A study from University of North Carolina at Chapel Hill suggests that not everyone needs a genetic test prior to taking Camptosar (irinotecan).

Irinotecan, also known as Camptosar, is used as a second-line treatment for colorectal cancer. The FDA recommends screening for a gene that could make patients more susceptible to the harmful side effects of the drug, namely neutropenia, which is an abnormally low level of white blood cells.

The UNC researchers analyzed data from nine previous studies of irinotecan. They found that patients who received a medium or high dose had a greater risk of neutropenia if they had two copies of a specific variant of the gene UGTA1. At lower doses of the drug however, the risk was the same regardless of UGTA1 status.

The authors, led by Howard McLeod, Pharm.D., recommends that the FDA amend their guidelines to reflect this knowledge. Changing this guideline may help avoid unnecessary tests and expenses as well as quicken treatment waiting times.

Development of a rash after treatment with inhibitors of epidermal growth factor receptor (EGFR) such as Tarceva (erlotinib) may actually indicate that the treatment is working well, according to an analysis of two phase III trials. According to the analysis, the worse the rash, the more likely patients are to survive their cancers or maintain control of the disease.

The first trial analyzed patients who received erlotinib for stage IIB/IV non-small-cell lung cancer who had failed at least one chemo regimen. The second study looked at erlotinib plus gemcitabine (Gemzar) for patients with locally advanced, unresectable or metastatic pancreatic cancer. The team concluded that those patients who do not develop the characteristic rash within 2 to 4 weeks are less likely to benefit from erlotinib.

This study was conducted by researchers from OSI pharmaceuticals, the company that manufactures Tarceva.

A new study in mice suggests that a way of starving tumors of their blood supply may cause heart attacks and strokes. This study raises concerns about this type of cancer therapy according to the researchers at UCLA.

Drugs that block blood vessel growth, such as Avastin, do so from the outside of the cell by blocking vascular endothelial growth factor (VEGF), a signaling protein.

In the study, Luisa Irula-Arispe and her team bred mice that lacked VEGF in endothelial cells. The team did not use drugs to block the VEGF. More than half of the mice in their study suffered heart attacks and fatal strokes and even those that lived became ill. Irula-Arispe said that signaling inside the cell is different that signaling outside the cell. She said it is not clear if such drugs as Avastin are dangerous., although she believes that researchers should try to find a more targeted way of getting the drug to the tumor. Currently Avastin and other such drugs are infused, and therefore circulate through the patient's whole body.

Breast cancer occurs in one of every 3,000 pregnancies. Amazingly, depending on the stage of the pregnancy, pregnant women can receive treatment and still deliver healthy babies.

According to a case study published in February's Reproductive Toxicology, a 32-year-old woman who took the targeted Her-2 positive breast cancer drug Herceptin for the first 24 weeks of her pregnancy gave birth to a healthy baby girl. There have been three other similar cases reported. In all three, the babies were born healthy.

Due to a limited number of controlled studies, pregnant women are advised to take Herceptin only if the potential benefits outweigh the potential risk to the fetus.

Source: MAMM magazine, May/June 2007

"Blessings arrive in unexpected packages -- in my case, cancer," writes White House Press Secretary Tony Snow in the July issue of Christianity Today.

Snow, who discovered in March that his colon cancer had recurred and spread to his liver, said his life-threatening setback is also life-affirming. It has strengthened his faith and brought clarity to his life.

"We don't know how the narrative of our lives will end, but we get to choose how to use the interval between now and the moment we meet our Creator," says the 51-year-old.

Researchers now report that surgery plus either preoperative chemotherapy or chemoradiotherapy for locally advanced esophageal squamous cell carcinoma (SCC) and adenocarcinoma does show a survival benefit.

Preoperative chemoradiotherapy resulted in a 19% reduction in mortality risk, with a greater survival benefit in patients with adenocarcinoma rather than SCC. Preoperative chemotherapy resulted in a 10% reduction in mortality risk, with this benefit seen only in patients with adenocarcinoma. These results come from a large meta-analysis of randomized trials.

Previous studies had shown that preoperative chemotherapy or radiotherapy did not show a survival benefit. However, many of these studies were small. Most oncologists no longer treat esophageal cancer with only surgery, due to recent trials. This study strengthens that conclusion.

This study was published in Lancet Oncology in March 2007.

Italian opera superstar Luciano Pavarotti, hospitalized on Wednesday with a fever, is doing better and should be discharged within the next few days, according to his wife, Nicoletta Mantovani.

The 71-year-old tenor underwent surgery for pancreatic cancer one year ago and has since endured at least five rounds of chemotherapy. Although not confirmed, some sources say Pavarotti has pneumonia.

My hair is changing -- again. It started out perfectly straight, blond, and shoulder length. Then it came tumbling out, thanks to the chemotherapy drugs adriamycin and cytoxan. Four months later, it was back -- curly, dark, and way too short for my liking.

Over the past two years, I've grown to enjoy my hair. The longer it gets, the less curl it keeps. I like it this way. The color has grown on me too. When I look back at photos of my lighter locks, I think dark suits me better. Why do I get the feeling, though, that my hair won't be dark for long?

I still think of my hair as dark, I guess because it was once so very blond and it is so very not blond at the moment -- in my opinion anyway.

According to reseachers at Duke, a combination of two drugs works better than either drug for patients with renal cell carcinoma, the most common form of kidney cancer. This study was published in the August 1st issue of the Journal of Clinical Oncology and was funded by the National Cancer Institute.

The two drugs used in the study together were interferon alpha and sorafenib, which is sold as Nexavar. Interferon alpha is an immunotherapy agent, but kidney tumors only respond to it about 5 to 10 percent of the time. The second drug, sorafenib, is a anti-angiogenic, a class of drugs that work by choking a tumor's blood supply. But sorafenib shrinks tumors in only 5 to 10 percent of kidney cancer patients.

However, when both of these drugs were used in combination, the combination led to significant tumor shrinkage in 33 percent of the 40 patients who participated in the study. Two of the patients had complete responses, meaning their tumors were destroyed. The particpants in the study all had renal cell carcinoma in stage IV disease.

Based on the success of this small study, researchers will soon beging a multisite trial to both confirm these findings and investigate whether patients show additional progress when they take increasing doses of sorafenib alone after the dual therapy.

"This is a deadly cancer that has been hard to treat, and the results of our study suggest that we may be able to further improve the efficacy of exciting new drugs like sorafenib," said Dr. Jared Gollub, lead investigator.

A study published in the journal Cancer says that improvements in the treatment of metastatic breast cancer are making a difference and patients are living longer with the disease.

Researchers in Canada conducted a study evaluating 2,000 women diagnosed with advanced breast cancer. The time periods in the study were broken up into four groups dating from 1991 until 2001. The researchers concluded that one year survival improved from 55 percent to 71 percent and two year survival improved from 33 percent to 45 percent.

The introduction of new chemotherapy drugs, new approaches to hormonal therapy, and new targeted therapy have been introduced over the period of time evaluated in the study.

Cancer patients who receive drugs such as Neupogen and Neulasta, which stimulate the growth of white blood cells, may be less likely to die from chemotherapy-related complications, according to researchers at the University of Rochester and Duke.

This study examined 17 trials involving more than 3,000 patients receiving chemotherapy. The researchers found that nearly 40 percent of patients who did not receive the drugs developed fever and low white blood cell levels called febrile neutropenia compared to only 22 percent who took the drugs while taking the chemotherapy.

The researchers published these findings in the July 20, 2007 issue of the Journal of Clinical Oncology. The work was being conducted by the Awareness of Neutropenia in Chemotherapy (ANC) Study Group, a network of investigators whose work is unrestrictedly funded by Amgen, the maker of a commonly utilized white blood cell booster that goes by the names Neupogen and Neulasta.

A recently-published study has found that a significant proportion of children under the age of three with the brain tumor ependymoma can skip or delay radiotherapy by using chemotherapy without lowering their chances of survival.

This research has taken 12 years to complete and were released in Lancet Oncology in July 2007 by the Children's Cancer and Leukaemia Group at The University of Nottingham in the UK

Radiotherapy can be harmful to a young child's brain, affecting IQ, short term memory, growth and puberty.

According to experts, the survival rate for children with ependymoma is increasing, but still unacceptably low.

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults. According to the National Cancer Society an estimated 60,000 people are living throughout the United States with CLL.

An article published in The Lancet stated that the chemotherapy combination of Fludara plus Cytoxan improves progression free survival compared to therapy consisting of Fludara alone. The drugs used to treat CLL consist of Fludara, Cytoxan and chlorambucil. Recent studies have shown that Fludara in combination with Cytoxan to be the most effective treatment for CLL.

Researchers wanted to test to see if higher anticancer responses were seen with the combination of Fludara plus Cytoxan, treatment with Fludara alone or treatment with chlorambucil.

When afflicted with any health condition or disease, trying to make life normal is sometimes hard but it's great at getting your mind in a healthy state. If you're a teenager with cancer, attending a prom probably is the best way to find a semblance of normalcy for at least one evening.

That is, if you can stand. Some cancer patients I've talked to can be week the day of a chemotherapy treatment, but still talk and carry on, even in pain, as if they are the strongest people in the world. Guess what, they are.

The strength I've seen from teenagers and middle-aged folks going through a cancer battle is inspirational to say the least. Tired of looking to professional baseball players and movie stars as fake heroes? Try a cancer patient putting up a daily struggle with a smile at the same time. That's a hero.