• January
New Developments in the Epidemiology of Cancer Prognosis: Traditional and Molecular Predictors of Treatment Response and Survival
American Association for Cancer Research (AACR)
Jan. 11-15
Charleston Place
Charleston, South Carolina

Ubiquitin and Cancer: From Molecular Targets and Mechanisms to the Clinic
American Association for Cancer Research (AACR)
Jan. 18-22
Disney’s Contemporary Resort
Lake Buena Vista, Florida

Drugging the Cancer Genome: Developing Rational Combination Therapies for Multigene Cancers
American Association for Cancer Research (AACR)
Jan. 25-29
Marriott Rancho Las Palmas Resort & Spa
Rancho Mirage, California

• February
Conference on Molecular Basis for Targeted Therapy for Leukemia
American Association for Cancer Research (AACR)
and European School of Haematology (ESH)
Feb. 2-6
Cascais, Portugal

BMT Tandem Meetings
(Combined ASBMT and CIBMTR annual meetings)
Feb. 16-20
Hawaii Convention Center
Honolulu, Hawaii

2nd Advances Against Aspergillosis Conference
Feb. 22-25
Hilton Athens
Athens, Greece

• March
Cancer Susceptibility and Cancer Susceptibility Syndromes
American Association for Cancer Research (AACR)
March 1-5
Sheraton Maui
Maui, Hawaii

Frontiers of Immune Suppression
American Society of Transplantation (AST)
10th Annual Winter Symposium
March 16-19
Westin Resort & Spa Cancun
Cancun, Mexico

European Group for Blood and Marrow Transplantation (EBMT)
32nd Annual Meeting
March 19-22
Congress Centrum Hamburg
Hamburg, Germany

• April
American Association for Cancer Research (AACR)
97th Annual Meeting
April 1-5
Washington Convention Center
Washington, D.C.

American Society of Pediatric Hematology/Oncology (ASPH/O)
19th Annual Meeting
April 28-May 1
San Francisco, California

• May
American Society for Apheresis (AAFS)
27th Annual Meeting
May 23-26
Venetian Resort Hotel
Las Vegas, Nevada

• June
Federation of Clinical Immunology Societies (FOCIS)
6th Annual Conference
June 1-5
San Francisco Marriott
San Francisco, California

American Society of Clinical Oncology (ASCO)
42nd Annual Meeting
June 3-6
Georgia World Congress Center
Atlanta, Georgia

International Society for Stem Cell Research (ISSCR)
4th Annual Meetings
June 29-July 1
Metro Toronto Convention Center
Toronto, Ontario

• July
World Transplant Congress 2006
American Society of Transplant Surgeons (ASTS)
and the American Society of Transplantation (AST)
July 22-27
Hynes Convention Center
Boston, Massachusetts

Society for Cryobiology
Cryo 2006: 43nd Meeting
July 24-27
Hamburg Chamber of Commerce
Hamburg, Germany

• September
German Society for Transfusion Medicine and Immunohematology (DGTI)
in collaboration with the International Society for Cellular Therapy-Europe (ISCT-Europe)
39th Annual Congress
Sept. 19-22
Congress Centre Messe
Frankfurt, Germany

10th Biennial National Symposium on Hematopoietic Cell Transplantation
Stanford University School of Medicine
Sept. 28-30
Fairchild Auditorium
Stanford, California

2007
BMT Tandem Meetings
(Combined ASBMT and CIBMTR annual meetings)
Feb. 8-12
Keystone Conference Center
Keystone, Colorado

2008
BMT Tandem Meetings
(Combined ASBMT and CIBMTR annual meetings)
Feb. 13-17
Manchester Grand Hyatt Hotel
San Diego, California

A Word from President Nelson Chao, M.D.

Primum non nocere. . . . It is a widely held misconception that the familiar dictum “First, do no harm” comes from the Hippocratic Oath. But the Hippocratic Oath does not, and never did, contain those words.

Many scholars are of the opinion that Hippocrates did, in fact, originate the phrase, but in another of his writings, Epidemics, Bk. I, Sect. XI. One translation reads: “Declare the past, diagnose the present, foretell the future; practice these acts. As to diseases, make a habit of two things — to help, or at least to do no harm."

It is true that “First, do no harm” is expressed Primum non nocere in Latin, but Hippocrates wrote in his native Greek. So Latin cannot be the origin of the phrase. Some sources attribute Primum non nocere to the Roman physician, Galen.

What does this have to do with anything? I am writing to you about a recently introduced Senate bill that addresses two particular needs of terminally ill patients: unnecessary barriers to promising new therapies and ethical concerns about enrolling patients in studies that are placebo-controlled or that have a “no treatment” arm.

Introduced by Sen. Sam Brownback (R-Kan.), the proposed legislation would reform the Food and Drug Administration’s approval system of treatments for patients with cancer and other life-threatening diseases. It would accelerate the availability of cancer drugs, biological products and medical devices for terminally ill patients, creating a three-tiered approval system that may be more responsive to their needs.

The bill also addresses one of the cornerstones of medical research, which also is one of the great ethical dilemmas for studies with terminally ill patients: the random assignment of patients to placebo or to conventional therapy in clinical trials. The bill would relax, when it makes sense to do so, rigid requirements that trials have a placebo or no-treatment arm. It would encourage the FDA to consider modern alternative methodologies that may not involve placebos. The agency already is doing this in its medical devices division for tests of lifesaving products such as defibrillators.

The FDA’s cancer division has, over the years, largely relied on mortality statistics when approving new therapies. The agency has been reluctant to endorse other metrics such as tumor shrinkage and improved quality of life. Recently, though, the FDA has acknowledged “progression-free survival” as a clinical benefit. For example, if a tumor has not grown or a malignancy has not spread and the patient is still alive, the treatment may be considered to have clinical value.

The Wall Street Journal put it more bluntly the other day, saying that “the FDA is no longer insisting that we wait around for people to die to get statistics when a drug is obviously working.”

We all want to help seriously ill patients, but we also want to avoid harm. As stem cell physicians, we understand these issues well, as we deal with them on a daily basis in patients with advanced disease. What we do has the potential for cure, but also the potential for causing harm and suffering.

We absolutely want to avoid the snake oils, coffee enemas and laetrile-like “cures.” Placebo-controlled trials are critical in the early development of a therapy when there’s no other option and effectiveness is highly uncertain. But it is difficult to enroll a seriously ill patient in a study that has a placebo arm or a no-treatment arm when an alternative therapy promises real benefits and an improved outcome.

Sen. Brownback’s bill is S 1956 and is titled Access, Compassion, Care and Ethics for Seriously Ill Patients Act (or the “Access Act” for short). Co-sponsors are Sen. James Inhofe (R-Okla.) and Sen. Johnny Isakson (R-Ga.).

According to Sen. Brownback, the decision for terminally ill patients to participate in an investigational therapy should be between the physician and the patients, not government bureaucrats.

Declaratio ab definio, difficultas discordia. Expressed in those terms, it’s hard to disagree.

– Nelson