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Michigan Oncology Journal Spring 98

Of Interest

News

ProstaScint™ Scanning Now Available at U-M
The U-M’s Division of Nuclear Medicine has added ProstaScint (Indium In 111 Capromab Pendetide) monoclonal antibody scanning to its imaging capa-bilities. The American College of Nuclear Physicians recently certified that U-M personnel and interpreting physicians have completed training in the interpretation of these images. Only a limited number of U.S. sites have personnel with the specific training in ProstaScint imaging and interpretation that is required to avoid false-positive and false-negative image results.

ProstaScint scanning is useful for locating the source of a rising serum prostate specific antigen (PSA) level in patients who are post-radical prostatectomy and who have had negative or equivocal tests to localize the site of recurrence. With the information provided by the scan, in concert with other information, management of these patients may be made more appropriate. An article in January’s Journal of Clinical Oncology showed that patients who have rising PSA levels and a ProstaScint scan that shows no distant metastases are much more likely to benefit from radiation therapy to the pelvis than patients whose scans show disseminated disease. “Although based on a small sample size, the results were highly significant,” says Richard Wahl, M.D., director of U-M’s General Nuclear Imaging.

Medicare Now Covers Positron Imaging with FDG for Lung Cancer
New Medicare guidelines, effective January 1, 1998, make positron emission tomography (PET) scanning using the radioisotope FDG available for evaluating whether solitary pulmonary nodules are likely to be malignant and for staging the exact location of lung cancer in the body, once the diagnosis is made.

Richard L. Wahl, M.D., professor of Internal Medicine and Radiology and director of the Cancer Center’s Radiopharmaceutical Program, participated in the Health Care Financing Organization’s development of these guidelines. In 1994, he along with colleagues Leslie Quint, Mark Orringer and Charles Meyer were first to report that PET was significantly more accurate than CT scanning in staging non-small cell lung cancer. These results have been confirmed by multiple other groups in the past several years, and Blue Cross/Blue Shield Association Technical Evaluation Center recently concluded that PET with FDG is clinically effective and can improve health outcomes in patients with lung cancer. Because PET is more accurate than CT, it can lead to more appropriate management at a lower overall cost.

The U-M’s Division of Nuclear Medicine offers clinical PET studies on a routine basis. To schedule PET scans, please call (734) 936-5090.
Note: more than 500 private insurance plans now pay for PET studies.

Clinical Trials

Randomized trial is comparing dose-escalated external beam conformal boost versus brachytherapy boost in patients with localized intermediate risk adenocarcinoma of the prostate.
The trial is designed to compare the two most advanced forms of radiotherapy used in prostate cancer treatment: conformal 3D external beam therapy and permanent radioactive seed implantation. Both of these techniques employ the latest technology to deliver the highest possible doses to the prostate while minimizing exposure to uninvolved nearby anatomic structures.

The C.A.R.E Project (Cervical Application of Retinoid Evaluation) is seeking patients with confirmed high-grade cervial lesions (CIN II and III).
Tretinoin (drug marketed as Retin A) is placed on the cervix for five consecutive days with a cervical cap. To date all participants have experienced minimal toxicities and have been enthusiastic about the opportunity to receive this treatment. Participants can receive treatment either in the Ann Arbor or Detroit area.

The University of Michigan Cancer Center is soliciting concepts or full protocols for clinical trials to improve cancer prevention and control practices in community clinical settings.
The project is funded by a three-year Community Clinical Oncology Program (CCOP) research base grant, and supported by CCOPs in Grand Rapids, Kalamazoo, Columbus, Toledo and Dayton. CCOP is a network of community cancer specialists, primary care physicians and other health care professionals who conduct cancer prevention and control research and cancer treatment research.

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