Warrell's lab has undertaken an active investigation into the effectiveness
of arsenic trioxide for APL and other
cancers. "We've looked at patients who
have had relapses with other therapies
and found that in 11 of 12 APL patients
who were given arsenic trioxide, complete remission occurred. Our longest
survivor has been on the therapy for 12
months so far."
Warrell also noted that there were
surprisingly few side effects with this
treatment. Four patients received four
cycles of treatment without evidence of
adverse cumulative effects. The arsenic
therapy appears to be much better than
the currently used all-trans-retinoic acid
therapy, which is the gold standard for
APL. Based on Warrell's success, a
multicenter trial at over a dozen sites
has been initiated to try and confirm
these early findings.
Arsenic trioxide apparently concentrates primarily in the red blood cells.
It's initial action seems to be an induction of partial differentiation, followed
by programmed cell death. Resistance
has been shown to develop rapidly and
since the drug doesn't specifically target
APL cells, it may have utility against
other cancers, Warrell said.
Samuel Waxman, M.D., ofMount
Sinai Medical Center, said that arsenic
trioxide, based on both in vitro and in
vivo experiments, appears to be selectively apoptotic in that it affects certain
cell lines, but not others (bone marrow
progenitor cells, for example).
Waxman found that 33 of34 ofhis
patients who were refractory to conventional APL therapy showed complete
remission with arsenic trioxide for a
median period of 14 months. Waxman
also found that "administration of arsenic trioxide prior to all-trans-retinoic
acid therapy was much more beneficial
than a reverse administration of the
drugs." Waxman's next effort will be an
attempt to understand how to make
arsenic trioxide insensitive cells responsive to low levels of the drug.
Elevated liver enzymes associated
with the arsenical indicate that close
patient monitoring is essential. As an
interesting footnote to the toxicity problem, Warrell mentioned the visibility
that arsenic
wasgammg,
due, in part, to
"an above-thefold, frontpage article in
The New York
Times about a
plague of
arsenic poisoning that is
Dr. Raymond Warrell, Jr.
occurring in
Bangladesh
due to attempts to bring clean water to
the impoverished nation." Bangladesh is
undergoing one of the biggest mass
poisonings in history, with tens of thousands and perhaps millions of people
affected due to leaching of arsenic from
the ground water through supposedly
safe tube wells that were devised as part
of a safe water program.
Warrell said that "the symptoms of
arsenic poisoning in Bangladesh are
similar to the symptoms of arsenic toxicity we see in some patients given arsenic trioxide for APL, with skin that
becomes spotted and warts and sores
that begin to cover their hands, feet, and
bellies." In contrast to the new found
beneficial effects of arsenicals in this
country, Allan Smith, Ph.D., of the University of California at Berkeley, states
that "arsenic in the drinking water in
Bangladesh poses the highest cancer
risk we have ever found."
-Mike Miller
Journal of the National Cancer Institute, Vol. 90, No. 24, December 16, 1998
Awards,
Appointments,
Announcements
The Am~rican Cancer Society, Atlanta, presented the Medal of Honor, its
most prestigious award, to individuals
expert in prevention, nutrition, and
medical oncology.
The Medal of Honor for clinical
research went to Saul A. Rosenberg,
M.D., of
Stanford University for
achievements
that included
"his outstanding clinical
studies of
malignant
lymphomas."
The medal
Dr. Saul A. Rosenberg
for basic research went to
Roswell K. Boutwell, Ph.D., Sc.D.,
professor emeritus at the University of
Wisconsin
McArdle
Laboratory,
Madison, for
his contributions to
chemical
carcinogenesis, including his discovery of
Dr. Roswell K. Boutwell
how "Vitamin
A affects skin
cancer in mice and, together with his
colleagues, developed" the SENCAR
strain of mice now widely used for both
research and bioassays.
Charles A. LeMaistre, M.D., president emeritus of the University ofTexas
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M. D. Anderson Cancer Center, Houston, won the medal for cancer control,
particularly for his contributions in
cancer prevention.
The society
also presented
its Distinguished Service Award to
James S.
Marks, M.D.,
of the Centers
for Disease
Dr. Charles A. LeMaistre
Control and
Prevention,
Atlanta; to Donald R. Shopland of the
National Cancer Institute; and to Amy S.
Langer of the National Alliance of
Breast Cancer Organizations, New York.
Marks was cited for developing collaborative relationships between CDC
and ACS to lower the cancer burden.
Shapland was cited for his career-long
work on tobacco control. Langer was
cited for her leadership in the consumer
breast cancer movement.
ACS presented its Humanitarian
Award to Gilbert H. Frieden, M.D.,
director emeritus of the University of
Kentucky Cancer Center, Lexington, for
"dedication to the improvement of cancer control and for genuine accomplishment in human welfare."
Genevieve V. Foley, vice president
for patient care services at St. Jude
Children's Research Hospital, Memphis,
Tenn., received the ACS Volunteer
Leadership Award for "long and exemplary service" to the society.
Lymphoma Awards
The Cure for Lymphoma Foundation,
New York, recently honored two leaders
in cancer advocacy and research.
The foundation recognized Ellen
Stovall, executive director of the National Coalition for Cancer Survivorship
and a CLM board member, with a "Together Award" in recognition of her
"outstanding leadership and advocacy on
behalf of cancer survivors nationwide."
It presented its "Key to the Cure"
award to Mortimer J. Lacher, M.D., a
consultant in medicine at Memorial
Sloan-Kettering Cancer Center, New
York, for, his "long-standing commitment and dedication to lymphoma research and survivorship issues."
Johnson Honored
The International Society of Nurses
in Cancer Care presented its highest
honor, the Distinguished Merit Award,
to Judith Johnson, Ph.D., for her
"steadfast, unique, and prolific contribution to the art and science of cancer
nursing worldwide."
Johnson, who founded the "I Can
Cope" patient education program and
served as president of the Oncology
Nursing Society for 4 years, is adjunct
associate professor at the University of
Minnesota School ofNursing, Minneapolis.
Award to Epstein
Journal Tops Oncology Journals
The 1997 SCI Journal Citation Reports, compiled by lSI (Institute for
Scientific Information), Philadelphia, shows the Journal of the National Cancer Institute with the highest impact factor among the 100 oncology journals
rated.
The 1997 impact factor is the number of times on average that a journal
article published in 1995 or 1996 was cited by scientific papers published in 1997.
The Journal's impact factor in 1997 was 11.4, up an entire point over 1996.
The Journal has been the number one primary cancer journal in 5 of the last 6
years. For 1997, Cancer Research had a 1997 impact factor of 8.4, and the
Journal of Clinical Oncology had a factor of 7.9.
Among medical journals, the Journal is number four behind the New England
Journal ofMedicine at 27 .8, Lancet at 16.1, and the Annals of Internal Medicine
at 12.1, but ahead of the Journal of the American Medical Association at 9.3.
Except for Nature (27.4) and Science (24.7), the Journal ranked ahead of all
other competitors in closely related categories. Lower ranking journals include
Circulation (9 .8), Blood (9 .5), Proceedings of the National Academy of Sciences (9 .0), and the Journal of Biological Chemistry (7 .0).
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The Right Livelihood Award Foundation, Stockholm, presented one of its
1998 Right Livelihood Awards to
SamuelS. Epstein, M.D., for "his exemplary life of scholarship, wedded to
activism on behalf of humanity."
Epstein, who is professor of occupational and environmental medicine at
the University of Illinois, Chicago,
received the award Dec. 9 in a ceremony at the Swedish Parliament in
Stockholm.
Lectureship Established
The Astute Clinician Lectureship was
recently established at the National
Cancer Institute by Robert W. Miller,
M.D., and Mrs. Haruko Miller "to
honor scientists whose research began
with an unusual clinical observation
Journal of the National Cancer Institute, Vol. 90, No. 24, December 16, 1998
and, through laboratory studies, opened
a new area of research."
The first lecturer was J. Bruce Beckwith, M.D., professor of pathology and
human anatomy at Lorna Linda University, Lorna Linda, Calif. Beckwith
and Hans Wiedemann, M.D., of Kiel,
Germany, independently identified the
syndrome named for them, the BeckwithWiedemann Syndrome. Miller is scientist emeritus with NCI's Genetics Epidemiology Branch.
Cushing Named
The National Cancer Institute named
Mary Cushing as chief of its Financial
Management Branch.
John Hartinger, NCI's associate
director for financial management, who
made the announcement, said Cushing
has been executive officer at the National Institute for Nursing Research.
Earlier she had been a member of the
staff of the branch she now heads.
ACS Elects Officers
The American Cancer Society, Atlanta, elected Charles J. McDonald,
M.D., as president, and
Francis L.
Coolidge as
chairman of
the board.
McDonald is
chairman of
dermatology at
Brown University, ProviDr. Charles J. McDonald
dence, R.I.,
and Coolidge
is a partner with the Ropes & Gray law
firm in Boston. Others elected include:
President-elect: Gerald Woolam,
M.D., clinical professor of surgery,
Texas Tech University School of Medicine, Lubbock.
Chair-elect: John Kelly, Ph.D., director of the Navy Family Service Center, Gulfport, Miss.
Vice-chair: John C. Baity, senior
partner in the Milbank, Tweed, Hadley
& McCloy law firm, New York.
Chairman
of the Medical
Affairs Committee:
Dileep G. Bal,
M.D., chief of
cancer control
in the California Department of
Health Serv1ces.
Francis L. Coolidge
Vice-Chair
oftheMAC:
Robert C. Young, M.D., president of
the Fox Chase Cancer Center, Philadelphia.
Fingert Named
Genta, Inc., San Diego, named
Howard J. Fingert, M.D., as vice
president for clinical and regulatory
affairs. He had headed regulatory affairs
at Serono Laboratories, Inc., since 1995.
Genta's announcement said it is a
biopharmaceutical company focusing on
antisense products to treat cancer at its
genetic source.
NCI Appoints White
The National Cancer Institute recently appointed Jeffrey D. White,
M.D., as director of the institute's new
Office of Complementary and Alternative Medince. Robert E. Wittes, M.D.,
NCI's deputy director for extramural
science, who made the appointment,
said White will focus and coordinate
NCI's efforts with complementary and
alternative approaches in all areas of
research.
Journal of the National Cancer Institute, Vol. 90, No. 24, December 16, 1998
White also will serve as NCI's liaison with the newly created National
Center for Complementary and Alternative Medicine (formerly the Office of
Alternative Medicine) at the National
Institutes of Health, and with organizations outsid~ of the NIH.
In the area of complementary and
alternative medicine research, White's
office will "take on the challenge of
identifying key research opportunities
and making sure that the studies NCI
supports incorporate the best science
and employ the strongest methodologies currently available so that the
answers we obtain actually serve medical need and advance the field," Wittes
said.
Rochester Appointments
The University of Rochester (N.Y.)
Cancer Center announced new appointments to its faculty:
Kari Kendra, M.D., Ph.D., was
named assistant professor of medicine in
the center's Hematology/Oncology Unit.
She recently was a biotherapy fellow
and research associate at the University
ofWisconsin, Madison.
Frank Slovick, M.D., also was
named assistant professor of medicine in
the Hematology/Oncology Unit, and
was named associate member of the UR
Cancer Center. He was an instructor
and fellow in hematology at the Strong
Memorial Hospital, Rochester.
Pain Book Published
The American Academy of Pain
Medicine announced that Gerald M.
Aronoff, M.D., the medical director of
Presbyterian Orthopedic Hospital Center for Pain Medicine, Charlotte, N.C.,
recently published a book, Evaluation
and Treatment of Chronic Pain.
Aronoff is president of the North
Carolina Pain Society.
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