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Executive Summary

G-CSF ADMINISTRATION IN 27 CHEMOTHERAPY PATIENTS at Memorial Sloan-Kettering resulted in a dose-dependent increase in patient neutrophil counts and reduced the number of days antibiotics were needed to treat fever and neutropenia, according to Memorial Sloan-Kettering Cancer Center researcher Janice Gabrilove. The researcher reported the study results at a recent seminar held by the American Cancer Society in Irvine, California. Patients participating in the study had transitional-cell carcinoma of the urothelium. They were given recombinant human granulocyte colony stimulating factor (G-CSF) before and/or during treatment with a chemotherapeutic regimen of methotrexate, doxorubicin, vinblastine and cisplatin. G-CSF treatment was also found to significantly increase the percentage of patients qualified to receive a second course of chemotherapy after two weeks and to significantly decrease the incidence and severity of mucositis. Drug for the study was supplied by Amgen. Gabrilove said her findings suggest that G-CSF has the potential to reduce cancer treatment morbidity, improve patient survival by allowing treatment to be maintained, and increase the maximum tolerated dose by "diminishing the complication of neutropenia." She and her colleagues are presently investigating the role of G-CSF as a primary treatment of myeloid leukemia, and studying non-malignant conditions that might develop from a deficiency of G-CSF. Gabrilove also presented results of the Phase I/II study to the National Institutes of Health's April 17-19 consensus conference on oral complications of chemotherapy. Among other presentations at the American Cancer Society conference, William Dalton, University of Arizona College of Medicine, reported on the use of verapamil (Searle's Calan and Knoll's Isoptin) to overcome drug resistance in patients with myeloma and non-Hodgkin's lymphoma. Dalton said preliminary results have shown that continuous infusion verapamil, given with the cytotoxic agents doxorubicin and vincristine, "is capable of reversing resistance" in some patients whose tumors overexpress P-glycoprotein. In another presentation, Selwyn Broitman, Boston University School of Medicine, reported that lovastatin (Merck's Mevacor) retarded tumor cell growth by blocking cholesterol synthesis in five out of six human colon tumor cell lines. "These findings imply that it may be possible to inhibit hepatic metastasis from colon tumors with an inhibitor of cholesterol synthesis," such as lovastatin, he stated.

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