4/3/2005 Trenton, NJ Ed Silverman The Star Ledger (New Jersey) Parents balk at idea of STD drug for kids At first blush, a vaccine that prevents a deadly form of cancer would seem like a no-brainer for parents. But as two major drug makers prepare to introduce such a product, sides are already being drawn in what promises to be an all-out culture clash. Within two years, Merck and GlaxoSmithKline hope to market a pair of groundbreaking vaccines to prevent a sexually transmitted disease. Known as the human papillomavirus, or HPV, the disease is a leading cause of cervical cancer. About 5,000 women in the United States die each year from cervical cancer, and the drug makers expect to use this as a rallying cry to make their vaccines widely available and generate billions of dollars in sales. One drug maker, Merck, says it will try to convince states to require vaccination before children as young as 12 can enter school. "The best way to prevent infection is to vaccinate the population just before they become sexually active, which is when they're young," Eliav Barr, Merck's senior director of biologics clinical research, said. "This way, it can be folded into routine medical care." But the rollout of the vaccines promises be anything but routine. Vaccinating children for a disease caused by sexual activity will be a tough sell, especially for parents who fear children will take it as a green light to have sex. The HPV vaccine is likely to [...]

4/3/2005 Charlotte, NC Alison Morris The Charlotte Observer April 11-17 is International Oral, Head and Neck Cancer Awareness Week. Head and neck cancer is a general term applied to several types of cancer in a variety of locations in the head and neck, including the throat, mouth, voice box and tongue. About 4 percent of new cancers diagnosed are head and neck cancers, said Dr. Frank Mauldin of Graystone Ear Nose & Throat Associates in Hickory. According to recent statistics, more than 55,000 Americans will be diagnosed with head and neck cancer this year, and more than 12,000 will die of the disease. Sadly, most cases could be prevented. In a survey of more than 40,000 Americans, 75 percent of those polled did not know or incorrectly identified the signs of oral cancer. As many as 90 percent of head and neck cancers arise after prolonged exposure to tobacco and alcohol. Use of tobacco (cigarettes, cigars, chewing tobacco or snuff) and alcohol are linked with cancers of the mouth, throat, voice box and tongue. In adults who neither smoke nor drink, cancer of the mouth and throat are nearly nonexistent. Cancer of the head and neck is curable if caught early. While prevention is the primary goal of increasing the awareness of head and neck cancer, early detection is even more important. People at high risk for developing head and neck cancer should know and recognize the warning signs of these cancers: A lump in the neck; hoarseness or change [...]

4/3/2005 United Kingdom BBC News A chemical extracted from green tea could help scientists to develop new drugs to fight cancer. Tests by UK and Spanish researchers showed polyphenol EGCG taken from green tea leaves inhibits cancer cell growth. The effect was seen even at low concentrations, equivalent to drinking two or three cups of green tea a day. However, the study, published in Cancer Research, also found high concentrations of the chemical may increase the risk of birth defects. Previous research has suggested that drinking green tea helps to cut the risk of certain forms of cancer. The latest study found that EGCG binds to a key enzyme - dihydrofolate reductase (DHFR) - that is targeted by established anti-cancer drugs. This stops the enzyme from triggering the manufacture of new DNA in tumour cells. It appears to work in the same way as the cancer drug methotrexate - but in practice would probably have fewer side effects. Drug development Professor Roger Thorneley, from the John Innes Centre in Norwich, conducted the research with team from the University of Murcia in Spain. He said: "This is a very exciting discovery. For the first time we have a clear scientific explanation of why EGCG inhibits the growth of cancer cells at concentrations which are found in the blood of people who drink two or three cups of green tea a day. "We have identified the enzyme in tumour cells that EGCG targets and understand how it stops this enzyme from making [...]

4/1/2005 Durham, NC Marshall R. Posner, M.D. The Oncologist, Vol. 10, No. 3, 174-175, March 2005 In May of 2004, two articles appeared in the New England Journal of Medicine, reporting the final results of large Phase III trials comparing adjuvant post-operative chemoradiotherapy to standard post-operative radiotherapy in patients with resected, poor-prognosis Squamous Cell Cancer of the Head and Neck (SCCHN) [1, 2]. The trials were performed by the EORTC and the North American Intergroup; they gave identical chemotherapy, almost identical radiotherapy, treated somewhat different populations, and were started over a decade ago. In this issue of The Oncologist Jacques Bernier and Jay Cooper, the principal investigators of the trials, review the background, the results of the trials, and the evidence supporting a standard role for chemoradiotherapy for the post-operative adjuvant therapy of patients with resected SCCHN [3]. Graph of results available here Both trials resulted in a substantial and significant increase in local regional control with post-operative adjuvant chemoradiotherapy in poor prognosis patients. There is no question that post-operative chemoradiotherapy with bolus cisplatinum improves local regional control and prevents the devastating consequences of locally or regionally recurrent disease in patients with SCCHN. Both trials and the historical data support the role of platinum based chemoradiotherapy for this purpose [4, 5]. Is this enough? Shouldn’t we expect a survival advantage for therapy? Both trials also demonstrated a substantial short-term increase in survival, although only the European trial proved to have significant and sustained increase in this important result. In absolute [...]

3/31/2005 A. Falanga and L. Zacharski Annals of Oncology, doi:10.1093/annonc/mdi165 Patients with cancer have long been recognised to be at high risk of venous thromboembolism (VTE), although the condition remains under diagnosed and under treated in these patients. As a consequence, the morbidity and mortality due to deep venous thrombosis and pulmonary embolism remains unacceptably high in this group. Furthermore, the management of VTE in the presence of malignancy is complex, due both to the effects of the cancer itself and its treatments. Conventional long-term management of VTE involves the use of vitamin K antagonists (VKAs), such as warfarin, to reduce the risk of recurrence. However, this approach is associated with a range of practical difficulties including the need for regular laboratory monitoring, the potential for drug interactions, in addition to the risk of treatment resistance and bleeding in patients with cancer. Recent research indicates that the use of low molecular weight heparin (LMWH) therapy instead of VKAs may be beneficial in these patients. In particular, evidence from a large clinical trial of the LMWH dalteparin indicates that this agent offers an effective alternative to VKAs in the long-term management of VTE, that is free from the practical problems associated with the use of VKAs and without increasing the risk of bleeding. Authors: A. Flanga (1) L. Zacharski (2) Authors' Affiliations: (1) Department of Hematology-Oncology, Ospedali Riuniti, Bergamo, Italy (2) VA Medical Center, White River Junction, Vermont, USA

3/31/2005 Ann Arbor, MI University of Michigan Health System as reported by Newswise.com Alice Lundsten thought it was just a cough that wouldn’t go away. But it turned out to be much more than that. Sounding hoarse, and feeling like there was something stuck in her throat, Alice went to her doctor for a checkup. The doctor suspected something was wrong but couldn’t see it, so she sent Alice to a specialist. And that’s when Alice learned she had cancer — on one of her vocal cords. After laser microsurgery to remove the tumor, and voice therapy to optimize the quality of her voice, Alice is sounding so good that she’s been able to work as a church receptionist. But her experience should be a lesson for others, she warns. “It would’ve been helpful if I had listened to my own voice earlier and gone to the doctor” sooner, she says. “Now I know that that’s the thing to do — not to wait.” The voice specialist who discovered and treated Alice’s cancer couldn’t agree more. “She’s the perfect example of why it’s important to pay attention to a voice change,” says Norman D. Hogikyan, M.D., F.A.C.S., who heads the University of Michigan’s Vocal Health Center. “People need to be aware that a voice change can indicate health problems.” He notes that voice specialists have designated April 16 as World Voice Day to bring attention to the many voice problems that can occur, and ways to prevent them. Hogikyan is [...]

3/31/2005 Alexandria, VA Michael Stahl et al. Journal of Clinical Oncology, Vol 23, No 10 (April 1), 2005: pp. 2310-2317 Purpose: Combined chemoradiotherapy with and without surgery are widely accepted alternatives for the curative treatment of patients with locally advanced esophageal cancer. The value of adding surgery to chemotherapy and radiotherapy is unknown. Patients and Methods: Patients with locally advanced squamous cell carcinoma (SCC) of the esophagus were randomly allocated to either induction chemotherapy followed by chemoradiotherapy (40 Gy) followed by surgery (arm A), or the same induction chemotherapy followed by chemoradiotherapy (at least 65 Gy) without surgery (arm B). Primary outcome was overall survival time. Results: The median observation time was 6 years. The analysis of 172 eligible, randomized patients (86 patients per arm) showed overall survival to be equivalent between the two treatment groups (log-rank test for equivalence, P < .05). Local progression-free survival was better in the surgery group (2-year progression-free survival, 64.3%; 95% CI, 52.1% to 76.5%) than in the chemoradiotherapy group (2-year progression-free survival, 40.7%; 95% CI, 28.9% to 52.5%; hazard ratio [HR] for arm B v arm A, 2.1; 95% CI, 1.3 to 3.5; P = .003). Treatment-related mortality was significantly increased in the surgery group than in the chemoradiotherapy group (12.8% v 3.5%, respectively; P = .03). Cox regression analysis revealed clinical tumor response to induction chemotherapy to be the single independent prognostic factor for overall survival (HR, 0.30; 95% CI, 0.19 to 0.47; P < .0001). CONCLUSION: Adding surgery to chemoradiotherapy improves [...]

3/31/2005 Houston, TX CancerWise (www.cancerwise.org) New Devices May Help Detect Tumors Earlier In the hope of finding an often-devastating cancer before it has a chance to develop, researchers are designing a series of probes that will literally highlight suspicious lesions in the mouth that may harbor fledgling tumors. These devices — a “scanner” that first bathes the mouth with light to pick out problem areas and a follow-up probe that shines a concentrated diagnostic beam on the lesions— are scheduled for testing at M. D. Anderson this spring and summer. If they fare well, the device designers foresee a time when community dentists or physicians turn to the probes to help screen for spots that can be difficult to pick out by observation alone. “I can’t always tell which mouth lesions might be precancerous. They can be tiny white, pink or red areas that are really hard to tell apart from normal tissue,” says Ann Gillenwater, M.D., an associate professor in M. D. Anderson’s Department of Head and Neck Surgery. “Now, our only choice is to biopsy an area that looks suspicious, and this can be more invasive than is necessary.” "More research needs to be done, but with these devices it may be possible to find oral cavity cancers when they are at their most treatable,” says Gillenwater, who has been conducting studies on the technology for several years. “When found later, as many of these cancers are, the effects of surgery and radiation treatment can impact a patient’s [...]

3/31/2005 Amanda Gardner Forbes (www.forbes.com) Despite gains, a new report finds that half of all cancers could still be prevented through early detection and lifestyle changes. Tobacco use, physical inactivity, obesity and poor nutrition remain the major preventable causes of cancer and other diseases in the United States, according to the American Cancer Society (ACS) report released Thursday. "We have sufficient knowledge of cancer causes and prevention that could prevent cancer burden in the U.S. by at least half," said Vilma Cokkinides, one of the lead authors of the report and program director of risk factor surveillance for the ACS in Atlanta. "A healthy lifestyle coupled with early detection and treatment is the best personal weapon each of us has to fight this disease." "It just reinforces the two messages: quit smoking or don't start, and get screened [for cancer]," added Dr. Ronald Blum, director of Beth Israel Cancer Center in New York City. "The message bears repeating." The ACS estimates that about one-third (570,280) of cancer deaths in this country in 2005 can be traced back to poor nutrition, lack of exercise, overweight and obesity and other lifestyle factors. And although tobacco use is down, the society predicts that this year smoking will still be the underlying cause of more than 168,140 cancer deaths. Overweight and obesity could cause as many as one in seven cancer deaths in men and one in five such deaths in women, the report adds. Having a high body mass index increased death rates [...]

3/31/2005 Toronto, Ontario, Canada cancerconsultants.com According to a recently completed clinical trial, a vaccine that is injected directly into the site(s) of cancer produces promising results in patients with head and neck cancer who have stopped responding to standard therapies. Approximately 40,000 people in the United States are diagnosed with head and neck cancer every year. Cancers of the head and neck comprise several types of cancer, including the nasal cavity and sinuses, oral cavity, nasopharynx, oropharynx, and other sites located in the head and neck area. Once the cancer stops responding to standard therapeutic approaches, which typically consists of chemotherapy and/or radiation therapy, it is referred to as “refractory”. Patients with refractory head and neck cancer currently have very limited effective treatment options, with overall survival being dismal in this group of patients. There are currently no treatment modalities that have demonstrated an improvement in survival in the treatment of refractory head and neck cancer. Several clinical trials are underway to evaluate novel therapeutic approaches for the treatment of this disease. A novel vaccine Proxinium™ recently completed an early-phase clinical trial in the evaluation of advanced head and neck cancer. Proxinium™ is comprised of a monoclonal antibody, which is a protein that is targeted against and binds to a specific component of a cell. The monoclonal antibody portion of Proxinium™ is targeted against EpCAM, a molecule that is often highly expressed in head and neck cancer cells. Proxinium™ also contains the toxin produced by the bacterium Pseudomonas. When the [...]