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					                                    NCI Cancer Bulletin                               Eliminating the Suffering and Death Due to Cancer



                                                             Virus Selectively Kills Cancer
July 5, 2005
Volume 2 | Number 27

In this issue:
Virus Selectively Kills Cancer
Cells, Study Indicates...1
                                                             Cells, Study Indicates
Director’s Update...1
                                                             A common, benign virus may be               studied. Not so for human papilloma-
   Strengthening the Evidence                                a more powerful foe of some can-            virus (HPV)-related cervical cancer,
    Base for Quality Cancer Care                             cer cells than previously thought.          explains Dr. Craig Meyers, professor
Spotlight...3                                                Research has indicated that the             of microbiology and immunology at
   Complementary and Alterna-                                virus, adeno-associated virus type          the Penn State College of Medicine
    tive Medicine: Expanding Ap-                             2 (AAV2), can inhibit the growth of
    proaches to Cancer Treatment
                                                                                                         and the lead investigator on the study.
Cancer Research Highlights...4                               some cancer cells and, in some cases,
                                                                                                         “We did the experiment 30 or 40
   PLCO Publishes                                            cause cell death (apoptosis). But re-
                                                                                                         times with all different types of
    Sigmoidoscopy Results                                    searchers from Penn State University
                                                                                                         [HPV-related] cervical cancer lines:
   Women’s Health Study Finds                                recently reported at the annual
   No Anticancer Benefit of                                                                               preneoplastic, ...invasive carcinoma,
                                                             meeting of the American Society for
   Aspirin and Vitamin E                                                                                 HPV16, HPV18, HPV31,” he says.
   “Freckling” Gene Associated                               Virology that, in laboratory cultures,
                                                                                                         “Every single time, they died at 6
    with Melanoma Risk in Italian                            AAV2 entirely wiped out cancer cells
    Population                                                                                           days, like clockwork.” The 6-day time
                                                             of four different types: cervical, squa-
   During Pregnancy, Chemother-                                                                          frame for cell death held true for all
                                                             mous cell, breast, and prostate, while
    apy for Breast Cancer Is Safe                                                                        four cell types studied.
   Adjuvant Capecitabine Effec-
                                                             leaving healthy epidermal cells intact.
    tive Against Colon Cancer
                                                                                                         AAV2, which is estimated to have
                                                             Only single cell lines of breast, squa-
   Incidence of Inflammatory
                                                                                                         infected 80 to 90 percent of the U.S.
                                                             mous cell, and prostate cancer were         (continued on page 2)
    Breast Cancer May Be Rising,
    Study Suggests
Featured Clinical Trial...6
                                                             Guest Update by Dr. Robert Croyle
                                    D ire ctor ’s Up d ate




   Chemotherapy and Biological
    Therapy for Advanced
    Mesothelioma                                             Strengthening the Evidence Base
Notes...7
   NCI Staff Present at
                                                             for Quality Cancer Care
    PACHA Meeting
                                                             One of the most signifi-                                  er clinical trial findings are
   Tomaszewski Named Deputy
    Director of DCTD
                                                             cant challenges in cancer                                being applied appropriately
   Retiring BSA Members Honored
                                                             research is connecting                                   in everyday practice and
   Special Issue on Cancer                                   the discovery and devel-                                 whether cancer patients are
    Communications                                           opment of proven can-                                    receiving the highest pos-
Community Update...8                                         cer therapies with their                                 sible quality of care—from
   Cancer.gov Unveils New User-                              optimal dissemination                                    initial diagnosis through the
    Friendly Drug Dictionary
                                                             and implementation in                                    end of life.
                                                             general clinical practice.      Dr. Robert Croyle        In order to strengthen the
                                                             Research on cancer care         Director, NCI Division
                                                                                                                      evidence base for what con-
                                                             delivery in the community, of Cancer Control and stitutes high-quality cancer
A Publication of the                                                                         Populations Sciences
National Cancer Institute                                    and the impact of that care                              care, the National Cancer
U.S. DEPARTMENT OF                                           on both patients’ quality of life and
HEALTH AND HUMAN SERVICES                                                                                 Institute (NCI) launched the 5-year,
National Institutes of Health                                survival, is a critical complement to        $34 million Cancer Care Outcomes
NIH Publication No. 05-5498                                  randomized clinical trials. Evidence         (continued on page 2)
http://www.cancer.gov                                        concerning delivery can tell us wheth-
                                                                                                                                 1 NCI Cancer Bulletin
(Virus continued from page 1)                In addition, says Dr. Doug Lowy, chief      Sciences, we have many important
population, appears to recognize the         of the NCI Laboratory of Cellular           partners, including the Department
cancer cells as being abnormal, the          Oncology, it’s possible that preexisting    of Veterans Affairs and the Centers
researchers contend, although they           AAV antibodies or antibodies gener-         for Disease Control and Prevention.
still don’t know how or why it takes 6       ated by the introduction of the thera-      An external expert panel also has
days before apoptosis sets in.               peutic virus might limit its oncolytic      provided valuable advice to the
                                             activity. Nevertheless, he says, “It’s      funders and investigators.
“With the cervical cancer lines, AAV2        certainly a provocative observation
doesn’t care if it’s preneoplastic or                                                    CanCORS’ power lies in its large
                                             that’s in line with previous observa-       sample size, diverse population-based
invasive,” Dr. Meyers continues. “So         tions on AAV.”
it has to be something that happens                                                      patient sample, and ability to trian-
early in the carcinogenic process.           The study results have generated sig-       gulate a rich set of relevant informa-
But whatever it is, it remains into the      nificant interest, says Dr. Meyers. His      tion from multiple sources, such as
invasive stage.”                             intent is to conduct further investiga-     biological characteristics, treatment
                                             tions into the intracellular signaling      details, comorbidities, patient and
AAV2, says Dr. Selvarangan                   pathways affected by AAV2. He is also        physician preferences and attitudes,
Ponnazhagan, an associate profes-            working with colleagues at Penn State       sociodemographic characteristics,
sor of pathology at the University of        “to figure out what we need to do to         and many other potential explanatory
Alabama at Birmingham, is consid-            get from the lab to clinical trials,” he    factors. This wealth of information
ered to be “replication incompetent,”        says. “That’s a major goal right now.” d    provides a unique opportunity to test
meaning that even after it has infected                                                  numerous hypotheses regarding treat-
a cell and integrated into its genome,       (Director’s Update continued from page 1)   ment decisions and patient outcomes.
it needs the assistance of another
virus, such as HPV, to replicate and         Research and Surveillance Consortium        Looking beyond CanCORS, we are
invade its next cellular target.             (CanCORS) project. With an expected         developing ideas for moving our
                                             enrollment of 11,000 patients with          knowledge about cancer care quality
In terms of AAV2’s therapeutic po-           newly diagnosed lung or colorectal          into promising new areas. For ex-
tential, Dr. Ponnazhagan says, “One of       cancer, CanCORS is structured to col-       ample, future projects could track re-
the limitations you need to overcome         lect data that reflect the entire span of    cently developed therapies, including
is the ability of the virus to penetrate a   care from diagnosis through end-of-         the integration of molecular studies
good proportion of the tumor cells to        life care, capturing data from patients,    with quality-of-care studies to predict
have a killing effect.”                       their physicians (surveys and medical       and assess outcomes. Such efforts
In this study, however, AAV2 worked          records from specialists and nonspe-        would address a high-priority goal
without another virus’ help, Dr.             cialists), and their informal caregivers    at NCI: the integration of molecular
Meyers notes. His lab has done other         who provide care during their treat-        biology and population science.
work with healthy cells showing the          ment. Our aim is to determine the
                                                                                         Another critical objective of
virus can replicate on its own.              factors that influence the interventions
                                                                                         CanCORS is to uncover the reasons
Engineered, or recombinant, versions         that cancer patients actually receive,
                                                                                         for disparities in cancer care delivery,
of AAV are increasingly being used as        and then to evaluate the effects of that
                                                                                         such as those associated with age and
a delivery vehicle for gene therapy ap-      care on patients’ survival, quality of
                                                                                         race/ethnicity. Better evidence con-
proaches to cancer and other diseases.       life, and satisfaction with care.
                                                                                         cerning the reasons for disparities is
But whether the wild-type (naturally         CanCORS includes eight research             urgently needed to inform policies and
occurring) version of AAV2 could             teams, and a geographically and de-         programs designed to reduce them.
be transformed into a therapeutic            mographically diverse patient popula-
                                                                                         We believe CanCORS has the poten-
presents a number of unanswered              tion. Data are being collected from
                                                                                         tial to improve the delivery of cancer
questions, says Dr. Peter Beard, a se-       intensive patient interviews, medical
                                                                                         care by identifying, in a scientifically
nior scientist at the Swiss Institute for    records, physician surveys, caregiver
                                                                                         rigorous manner, the key factors in
Experimental Cancer Research who             surveys, linkages to Medicare claims,
                                                                                         usual clinical practice associated with
has closely studied the virus. Chief         and other sources. Although this is
                                                                                         high-quality care. For more informa-
among those is just how much virus           an NCI initiative, led by the Applied
                                                                                         tion about this initiative, visit http://
would be required to have a therapeu-        Research Program in the Division
                                                                                         healthservices.cancer.gov/cancors/. d
tic effect in vivo.                           of Cancer Control and Population
2 NCI Cancer Bulletin
                                                                                     methodology is crucial because it can
                                                                                     provide a solid foundation for the
               Spotlight                                                             field. CAM research can be just as
                                                                                     rigorous as any other,” she explained.
                                                                                     “Unfortunately, the debates often re-
                                                                                     volve around methods, not results.”
                                                                                     Dr. Lorenzo Cohen, who directs the
Complementary and Alternative Medicine:                                              Integrative Medicine Program at

Expanding Approaches to
                                                                                     M.D. Anderson, agrees. He works
                                                                                     with faculty from multiple depart-

Cancer Treatment                                                                     ments there and collaborates with
                                                                                     other Texas institutions. Recently, he
While NCI’s Office of Cancer                 of general health promotion, such as      led an OCCAM-supported project
Complementary and Alternative              diet and exercise, into the therapeu-     to create the International Center
Medicine (OCCAM) is only 6 years           tic prescription for cancer patients,”    of Traditional Chinese Medicine for
old, it embodies a spirit of struggle      continued Dr. White.                      Cancer, a partnership between M.D.
with cancer that goes back to the          A recent example is NCI’s Selenium        Anderson and the Cancer Hospital
early days of NIH in the 1940s, and        and Vitamin E Cancer Prevention           at Fudan University in China. “Many
ultimately to traditions in China and      Trial (SELECT), the largest study ever    of our drugs come from the Chinese
other cultures. NCI is not alone in        conducted on prostate cancer preven-      pharmacopeia,” said Dr. Cohen, “and
pursuing the many possibilities of nu-     tion. NCI dollars are being invested      we hope open communication and
tritional approaches, botanicals, herbal   to study specific nutritional therapies    exchange of ideas will allow Western
products, and interventions, such as       which appear to reduce risk by as         practitioners to learn about concepts
yoga and acupuncture for the treat-        much as 60 percent (selenium) and 30      of traditional medicine while expos-
ment of cancer symptoms and side           percent (Vitamin E). Also, only a large   ing Chinese practitioners to our ap-
effects of treatment.                       clinical trial like SELECT can provide    proach to clinical research.”
Many of the major cancer centers           the kind of data that individuals from    Another of OCCAM’s areas of inter-
in the United States have a formal         both the East and the West respect.       est is the mind-body connection. Dr.
program or center in CAM, which is         From less than $30 million in FY          David Rosenthal, past president of
also known as integrative medicine.        1998, NCI’s CAM research portfo-          the American Cancer Society (ACS),
Partnerships with and program fund-        lio has grown to $129 million in FY       became the first medical director
ing for integrative research centers,      2004, which goes to more than 400         of Dana-Farber’s Leonard P. Zakim
at the University of Texas M. D.           projects in the form of intramural        Center for Integrated Therapies.
Anderson Cancer Center, Memorial           projects, grants, cooperative agree-      “There’s no question that the mind-
Sloan-Kettering Cancer Center, and         ments, supplements, or contracts.         body programs increase a person’s
the Dana-Farber Cancer Institute, for      Recently, several aspiring CAM            sense of well-being and relaxation,
example, illustrate that good medicine     researchers attended a workshop in        thus making them better able to toler-
yields meaningful clinical results.        Bethesda, Md., to learn how to win        ate and accept their therapy,” he said.
“NCI created OCCAM in 1998,”               such support for their own projects.      Dr. Rosenthal became an advocate for
says Dr. Jeffrey White, director of         Dr. Wendy B. Smith, OCCAM’s               CAM, and his involvement acceler-
OCCAM. “We have a big job to do,           deputy director, noted that CAM cuts      ated while at the helm of ACS. He
but fortunately we have many part-         across disease types and has a role       continues to advocate for the inclu-
ners. We work with several other NCI       in cancer prevention, diagnosis, and      sion of evidence-based CAM into
programs to expand NCI’s ability to        treatment, as well as in managing the     U.S. medical practice in his current
extend its search for effective therapies   side effects of conventional cancer        position as president of the Society for
into areas outside the mainstream of       treatments and enhancing the quality      Integrative Oncology.
conventional biomedical research.”         of life of cancer survivors.              For more information on NCI’s activi-
“We also support research and infor-       Dr. Smith also serves as director of      ties in CAM, funding opportunities,
mation products which explore the          the office’s Research Development           and upcoming workshops, see http://
potential value of integrating aspects     and Support Program. “Emphasizing         www.cancer.gov/cam. d
                                                                                                       3 NCI Cancer Bulletin
                                                                                   aspirin and vitamin E on cancer and
                                                                                   cardiovascular disease among 40,000
               Cancer Research                                                     women aged 45 and over. Participants
                                                                                   were free of cancer and cardiovascu-

               Highlights                                                          lar disease at the start of the study.
                                                                                   No benefit was detected for the
                                                                                   cancers examined, including breast
PLCO Publishes                           scale flexible sigmoidoscopy screen-       and colon, but the researchers cannot
Sigmoidoscopy Results                    ing program was undertaken in the         rule out the possibility that aspirin
Some 23 percent of the participants      United States. He said the study’s        may protect against lung cancer. Two
aged 55 to 74 in NCI’s Prostate, Lung,   large population and broad geograph-      studies in men have reported similar
Colorectal, and Ovarian (PLCO)           ic catchment area, as well as the fact    findings, but “the evidence for such
Cancer Screening Trial have at least     that diagnostic follow-up was carried     an effect remains uncertain,” the
one polyp or mass in their lower         out by independent health care pro-       researchers write.
colons, according to results from        viders not associated with the trial,     A companion report in JAMA from
the largest study to date of flexible     make it more representative of actual     the Women’s Health Study found
sigmoidoscopy. The study, published      practice than most other screening        no evidence that taking 600 IU of
in the July 6 Journal of the National    trials. However, he noted that the        vitamin E every other day for 10 years
Cancer Institute, also found that 83     study population was somewhat less        protects women against cancer. “The
percent of participants who were         diverse and more educated than the        best recommendation for the preven-
offered sigmoidoscopy agreed to the       U.S. population as a whole.               tion of cancer and cardiovascular
procedure, which the authors charac-     The PLCO Trial will eventually            disease is to follow a healthy lifestyle,”
terize as a high rate of acceptance.     show whether screening reduces            notes Dr. Cook.
                                         the death rate from the four cancers
Starting in 1993, some 155,000 people                                              “Freckling” Gene
                                         being studied.
enrolled in the PLCO Trial, which is                                               Associated with Melanoma
being conducted at 10 centers nation-    Women’s Health Study                      Risk in Italian Population
wide. Half of the participants were      Finds No Anticancer Bene-                 A new study reports that certain
offered screening sigmoidoscopy, and      fit of Aspirin and Vitamin E               variants of a gene involved in regu-
the other half maintained usual care     Taking low doses of aspirin every         lating pigmentation are associated
with their own physicians. After the     other day for 10 years did not protect    with an increased risk of melanoma
screening, patients with polyps or       women against cancer, the larg-           in an Italian population, as they are
masses were referred to their primary    est clinical trial of aspirin in cancer   among lighter-skinned populations in
physicians for follow-up. Twenty-        prevention has found. The dose was        Northern Europe. The variants were
eight percent of men were referred       100 mg every other day. Higher doses      strongly associated with melanoma
for follow-up visits, compared with      of aspirin may have protective effects,    risk in both the familial and noninher-
18 percent of women.                     the researchers say, but increasing       ited, or sporadic, forms of the disease
One year after the initial screening,    the dose could potentially lead to side   in the Italian population.
1.8 per 1,000 women and 2.9 per          effects in some individuals.               The melanocortin-1 receptor (MC1R)
1,000 men had been diagnosed with        “The results at this time do not sup-     gene, also known as the “freckling”
colorectal cancer, usually after colo-   port the use of low-dose aspirin for      gene, comes in dozens of forms. Some
noscopy and biopsy.                      cancer prevention,” says Dr. Nancy        variants, like those typically found in
Women turned down sigmoidoscopy          Cook of the Brigham and Women’s           people with red hair, have been linked
more often than men, with women          Hospital in Boston, lead author of        to the risk of melanoma, but this was
older than 70 having the highest         the study published online in the July    the first study to test associations
rejection rate.                          6 Journal of the American Medical         between the variants and melanoma in
Dr. Paul Pinsky, of NCI’s Division       Association (JAMA).                       a Mediterranean population.
of Cancer Prevention, said that the      The findings are from the Women’s          After the researchers took into ac-
figures establish a benchmark for         Health Study, a randomized trial that     count known risk factors, such as hair
what could be expected if a large-       evaluated the protective effects of        (Highlights continued on page 5)
4 NCI Cancer Bulletin
(Highlights continued from page 4)          received cyclophosphamide, metho-        Their results are published in the June
color, tanning ability, and the presence    trexate, and fluorouracil.                30 New England Journal of Medicine.
of moles, some unexplained risk re-         One woman who was treated during         After 24 weeks of treatment and a
mained. In fact, the risk of melanoma       the first trimester of her pregnancy      median follow-up period of 3.8 years,
tended to be higher among individuals       miscarried. Among the remain-            patients in the capecitabine group
with fewer known risk factors, accord-      ing women, 22 were in their second       showed disease-free survival that
ing to findings in the July 6 Journal of     trimester and 5 were in their third      was at least equivalent to those in the
the National Cancer Institute.              trimester. Analysis showed a me-         fluorouracil-plus-leucovorin group.
“MC1R is a very interesting gene,”          dian gestational age at delivery of 37   They also showed longer relapse-free
says Dr. Maria Teresa Landi, of NCI’s       weeks; the infants were within nor-      survival, with 65.5 percent of the
Division of Cancer Epidemiology and         mal birthweights and had no signifi-      patients remaining relapse free after
Genetics, who led the research. “We         cant fetal abnormalities.                3 years, compared with 61.9 percent
believe it is important for pigmenta-       Based on similar studies—one of          of those in the fluorouracil-plus-leu-
tion, but its effects on the risk of mela-   which included long-term follow-up       covorin group.
noma extend beyond pigmentation.            data showing no malignancies in the      In addition, patients in the capecitabi-
We and others are trying to under-          children of women who underwent          ne group had fewer treatment-related
stand these effects.”                        chemotherapy during pregnancy—           side effects, including nausea, diar-
The MC1R variants were also as-             the authors suggest that chemo-          rhea, vomiting, hair loss, and a weak-
sociated with the thickness of              therapy during the second and third      ened immune system. There was one
melanoma, which is an indicator of          trimesters of pregnancy could also be    exception: incidence of grade 3 hand-
disease progression. In contrast, the       safe for babies in the long term. But    and-foot syndrome—a condition
researchers found no association in         they note that large prospective stud-   where the skin on patients’ palms and
this population between melanoma            ies are needed to confirm this trend.     soles of their feet becomes red and
risk and a variant of the Agouti            “Nonetheless,” they write, “on the       tender, and may peel—was significant-
Signaling Protein gene, which is also       basis of the current evidence, women     ly higher in the capecitabine group.
involved in pigmentation. The study         should not be denied the potential       “Our results support capecitabine
included 276 melanoma patients and          benefits of chemotherapy because          as an alternative to fluorouracil plus
382 people without the disease in           they are pregnant at the time of diag-   leucovorin in the adjuvant treatment
northeastern Italy.                         nosis of breast cancer.”                 of colon cancer,” the authors write.
During Pregnancy,                           Adjuvant Capecitabine                    “Capecitabine or oxaliplatin-based
Chemotherapy for Breast                     Effective Against Colon                   therapy should be considered for all
Cancer Is Safe                              Cancer                                   patients requiring adjuvant therapy for
                                            The standard adjuvant treatment for      colon cancer.”
During the second and third trimes-
ters of pregnancy, chemotherapy             metastatic colon cancer is a com-        Incidence of Inflammatory
can be given to women who have              bination of the drugs fluorouracil        Breast Cancer May Be
breast cancer with minimal risk of          plus leucovorin. But depending on        Rising, Study Suggests
peripartum complications or serious         how the drugs are administered, side     A relatively rare and aggressive form
adverse effects on the fetus. These are      effects can include diarrhea, a weak-     of breast cancer called inflammatory
the results of a retrospective study        ened immune system, and inflam-           breast cancer (IBC) may be slightly
published in the June 20 Journal of         mation of the mucous tissue in the       more common among women in the
Clinical Oncology.                          mouth. To see whether capecitabine       United States today than it was 15
                                            (Xeloda), an established first-line       years ago, according to an analysis
The study included 28 women who
                                            treatment for metastatic disease,        of more than 180,000 breast cancer
had been treated for breast cancer
                                            could be used as an alternative adju-    cases diagnosed between 1988 and
with chemotherapy during preg-
                                            vant treatment with fewer negative       2000. This form of breast cancer is
nancy at any of five London hospi-
                                            side effects, an international coali-     characterized by redness, warmth,
tals between 1986 and 2003. Sixteen
                                            tion of researchers recruited 1,987      and swelling, often without an un-
of the women received anthracy-
                                            patients with resected stage III colon   derlying palpable mass.
cline-based chemotherapy during
                                            cancer to the X-ACT clinical trial.
treatment, while the remaining 12                                                    (Highlights continued on page 6)

                                                                                                          5 NCI Cancer Bulletin
(Highlights continued from page 5)
The incidence of IBC increased from
2 cases per 100,000 to 2.5 cases per
100,000 between 1988 and 1999,
                                                          Featured Clinical Trial
according to findings in the July
6 Journal of the National Cancer
Institute. (By comparison, during the
same period, the incidence of more
common forms of breast cancer
                                          Chemotherapy and                              hope that it will be particularly effec-

decreased from 108 cases per 100,000
                                          Biological Therapy for                        tive against mesothelioma because

to 101 cases per 100,000.)
                                          Advanced Mesothelioma                         VEGF plays such a prominent role in
                                          Name of the Trial                             the growth of this disease,” said Dr.
The reasons for the apparent in-          Phase II Randomized Study of                  Kindler. “Additionally, bevacizumab
crease are unclear, but it will be        Gemcitabine and Cisplatin with or             works synergistically with chemo-
important to determine whether            without Bevacizumab in Patients with          therapy, so combining these treat-
the incidence is actually rising, or      Malignant Mesothelioma (UCCRC-                ments may yield better results than
whether IBC is simply better recog-       11046A). See the protocol summary             either chemotherapy or biological
nized today than in the past, com-        at http://cancer.gov/clinicaltrials/          therapy alone.”
ments Dr. Paul Levine, of the George      UCCRC-11046A.                                           “Because mesothelioma is an
Washington University Cancer                                                                      orphan disease, there often
                                          Principal Investigator
Institute, who led the study with Dr.                                                             isn’t the incentive to pursue
                                          Dr. Hedy Kindler,
Kenneth Hance of NCI’s Division of                                                                new therapies for it, so we
                                          University of Chicago
Cancer Prevention.                                                                                are very pleased that NCI is
                                          Cancer Research Center
The true incidence of IBC has             Why Is This Trial                                       supporting such a study,” Dr.
long been unclear. In this study,         Important?                                              Kindler added.
the researchers developed a “case         Malignant mesothe-                                       Who Can Join This Trial?
definition” of the distinct clinical and   lioma is a rare cancer of                                Researchers seek to enroll
pathological characteristics of IBC.      the lining of the lungs,                                 106 patients aged 18 and
They then surveyed the Surveillance,      the heart, or the abdo-                                  over with malignant me-
                                                                       Dr. Hedy Kindler
Epidemiology, and End Results             men (the pleura, peri-                                   sothelioma that cannot be
(SEER) Program database and de-           cardium, or peritoneum). If diagnosed removed by surgery. See the list of eli-
termined that 2 percent of breast         at the earliest stage, mesothelioma           gibility criteria for this trial at http://
cancer cases appeared to be IBC.          can be cured by surgery and treat-            cancer.gov/clinicaltrials/UCCRC-
Despite modest improvements in IBC        ment with chemotherapy or radiation           11046A.
survival throughout the 1990s, the        therapy. However, advanced meso-              Where Is This Trial Taking Place?
authors observed significant racial        thelioma is usually inoperable and is         Multiple study sites in the United
disparities in which the incidence was    rarely curable.                               States are recruiting patients for
higher and survival was worse among
                                          In this study, researchers are adding a       this trial. See the list of study sites
African American compared with
                                          biological agent called bevacizumab           at http://cancer.gov/clinicaltrials/
Caucasian IBC patients.
                                          (Avastin) to chemotherapy to see if it        UCCRC-11046A.
Improved methods of recognizing           can help delay the progression of me-         Contact Information
IBC will help researchers classify        sothelioma in patients with advanced          See the list of study contacts
patients, identify subtypes of disease,   disease. Bevacizumab is a monoclo-            at http://cancer.gov/clinicaltri-
and discover molecular “signatures”       nal antibody that blocks the action of        als/UCCRC-11046A or call the
for diagnostic and prognostic purpos-     a protein called vascular endothelial         NCI’s Cancer Information Service
es. “Getting a molecular handle on        growth factor (VEGF). In mesothe-             at 1-800-4-CANCER (1-800-
the tumor is very important,” notes       lioma, VEGF may stimulate both                422-6237). The call is toll free
Dr. Levine, who has developed an          tumor cell growth and the formation           and completely confidential. d
IBC registry and tissue repository. d     of tumor blood vessels.
                                          “Bevacizumab has shown promise in             An archive of “Featured Clinical Trial”
                                                                                        columns is available at http://cancer.gov/
                                          several other types of cancer, and we         clinicaltrials/ft-all-featured-trials.
6 NCI Cancer Bulletin
  Notes
NCI Staff Present at PACHA Meeting        assessing, and delivering optimal        Retiring BSA Members Honored
On June 20, Dr. James Goedert of         therapy. The genesis of cancer in this   Four retiring members of NCI’s Board
DCEG and Dr. Robert Yarchoan             population represents potential op-      of Scientific Advisors (BSA) were
of the Center for Cancer Research        portunities to study those factors in    honored at the meeting on June 27
presented information about cancer       carcinogenesis, while changes in the     by NCI Director Dr. Andrew C. von
in individuals with HIV/AIDS to the      treatment of HIV will require new        Eschenbach and BSA Chair Dr. Robert
Presidential Advisory Council on         therapeutic considerations. Most         Young of Fox Chase Cancer Center.
HIV/AIDS (PACHA).                        AIDS-associated malignancies are         Drs. Neil J. Clendeninn, a clinical
Dr. Goedert noted that the outbreak      caused by oncogenic viruses, which       pharmacology consultant; Thomas
of Kaposi’s sarcoma (KS) among           present unique opportunities for         Curran of St. Jude Children’s Research
homosexual men in New York and           targeted therapies. These approaches     Hospital; William G. Kaelin, Jr., of
California began in 1981. In 1996,       may also prove useful in treating        Dana-Farber Cancer Institute; and
the introduction of highly active        viral-induced tumors arising in im-      Christine A. Miaskowski of the
antiretroviral therapy (HAART) in-       mune-competent patients.                 University of California, San Francisco
creased the lifespan of HIV-infected     Tomaszewski Named Deputy                 concluded their 4-year BSA terms at
patients. At the same time, the de-      Director of DCTD                         this meeting. Dr. Young praised their
velopment of HAART contributed to                                 Dr. Joseph E.   commitment to excellence in cancer
an increase in the number of people                               Tomaszewski     research, as well as their contributions
living with AIDS. Currently 1 mil-                                has been        to BSA during their terms. d
lion HIV-positive individuals reside                              named
in the United States; half of them                                deputy direc-   Special Issue on Cancer
have AIDS. HAART is also affect-                                   tor of NCI’s    Communications
ing the spectrum of malignancies in                               Division        Next week, the NCI Cancer
HIV-positive patients. Data from the                              of Cancer       Bulletin will publish its second
AIDS Cancer Match Registry, which                                 Treatment       special issue of 2005. The issue will
currently links 465,000 people with      and Diagnosis (DCTD). Since May          highlight NCI’s communications
HIV/AIDS to population-based can-        2004, he has served as the act-          history, research, and initiatives,
cer registries in 6 metropolitan areas   ing associate director of DCTD’s         and will provide helpful com-
and 7 states, indicate that the inci-    Developmental Therapeutics               munications resource links for
dence of KS and some types of non-       Program while simultaneously             the media, educators, physicians,
Hodgkin’s lymphoma has decreased,        overseeing the Toxicology and            advocates, and scientists.
but the risk remains substantially       Pharmacology Branch, where he
elevated. Emerging malignancies,         served as chief for the past 14 years.   NCI Cancer Bulletin special issues
including Hodgkin’s lymphoma and                                                  have traditionally been the most
                                         “As the division advances its ef-        popular among our readership.
anal, liver, and lung cancer are on
                                         forts to lead the development of         Past special issues have focused
the rise.
                                         novel cancer therapies nationally, Dr.   on the NIH Clinical Center, NCI’s
Dr. Yarchoan described the difficul-       Tomaszewski will play a critical role    Office of International Affairs, and
ties and opportunities in developing     in helping DCTD move these new           the NCI Cancer Centers Program.
appropriate treatments for cancer        compounds forward seamlessly and
in the context of HIV infection and      quickly,” said Dr. James Doroshow,       Special issues planned for the fu-
HAART therapy. He noted that such        director of DCTD. “His broad exper-      ture include:
patients have two complex life-          tise in therapeutics development will      • Community Clinical Oncology
threatening disorders, and this poses    be essential in this process.”               Programs (CCOPs)
substantial challenges in developing,                                               • NCI Training Programs and Op-
                                                                                      portunities


                                                                                                    7 NCI Cancer Bulletin
                                                                                          • Browsing functionality—Users
                                                                                            who want to browse the diction-
               Community Update                                                             ary can select a letter of the al-
                                                                                            phabet and browse drug or agent
                                                                                            names (generic and U.S. brand
                                                                                            names) that begin with that letter.
                                                                                         • Links to clinical trials—Many
                                                                                           drug entries in the dictionary
Cancer.gov Unveils New                                                                     include links to current clinical
User-Friendly Drug Dictionary                                                              trials listed in NCI’s Physician
                                                                                           Data Query (PDQ®) cancer clini-
The latest enhancement to NCI’s           expand the amount of drug informa-               cal trials registry in which those
award-winning Web site is the NCI         tion for lay readers on NCI’s Web                drugs are being used. This cross-
Drug Dictionary (www.cancer.gov/          site. “Drugs as a category are second            indexing of NCI Drug Dictionary
drugdictionary). Approximately            only to types of cancer in searches              and PDQ clinical trial entries will
500 drugs and biologic agents cur-        performed on NCI’s Web site,” Dr.                become much more comprehen-
rently being used in cancer clinical      Manrow said.                                     sive in the future.
trials are listed in the dictionary.      A link to the NCI Drug Dictionary             Each entry in the NCI Drug
The dictionary will soon grow to          is located in the Quick Links box on          Dictionary draws on and provides
include additional categories of          the left side of most Web pages on            a link to more detailed information
drugs and agents.                         www.cancer.gov, as well as on drug            available in the NCI Thesaurus™,
The NCI Drug Dictionary pro-              information pages.                            which also contains information
vides brief, accurate descriptions of                                                   on relationships to specific can-
                                          The NCI Drug Dictionary contains              cers, molecular targets, and other
cancer-related drugs and biologic         several useful features:
agents, including information about                                                     drugs, as well as links to other drug
chemical class and mechanism of            • Flexible search options—In ad-             information resources. The NCI
action. “Although this dictionary            dition to a standard “starts with”         Thesaurus also contains informa-
is designed for health profession-           search option, users can also en-          tion on more than 3,000 other
als, we hope that others who are             ter only a part of a word or term,         cancer-related drugs and agents.
either involved in or have an interest       and use a “contains” option. Users         The Thesaurus is developed and
in cancer therapeutics, including            can also search by generic name,           maintained by NCI Enterprise
patients, will find it useful,” said Dr.      brand name, chemical structure             Vocabulary Services, a joint effort
Richard Manrow, associate direc-             name, FDA Investigational New              by NCI’s Office of Communications
tor of the Office of Cancer Content            Drug name, or Cancer Chemo-                and Center for Bioinformatics to
Management in NCI’s Office of                  therapy National Service Center            help meet the terminology needs of
Communications. Dr. Manrow also              number, which is NCI’s internal            NCI and its partners. d
commented that NCI’s Office of                 drug identification number.
Communications plans to greatly



                                          The NCI Cancer Bulletin is produced by the National Cancer Institute (NCI). NCI,
  Featured Meetings                       which was established in 1937, leads the national effort to eliminate the suffering
                                          and death due to cancer. Through basic, clinical, and population-based biomedical
  and Events                              research and training, NCI conducts and supports research that will lead to a future in
  A calendar of scientific meet-           which we can identify the environmental and genetic causes of cancer, prevent cancer
  ings and events sponsored by the        before it starts, identify cancers that do develop at the earliest stage, eliminate cancers
  National Institutes of Health is        through innovative treatment interventions, and biologically control those cancers
                                          that we cannot eliminate so they become manageable, chronic diseases.
  available at http://calendar.nih.
                                          For more information on cancer, call 1-800-4-CANCER or visit
  gov/cgi-bin/calendar d
                                          http://www.cancer.gov.
                                          NCI Cancer Bulletin staff can be reached at ncicancerbulletin@mail.nih.gov.

8 NCI Cancer Bulletin

				
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