Cancer and Leukemia Group B is emerging from a clinical trials group focused on testing multiple chemotherapeutic regimens to a more selected modular concept of therapy development. Current emphasis is on answering dose intensity questions and exploring the important scientific contributions of cytogenetics, immunology and molecular biology in an effort to improve the therapy of neoplastic diseases. Our emphasis continues in the areas of lymphoma, myeloma, breast cancer, leukemia, and respiratory cancer. Bowman Gray has chaired two major studies in the lymphomas consisting of CALGB protocol #8451 and 8452. These studies are designed to test the relative effectiveness of various drugs used in the treatment of lymphomas. Results of these two studies provided the development of the successor protocol, CALGB #8556, which is AMOPLACE. Evaluation of these studies will allow us to determine the relative role of adriamycin, whether given initially or sequentially, and further explore the importance of initial intensive combination therapy versus alternating noncross-resistant treatments. Pilot studies have demonstrated the effectiveness of these treatments in refractory Hodgkin's disease and this modular concept of combination chemotherapy has been extended to a pilot study, CALGB #8654. Bowman Gray chairs CALGB #8514, a randomized study comparing melphalan/prednisone treatment with or without alpha 2 in newly diagnosed myeloma patients. One hundred forty-six patients have accrued to this study since October 4, 1985. Pilot studies at Bowman Gray involving the combination of high-dose cytosine arabinoside and mitoxantrone will provide important information to be utilized by the group in developing subsequent leukemic studies. Our laboratory interest in drug resistance should provide important clues in the development of more effective treatments for acute leukemia. Our commitment to CALGB protocol studies is demonstrated by our accrual of 169 patients in 1986.
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