Patients with a broad range of neoplastic diseases will be entered on treatment protocols developed by Cancer and Leukemia Group B. These protocols, used under carefully defined conditions, seek to extend our knowledge regarding the best use of established drugs, new chemotherapeutic agents and other treatment modalities in the management of malignant diseases. Individuals from this institution take part in pilot studies, protocol design and group-wide studies in the evaluation of treatment programs. In particular, investigators from Dartmouth have been interested in new treatment programs for small cell carcinoma of the lung, multiple myeloma, acute leukemia and malignant melanoma. Dr. William North has continued his studies of neurophysins of vasopressin and oxytocin as tumor markers in small cell carcinoma of the lung. As a result of his findings, plasma samples from all patients entered on protocols #8083 (limited disease) and #8084 (extensive disease) are assayed for these substances at this institution. Dr. Leo Zacharski has been the principal investigator of two randomized cooperative VA trials studying the efficacy of an anticoagulant and an antiplatelet agent in the treatment of small cell and other neoplastic diseases. Findings from the now completed first VA trial indicated that Warfarin doubled the median survival time in patients with small cell carcinoma, and this agent is now being evaluated in one arm of protocol CALGB #8084. Pilot studies at this institution on macrophage activators, prostocycline activators, radiosensitizers and hyperthermia delivered by microwave antennas have potential for future group-wide studies. A panel of unique monoclonal antibodies which are cytotoxic for AML cells are being studied in vivo and will be used for in vitro treatment of bone marrow from patients with AML in second remission prior to autologous bone marrow transplantation.
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