Odds and Ends

Bruce Shriver

Is more frequently better?

There is an extremely interesting article concerning the rate at which chemotherapy agents should be administered on the Medscape WebMD website. Titled “The Anti-Angiogenic Basis of Metronomic Chemotherapy” and written by Robert S. Kerbel and Barton A. Kamen, it appeared eary this year in the journal Nature Reviews Cancer (Vol. 4, No. 6, pp 423-436). Kerbel and Karmen contend that “The anti-angiogenic efficacy of chemotherapy seems to be optimized by administering comparatively low doses of drug on a frequent or continuous schedule, with no extended interruptions — sometimes referred to as 'metronomic' chemotherapy. In addition to reduced acute toxicity, the efficacy of metronomic chemotherapy seems to increase when administered in combination with specific anti-angiogenic drugs. Gaining better insight into the mechanisms of these effects could lessen or even eliminate the empiricism used to determine the optimal dose and schedule for metronomic chemotherapy regimens.” They go on to state, “There are many different factors that have contributed to the line of reasoning that for chemotherapy, 'the more frequent the better' and that 'less is more'. First, the opposite approach — using 'high-dose' chemotherapy with autologous bone-marrow stem-cell transplants (to replace the destroyed bone-marrow-derived stem cells) — has not provided the kind of survival benefits expected, at least when this treatment strategy is used for patients with metastatic breast cancer. This approach is also very expensive and highly toxic. Furthermore, 'dose-dense' chemotherapy, in which one or more chemotherapeutic is administered at more frequent intervals (that is, every other week), has shown clear benefits in randomized Phase III clinical trials. This strategy is usually designed to administer at least the same amount or, more commonly, even a greater amount of drug in total over time. So, if every other week is better than every 3 weeks, then why not administer weekly or even daily treatment?” You can access the complete article by clicking on the above hyperlink.

Understanding Cancer Terminology.

The Aetna InteliHealth website has an article by Nancy Volkers introducing The Language of Cancer. Those who are new to cancer can benefit from reading this brief article. Abstracts and links for a large number of dictionaries, glossaries, and medical atlases can be found on our links page. Click here to access them

Making Government Sponsored Research Results Freely Accessible

Scientists want research papers freely available

Dan Vergano, in the above article, states. “Twenty-five Nobel Prize-winning scientists today are calling for the government to make all taxpayer-funded research papers freely available. "Science is the measure of the human race's progress," scientists say in a letter to Congress and the National Institutes of Health. Signers include DNA co-discoverer James Watson and former National Institutes of Health chief Harold Varmus, a longtime supporter of open access”.

Enhanced Public Access to NIH Research Information

The National Institutes of Health (NIH) has announced a 60-day consultation on its plan to enhance public access to the research it funds. The announcement states that “NIH intends to request that its grantees and supported Principal Investigators provide the NIH with electronic copies of all final version manuscripts upon acceptance for publication if the research was supported in whole or in part by NIH funding... [NIH] will archive these manuscripts and any appropriate supplementary information in PubMed Central (PMC), NIH’s digital repository for biomedical research. Six months after an NIH supported research study’s publication—or sooner if the publisher agrees—the manuscript will be made available freely to the public through PMC.” NIH is welcoming public comment (use this form). Click here to read an analysis of the policy that appeared in The Scientist.

More on Environmental Issues and Sarcoma

The Research News Column of the June issue of ESUN contained a section titled, “Exploring the links between the environment and sarcoma” That contained links to articles exploring possible links between various environmental conditions and sarcoma. An English language abstract of an article written in French is given on the PubMed website. The article, “Dioxin emissions and soft-tissue sarcoma: results of a population-based case-control study” is written by N. Floret, F. Mauny, B. Challier, J. Cahn, F. Tourneux, and J. Viel. The abstract states, “In 1998, the French Ministry of Environment revealed that of 71 French municipal solid waste incinerators processing more than 6 metric tons of material per hour, dioxin emission from 15 of them was above the 10 ng international toxic equivalency factor/m3 (including Besancon, emitting 16.3 ng international toxic equivalency factor/m3) which is substantially higher than the 0.1 international toxic equivalency factor/m3 prescribed by a European directive of 1994. In 2000, a macrospatial epidemiological study undertaken in the administrative district of Doubs, identified two significant clusters of soft-tissue sarcoma and non Hodgkin lymphoma in the vicinity of the municipal solid waste incinerator of Besancon. This microspatial study (at the Besancon city scale), was designed to test the association between the exposure to dioxins emitted by the municipal solid waste incinerator of Besancon and the risk of soft-tissue sarcoma”. It goes on to give the following results, “Thirty-seven cases of soft tissue sarcoma were identified by the Doubs cancer registry between 1980 and 1995, corresponding to a standardized incidence (French population) of 2.44 per 100,000 inhabitants. Compared with the least exposed zone, the risk of developing a soft tissue sarcoma was not significantly increased for people living in the more exposed zones”. The authors finally state that, “Before definitely concluding that there is no relationship between the exposure to dioxin released by a solid waste incinerator and soft tissue sarcoma, a nationwide investigation based on other registries should be conducted”. The article in French) appeared in Rev Epidemiol Sante Publique. 2004 Jun;52(3) pp 213-20.