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Azithromycin and cardiac risk; warfarin and heart failure; aspirin and VTE; effectiveness of long-acting contraceptives; and FDA actions.
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In a meta-analysis of current observational (both case-control and prospective cohort) studies evaluating the potential association between type 2 diabetes mellitus and the incidence of hematological malignancy, an increased risk for non-Hodgkin lymphoma and leukemia was demonstrated as well as a trend toward an increased risk for myeloma. Confounding factors such as age, obesity, smoking, and alcohol (risks for both diabetes and malignancy) could not be completely accounted for in such an analysis.
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This randomized, controlled, open-label, multicenter Phase 3 trial compared axitinib with sorafenib as second-line therapy for metastatic renal clear-cell cancer. The results showed that axitinib extended progression-free survival by 2 months more than sorafenib (6.7 months vs 4.7 months), and had a superior objective response rate (19.4% vs 9.4%).
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In a prospective trial conducted from 2004-2010, 21 patients (median age 65 years) with a clinical complete response after chemoradiotherapy were followed closely per a stringent wait-and-see policy consisting of MRI, endosopies, and CT scans. These patients were compared to 20 patients prospectively who underwent surgery and were found to have a pathologic complete response.
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Long-term follow-up of Lynch syndrome patients who completed 2 years of treatment (aspirin or placebo) on the CAPP2 colorectal cancer prevention trial revealed a significant reduction in colorectal cancer development. This was the first large-scale colon cancer prevention trial using aspirin as an intervention. Implications for the prevention of sporadic colon cancer remain conjectural, however tempting it is to extrapolate these findings to the general adult population.
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New treatment for prostate cancer; avastin and breast cancer; new CMS disclosure rule; and FDA actions.
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An asymptomatic 78-year-old retired accountant presented to his physician with intractable hiccups. Physical examination, complete blood count, and imaging studies did not reveal a cause of the hiccups, and after several days the symptom disappeared. However, upon review of the abdominal CT scan obtained in evaluation of the hiccups, a right renal mass was defined.
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Influenza remains a major source of morbidity and increased mortality among patients with cancer, and prior studies had indicated impaired response to vaccination. In the current report, lymphoma patients treated with rituximab, either in combination with chemotherapy or as a single agent, were found to have markedly deficient influenza vaccine response, with not 1 of 67 achieving a protective titer, compared with 42 of 51 controls. Thus, rituximab-treated lymphoma patients are particularly susceptible to vaccine failure and influenza infection should be highly considered in symptomatic patients, even in those who had been appropriately vaccinated.
