Among the highlights in the Mar. 2000 Cancer Watch issue are: Rice with Provitamin A, Aromatase Inhibitors in Breast Cancer Prevention, Gonadotropin-Releasing Hormone (GnRH) Analogues Combined with Aromatase Inhibitors in Premenopausal Breast Cancer, c-Myc Suppresses the Tumorigenicity of Lung Cancer Cells, A New Technique to Screen Colon Cancer:Virtual Colonoscopy, New Advances in the Diagnosis and Treatment of Ovarian Cancer, Minimally Invasive Colorectal Surgery for the Elderly, E-Cadherin: A Prognostic Marker in Breast Cancer, Topotecan in Salvage Therapy for Ovarian Cancer, Paclitaxel-Induced Neurotoxicity: Ovarian Cancer, Anastrozole Use in Place of Tamoxifen in Postmenopausal Breast Cancer, Thalidomide Continues to Combat Myeloma, Rituximab in Aggressive NHL, Researchers Look at Treatment Beyond NHL, SD/01: Single-Dose G-CSF Support , RhEPO/NESP Offer More Convenient Dosing Schedules, Electroporation: For Gene Therapy, Cancer Vaccination with Fused Cells, Genetic Testing: An Expanding Quandary.

• Rice with Provitamin A
• Aromatase Inhibitors in Breast Cancer Prevention
• Gonadotropin-Releasing Hormone (GnRH) Analogues Combined with Aromatase Inhibitors in Premenopausal Breast Cancer
• c-Myc Suppresses the Tumorigenicity of Lung Cancer Cells

• A new imaging technique less invasive than colonoscopy, but as good in detecting colorectal mass, may be more acceptable by general public as a screening tool. This technique is also found to be effective in staging the disease.

• At the 31st Annual Meeting of the Society of Gynecologic Oncologists, held in San Diego, CA, February 5 to 9, 2000, over 1000 gynecologic oncologists, radiologists, scientists, and other healthcare professionals gathered to hear the latest developments in the prevention, detection, and cure of gynecologic cancers. Since ovarian cancer is one of the most common and the deadliest of the gynecologic cancers, with more than 15,000 women dying from the disease each year, this is an area of particular concern. Discussed in the article are highlights of presentations reporting methods to enhance earlier detection, improve diagnosis, and better treat this serious problem.

• A minimally invasive surgical procedure for colorectal patients with the help of a fiber optic instrument, the laparoscope, is found to be beneficial for the elderly. It reduces many postoperative problems and reduces length of hospital stay to a minimum.

• Contemporary oncology deals very efficiently with localized and even infiltrating malignancy and many combination protocols are successful, for a time; but it is the distant metastases that are finally the cause of morbidity and fatal outcome in breast cancer. If it were possible to predict with some degree of certainty the metastatic potential in individual patients and their tumors, the selection of optimal treatment could be much more effective. At least in some cases, patients could avoid unnecessary discomfort and suffering, while in others, aggressive and timely treatment might be of benefit. So far, “markers” for a metastatic cancer cell phenotype have not fulfilled the demand for a reliable selection criterion; it appears that whole battery of such tests will be needed and E-Cadherin may be one of the promising candidates.

• Platinum-based chemotherapy has improved the response rate of platinum-sensitive ovarian cancer; but multiple course of this regimen increases the risk of cumulative adverse effects with each additional course. Topotecan, a drug that inhibits a key enzyme (topoisomerase I) in the replication of DNA kills cancer cells and found to be effective in recurrent, platinum-sensitive ovarian cancer; further the toxicity observed is not cumulative.

• French investigators have found a way to reduce neurotoxicity in patients with advanced ovarian cancer who are treated with a combination of carboplatin-paclitaxel.

• New data support the use of anastrozole as an alternative to tamoxifen in postmenopausal women with advanced breast cancer.

• Thalidomide continues to be a highly active agent in multiple myeloma, demonstrating power that outclasses standard chemotherapy. Although the drug needs to undergo further clinical trials, this approach could advance treatment of multiple myeloma and give patients a new treatment option.

• High response rates with the combination of rituximab+CHOP chemotherapy have been demonstrated in low-grade or follicular lymphoma. A new study of the combination in high grade NHL demonstrates both safety and efficacy. Initial data indicate that the regimen has an excellent overall response rate with a high percentage of complete responses..

• Beyond treatment for low-grade and follicular non-Hodgkin’s Lymphoma (NHL), researchers have begun looking at the potential for treating other B-cell malignant diseases with the CD20 monoclonal antibody rituximab.

• A single-dose of an investigational form of G-CSF allows single-injections per course of chemotherapy while providing equivalent shortening of the duration of severe neutropenia.

• Higher doses of rhEPO at less frequent intervals, or use of a new synthetic agent (NESP) for erythropoiesis support, offer quality of life advantages for patients receiving cancer treatment.

• Plasmid DNA carrying therapeutic genes can be efficiently introduced into tumor cells in animal model by electroporation. Electro-gene therapy can be repeated within short intervals without eliciting antivector cellular immunity that is sometimes observed with viral vectors. Effects of this technique can be improved by combining plasmid injection to the artery feeding the tumor followed by electroporation.

• Cancer vaccination can improve the clinical response after conventional treatment. Vaccination requires identification of known tumor antigen that can stimulate patients’ immune system to launch immune reaction against the cancer cells. For cancers such as that of the kidney where such antigens are not identified, a technique is developed to produce a hybrid between the tumor cell and an immune system cell that will contain all the tumor antigens. These customized hybrid cells when infused into the patient stimulate the host immune system to destroy the tumors.

• The number of available genetic tests for diseases has passed 800 and is continuously growing. Governments have supported the world-wide genome project with substantial sums, without seriously considering the moral and legal implications of this new understanding when applied to patient care. Originally confined to rare disorders, testing can now identify many "common" diseases and the outlook is overwhelming: because most disorders have multiple genetic and environmental causes, the majority of tests only determines levels of risk (with all the statistical flaws inherent to such interpretation). Ethical complications are becoming evident: do people really want to know their fate (and that of their relatives)? What if there is no cure for the disease, which may or may not strike? Is more information always helpful and is it for the benefit of the patient?

• A glossary of unfamiliar words and jargons in Cancer Watch, March 2000.