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Bone Marrow Transplantation

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  • No 'Go' with CoQ10 for Treatment-Related Fatigue

    Results of this well-done trial strongly suggest that CoQ10 administration over 24 weeks' time does not help relieve the treatment-related fatigue experienced by a significant proportion of women with newly diagnosed breast cancer.
  • Waldenström Macroglobulinemia with Hyperviscosity

    A 57-year-old retail pharmacist presented to his primary care physician because of progressive headaches, blurry vision, hearing loss, and episodes of confusion. He had not had night sweats, fever, or weight loss. On physical examination he was found to be pale and there were ecchymoses over his upper and lower extremities that he reported occurred spontaneously over the past 3 months. He had attributed these to his current medications including both aspirin (81 mg/day) and clopidogrel (75 mg/day), although he had been taking these medications for more than 5 years without noticing ecchymoses in the past. He did not have palpable lymphadenopathy nor was there splenomegaly.
  • Transarterial Chemoembolization ± Intravenous Bevacizumab in the Treatment of Hepatocellular Cancer

    In this single-institute pilot study, 30 subjects with hepatocellular cancer were randomized to transarterial chemoembolization with or without bevacizumab. Bevacizumab use significantly improved progression-free survival at 16 weeks but no significant difference was seen with respect to the primary outcome (vessel count) or in the overall survival.
  • Pharmacology Watch: FDA Approves First New Anti-Obesity Drug in Years

    Lorcaserin for weight loss; statins and fatigue; treatment-resistant gonorrhea; hydrocodone classification changes; USPSTF recommendations; and FDA actions.
  • Capecitabine Better Than, Not Inferior to, Fluorouracil in Perioperative Treatment of Rectal Cancer

    In a multicenter, Phase 3 trial, perioperative chemoradiotherapy with capecitabine proved safe and equivalently effective as fluorouracil in reducing local recurrence. In fact, post hoc analysis demonstrated better disease-free and overall survival for those treated with capecitabine. This is a finding that will resonate in the offices of community-based oncologists.
  • Clinical Briefs in Primary Care Supplement

  • Pemetrexed in the Treatment of Relapsed/Refractory Primary Central Nervous System Lymphoma

    In this Phase 2 trial, 11 patients with relapsed/refractory primary central nervous system lymphoma after high-dose, methotrexate-based regimen were treated with pemetrexed 900 mg/m2 every 3 weeks, dexamethasone 4 mg bid, folate, and B12 supplementation. The treatment had an overall response rate of 55%, disease control rate of 91%, median progression free survival of 5.7 months, and median overall survival of 10.1 months. Toxicities were more than expected with the standard pemetrexed dose (500 mg/m2) and were primarily hematologic and infectious, which were easily managed. Although single-agent activity of pemetrexed in this study is novel and promising, optimal dosing and efficacy need to be studied further.
  • Finally, Demonstrable Improvement in Remission Induction for Adult Acute Myelogenous Leukemia

    A multi-institutional study examined the addition of a purine analog, either cladribine or fludarabine, to the standard induction regimen ("7 & 3") in adult patients 60 years of age and younger with acute myelogenous leukemia, and found improved outcomes for those receiving cladribine. The added benefit from cladribine appears to be the result of a reduction in the incidence of resistant disease. The study arm containing cladribine, daunorubicin, and cytaribine yielded an overall survival at 3 years of 45% while conventional "7 & 3" therapy was only 33% at 3 years. Cladribine added to daunorubicin and cytarabine during remission induction improves leukemia control and patient survival for those 60 years of age and younger.
  • Pharmacology Watch: Does Finasteride Cause Permanent Sexual Side Effects?

    Side effects of finasteride; new ruling on pharmaceutical companies paying generic manufacturers; and FDA actions.
  • Adjuvant Chemotherapy for Older Patients

    Four large data sets were analyzed to evaluate the effect of adjuvant treatment on survival in patients with stage III colon cancer diagnosed after age 75. While adjuvant chemotherapy was associated with a survival benefit, oxaliplatin-based regimens offered no more than a small incremental benefit over non-oxaliplatin-containing regimens.