L.O. Baker - Böcker

There have been significant advances in the treatment of sarcomas in the past several years. Further, different clini­ cal treatment programs are being advocated in different areas including surgery alone, surgery with preoperative or post­ operative chemotherapy, surgery with different radiotherapy modalities, with each investigator espousing his own treat­ ment program. On the other side, there is the question of whether these treatment programs are offering better results or whether the natural history of sarcomas has changed. The International Symposium on Sarcomas was held at Innisbrook Resort, Tarpon Springs, Florida, October 8-10, 1987. This was the first international symposium to date involving all of the disciplines treating sarcomas including pathologists, orthopaedic surgeons, general surgeons, medical oncologists, pediatric oncologists, and radiation oncol­ ogists. The Symposium brought together a number of special­ ists working in the clinical field of sarcomas for a presen­ tation of their specific treatment programs and their results. The presentations were followed by panel discussions to stimulate educational debate as to the different forms of treatment for sarcomas and to formulate some conformity in control of disease, control of spread, and ultimate function for the patient. James R. Ryan, M.D.

This year notes two major changes in the annual Detroit Cancer Symposium. The first is our intention of selecting top­ ics of broad interest to the cancer community and examining the subject from both a basic laboratory and clinical viewpoint. In this way, the importance of both elements of cancer research are noted and the interplay between them emphasized. Further, we believe that Symposia such as this act to stimulate the basic scientist and clinician to continue their studies with the know­ ledge of the impact that each has upon the other and the nec­ essary cooperation required to solve the cancer problem. The second change is the publication of this Symposium. The pre­ vious sixteen were not committed to manuscript form. Given the change in format and intent of the series, we believe that this and subsequent volumes will make important contributions to the cancer literature. The topic of "Biology and Therapy of Acute Leukemia" was chosen for the first Symposium because of its historical signif­ icance in cancer chemotherapy. The therapeutic rationale for human leukemia is the result of understanding the basic tumor biology largely derived from transplantable leukemias in exper­ imental animals. It is through these models, as discussed by Dr. Fred Valeriote, that we learned the cellular kinetics of leukemia, the antileukemic effects of new agents and the ef­ fect of growth perturbation by various chemotherapeutic agents and their combinations.

Biochemical Modulation at the present time defines an area of study in which the intracellular metabolism of a given anti­ cancer agent is modulated (usually by a noncytotoxic agent or a cytotoxic agent at sufficiently low dosage to make it non­ cytotoxic) in order to either increase the effectiveness of the particular agent against tumor cells or decrease its cytotox­ icity against normal cells. The major focus of modulation has been the agents 5-fluorouracil (FUra), arabinofuranosylcytosine (ara-C), methotrexate (MTX) and a few alkylating agents. The major thrust of the studies has been to increase the flow of the anticancer agent along the pathway responsible for the formation of the cytotoxic species: for example, FUra to FUTP or ara-C to ara-CTP. While in most cases the application of research re­ sults to clinical trials does not require the subsequent exper­ tise of the laboratory researchers, application of biochemical modulatory schemes to clinical protocols necessitate a dramatic break with the past procedures. As shown in the laboratory­ clinical loop below, close collaboration between the laboratory and clinical investigator is essential. While the laboratory REDEFINE TECHNOLOGY, TESTS OR QUESTIONS FOR FURTHER THERAPEUTIC ADVANCE CLINICAL EXPERIMENTAL PROTOCOL (LABORATORY) RESEARCH STUDIES DEFINE AND TEST APPROPRIATE SCIENTIFIC PARAMETERS results define rationally-based regimens, it is essential that the clinical protocols contain the requirement that clinical material (either tumor or normal tissues) be sampled to deter­ mine whether the biochemical modulation being proposed is in fact beinq accomplished.

Biochemical Modulation at the present time defines an area of study in which the intracellular metabolism of a given anti­ cancer agent is modulated (usually by a noncytotoxic agent or a cytotoxic agent at sufficiently low dosage to make it non­ cytotoxic) in order to either increase the effectiveness of the particular agent against tumor cells or decrease its cytotox­ icity against normal cells. The major focus of modulation has been the agents 5-fluorouracil (FUra), arabinofuranosylcytosine (ara-C), methotrexate (MTX) and a few alkylating agents. The major thrust of the studies has been to increase the flow of the anticancer agent along the pathway responsible for the formation of the cytotoxic species: for example, FUra to FUTP or ara-C to ara-CTP. While in most cases the application of research re­ sults to clinical trials does not require the subsequent exper­ tise of the laboratory researchers, application of biochemical modulatory schemes to clinical protocols necessitate a dramatic break with the past procedures. As shown in the laboratory­ clinical loop below, close collaboration between the laboratory and clinical investigator is essential. While the laboratory REDEFINE TECHNOLOGY, TESTS OR QUESTIONS FOR FURTHER THERAPEUTIC ADVANCE CLINICAL EXPERIMENTAL PROTOCOL (LABORATORY) RESEARCH STUDIES DEFINE AND TEST APPROPRIATE SCIENTIFIC PARAMETERS results define rationally-based regimens, it is essential that the clinical protocols contain the requirement that clinical material (either tumor or normal tissues) be sampled to deter­ mine whether the biochemical modulation being proposed is in fact beinq accomplished.

This year notes two major changes in the annual Detroit Cancer Symposium. The first is our intention of selecting top­ ics of broad interest to the cancer community and examining the subject from both a basic laboratory and clinical viewpoint. In this way, the importance of both elements of cancer research are noted and the interplay between them emphasized. Further, we believe that Symposia such as this act to stimulate the basic scientist and clinician to continue their studies with the know­ ledge of the impact that each has upon the other and the nec­ essary cooperation required to solve the cancer problem. The second change is the publication of this Symposium. The pre­ vious sixteen were not committed to manuscript form. Given the change in format and intent of the series, we believe that this and subsequent volumes will make important contributions to the cancer literature. The topic of "Biology and Therapy of Acute Leukemia" was chosen for the first Symposium because of its historical signif­ icance in cancer chemotherapy. The therapeutic rationale for human leukemia is the result of understanding the basic tumor biology largely derived from transplantable leukemias in exper­ imental animals. It is through these models, as discussed by Dr. Fred Valeriote, that we learned the cellular kinetics of leukemia, the antileukemic effects of new agents and the ef­ fect of growth perturbation by various chemotherapeutic agents and their combinations.