth factor receptor and cyclooxygenase-2 inhibitors in SCCHN is warranted. Authors: Lori J. Wirth, Robert I. Haddad, Neal I. Lindeman, Xiaojun Zhao, Jeffrey C. Lee, Victoria A. Joshi, Charles M. Norris Jr, and Marshall R. Posner Authors' affiliations: Department of Adult Oncology, Dana-Farber Cancer Institute; the Department of Medicine, Pathology, [...]

9/20/2005 New York, NY staff Cancerpage.com Antioxidant vitamins may reduce the severity of adverse effects of radiation therapy but may increase the risk of recurrence of the underlying tumor, according to a report by Canadian researchers. Although many patients take vitamin and mineral supplements in the hope of improving cancer treatment outcomes, the authors point out, few studies have examined the efficacy and safety of adjuvant antioxidant vitamin supplementation in this setting. Dr. Isabelle Bairati from Laval University Cancer Research Center, Quebec City and colleagues examined whether daily supplementation with alpha-tocopherol and beta-carotene could reduce the rate and severity of acute adverse effects of radiation therapy in 540 patients with head and neck cancer. Severe acute adverse effects during radiation therapy occurred in fewer patients in the supplement group (19.2%) than in the control group (24.8%), the authors report in the August 20th issue of the Journal of Clinical Oncology. There was a tendency for less severe adverse effects during radiation therapy at any site and overall among those receiving antioxidants, the results indicate. Combined treatment with alpha-tocopherol and beta-carotene was associated with a significant 62% reduction in adverse effects overall and a similar reduction among patients with cancer of the larynx. However, local recurrence of tumor was 37% more likely among patients in the supplementation group, the investigators report, and was somewhat higher among patients treated with both antioxidants. In light of these findings, the researchers observe that "randomized controlled trials should be conducted to provide clear scientific evidence [...]

9/19/2005 Mi Sun Choe et al. Mol Cancer Ther. 2005;4:1448-1455 Head and neck squamous cell carcinoma is a well-known model for chemoprevention studies because of its field cancerization effect, its multistep carcinogenesis process, and the easy accessibility of biopsies to target lesions. With new understandings of head and neck carcinogenesis and the development of molecular targeted therapy, chemoprevention trials for head and neck squamous cell carcinoma have been rapidly updated. Cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are gaining significant attention as potential chemopreventive agents. Both COX-2 and EGFR are involved in head and neck carcinogenesis. Targeting COX-2 and EGFR separately has shown promising antitumor activity. Recently, combinations of COX-2 and EGFR tyrosine kinase inhibitors have been reported to show synergistic/additive effects in preclinical studies. Because COX-2 and EGFR tyrosine kinase inhibitors are toxic as single agents in clinical trials, the combination of COX-2 and EGFR tyrosine kinase inhibitors used at lower doses seems more promising than monotherapy with either as a novel strategy in head and neck cancer chemoprevention. Authors: Mi Sun Choe1, Xin Zhang1, Hyung Ju C. Shin2, Dong M. Shin1 and Zhuo (Georgia) Chen1 Authors' affilitions: 1 Department of Hematology/Oncology, Winship Cancer Institute, Emory University and 2 Quest Diagnostics, Atlanta, Georgia

9/19/2005 Akihiro Terada et al. Head Neck, September 9, 2005 Background: The sentinel node concept has become one of the most interesting topics in the treatment of head and neck cancer. The aim of this article is to report the results of our feasibility study and clinical application of sentinel lymph node (SLN) radiolocalization and biopsy in patients with clinically negative neck oral cancer. Methods: Individuals with previously untreated N0 oral cancer participated in the study. The radioactive tracer used was 99m Tc phytate. Lymphoscintigrams were taken in the feasibility study, and fusion images of SPECT and CT were obtained in the clinical SLN biopsy (SLNB) group. In the feasibility study, metastases to SLNs and other nodes were analyzed in permanent specimens. In the clinical application group, we investigated the comparative effectiveness of multi-slice frozen section analysis and imprint cytology for the intraoperative diagnosis of SLNB. Results: Fifteen individuals participated in the feasibility study. Six SLNs in five patients were cancer-positive, and two thirds of the SLNs were micrometastases. The SLN concept was established, and SLNs with the highest to the third highest radioactivity reflected the patients' neck status accurately. Twelve patients participated in the clinical application group of SLNB. Intraoperative diagnosis of the three hottest SLNs correctly predicted the neck status of 10 patients. Three patients underwent modified radical neck dissection on the basis of the intraoperative diagnosis of cancer metastasis to SLNs, whereas neck dissections were spared in patients with no evidence of such metastases. There were two [...]

9/18/2005 Australia staff World News Australia (www9.sbs.com.au) Nearly all of Sydney's south Asian grocery stores are selling deadly chewing tobacco, despite an Australia-wide ban on the substance. A new study published in the Medical Journal of Australia has found 94 per cent of Indian, Sri Lankan, Pakistani, Bangladeshi and Fijian grocery shops sell products containing the tobacco. A plug of the product held in the mouth for 30 minutes delivers as much nicotine as up to four cigarettes and has been linked to oral cancer. Researchers from the University of Sydney, who surveyed 53 Asian mixed businesses in suburbs with large south Asian populations, discovered 50 of the businesses sell the dangerous smokeless tobacco. The study's co-author, Professor Simon Chapman, says of those, 31 kept it under the counter, 14 on display behind the counter and five on shelves accessible by customers. "I think the fact that they didn't have the products on open display, but if you asked for it, it was pulled out from under the counter, suggests they're aware they're not supposed to be selling it. "These products are very carcinogenic - rapid cancer can be caused in as little as seven years. "Mouth and throat and tongue cancer are a very, very disfiguring and fatal form of cancer and totally preventable if people don't use these sort of products." The manufacture and commercial supply of smokeless tobacco is banned in Australia but individuals can import up to 1.5 kilograms at a time of it for personal [...]

9/15/2005 New York, NY Gabriella M. D'Andrea, MD CA Cancer J Clin 2005; 55:319-321 The term "complementary and alternative methods" (CAM) refers to products and regimens that individuals may employ either to enhance wellness, relieve symptoms of disease and side effects of conventional treatments, or cure disease. CAM articles provide evidence-based information on promising complementary and alternative methods, and inform clinicians of methods that may harm patients. Many patients being treated for cancer use dietary supplements, particularly antioxidants, in the hope of reducing the toxicity of chemotherapy and radiotherapy. Some researchers have claimed, furthermore, that antioxidants also increase the effectiveness of cytotoxic therapy and have explicitly recommended their use. However, mechanistic considerations suggest that antioxidants might reduce the effects of conventional cytotoxic therapies. Preclinical data are currently inconclusive and a limited number of clinical studies have not found any benefit. Clinicians should advise their patients against the use of antioxidant dietary supplements during chemotherapy or radiotherapy. Such caution should be seen as the standard approach for any unproven agent that may be harmful. Author's affiliation: Assistant Clinical Member, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY

9/15/2005 New Jersey Bob Groves NorthJersey.com Income and race appear to make a difference in New Jersey when it comes to surviving cancer, according to the state's first county-by-county tally of the disease. Those factors appear to affect access to health care - particularly early diagnosis - which is key in reducing mortality, state health officials said Wednesday in presenting statistical "snapshots" of all 21 counties in the state. Those profiles were based on 1996-2000 state and federal data. In Bergen County - which is 78 percent white and has a median household income of $65,241 - the incidence for all cancers among men was 633.3 per 100,000, compared with New Jersey's overall rate of 628.7. But the mortality rate for Bergen County men with cancer was 241.2, slightly less than the 261.1 statewide average rate for men. Women in Bergen County had a 456.8 incidence rate, compared with 453.7 for the state, and a 173.2 mortality rate, compared with 181.6 for the state. By comparison, Essex County - which is 45 percent white and has a median household income of $44,944 - had more cases and deaths among men than the state average. Women in the county had a lower incidence than the statewide average, but they had a 188.1 mortality rate, compared with the 181.6 statewide rate for women. Essex also had the highest prostate cancer mortality rate and one of the highest oral cancer death rates. "We have to help people understand the benefits of cancer screening [...]

9/14/2005 Santa Fe, NM Susan Aldridge Health & Age, Sept. 14, 2005 People who smoke are less likely to visit the dentist, even though they run a greater risk of oral health problems. A regular visit to the dentist is a must for everyone. Not only can your dentist pick up problems with teeth, he or she can also check for gum disease or oral cancer. But, according to a survey sponsored by the US National Institutes of Health and the Center for Disease Control, smokers are missing out on dental care. This is a cause for concern as smoking can promote both gum disease and oral cancer. The survey showed that 33 per cent of current smokers had had at least one dental visit in the last year compared to 45 per cent of non-smokers. The researchers would now like to know why smokers are so reluctant to go to the dentist. Perhaps they fear being judged and urged to quit smoking. It's important that dental professionals do more to educate smokers on the added risk they run regarding their dental health. But they need to tread a fine line between judgement and concern. If the dentist can help someone quit smoking, that's good. If they cannot, then at least more regular dental checks can be encouraged. Source: American Journal of Health Behavior August 2005

9/14/2005 Newton, PA Neal Bellucci PharmaLive (www.pharmalive.com) With a continued investment in innovative therapies in oncology, Merck KGaA has ongoing active development programs with additional novel therapies that may offer new hope to people with cancer. The company is best known for the first-in-class EGFR-targeted monoclonal antibody, Erbitux, comprising cetuximab, that works by blocking the epidermal growth factor receptor to inhibit tumor growth and spread. Merck KGaA focuses on four therapeutic technology platforms in oncology: EGFR-targeting monoclonal antibodies that may block tumor growth; immunocytokines that may provide local stimulation of the immune system; angiogenesis inhibitors that may starve tumors of the blood supply they need to grow and spread; and cancer vaccines that may stimulate a specific immune response against tumors. "These are exciting times in oncology," says Dr. Bernhard Ehmer, VP, oncology, Merck KGaA (merck.de). "With a better understanding of the growth and spread of tumors, we are able to develop treatments that target the cancer cells and give physicians and their patients additional options with which to fight cancer. "We are particularly excited by Erbitux not only in the treatment of colorectal cancer but also in its potential in head and neck cancer, and by BLP25 Liposome Vaccine, which is showing impressive results in the treatment of nonsmall cell lung cancer. Furthermore, our humanized EGFR-targeting monoclonal antibody matuzumab is showing potential in several types of cancer." Erbitux is a first-in-class and highly active IgG1 monoclonal antibody targeting the epidermal growth factor receptor. As a monoclonal antibody, the mode [...]

9/14/2005 Steve Walters EarthTimes Health News (www.earthtimes.org) A new research indicates that vitamin C might have cancer-fighting properties, but at very high doses, possible only through injection into the bloodstream. The study, by researchers from the National Institutes of Health in Bethesda, Maryland, studied the action of vitamin C as ascorbate on cultures of nine cancer and four normal cells. They found that ascorbate increased the production of hydrogen peroxide that in turn killed cancer cells while leaving normal cells safe. If found effective, the vitamin can revolutionize cancer treatment and eliminate damage to healthy cells that are also affected when a patient undergoes chemotherapy. The findings, however, don't hold true for high oral doses of vitamin C, as many previous studies have discounted any cancer-fighting benefits of the vitamin. “These findings give plausibility to intravenous ascorbic acid in cancer treatment, and have unexpected implications for treatment of infections where hydrogen peroxide may be beneficial,” the researchers said in a report published in the Proceedings of the National Academy of Sciences. “Because intravenous ascorbate is easily available to people who seek it, a phase 1 safety trial in patients with advanced cancer is justified and underway,” the report added. Mark Levine, the lead author of the study, said that further tests, especially on animals and humans, are required to take these findings seriously. “If it were to work, even in a couple of cancers, that would be wonderful for patients. So the message is that there may be new hope [...]