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n a small, multicenter, randomized Phase 2 trial, the all-oral combination of cyclophosphamide and capecitabine demonstrated a trend toward an increasing response rate when compared to capecitabine alone in the treatment of locally advanced or metastatic breast cancer. The combination was well tolerated.
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Current strategies to prevent chemotherapy-induced nausea and vomiting frequently include a 3-day course of aprepitant. In a multicenter trial from Japan, administration of a single dose of the aprepitant prodrug fosaprepitant, when used in combination with granisetron and dexamethasone, was shown to provide significant improvement when compared to placebo plus granisetron/dexamethasone. Thus, single-dose fosaprepitant may offer a more convenient and less complicated approach in the regimen to prevent nausea and vomiting.
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Clinically significant disparities exist in the quality of ovarian cancer care delivered and in overall survival along both racial and socioeconomic status. These effects appear to persist despite adherence to National Comprehensive Cancer Network guidelines; however, deviation in guideline adherence is common and further impacts survivorship and represents key opportunities for further investigation and study.
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Beta-blockers and noncardiac surgery; prenatal medication exposure and risk of autism; reasons for statin discontinuations; and FDA actions.
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One-third of non-small cell lung cancer patients treated with adjuvant chemotherapy start it more than 10 weeks after surgery. Although the time interval between surgery and initiation of adjuvant chemotherapy impacts survival in colorectal and breast cancers, delaying adjuvant chemotherapy does not appear to be associated with inferior survival in non-small cell lung cancer.
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In a retrospective review of adjuvant chemotherapy for elderly (≥ 75 years) patients with stage III colon cancer, performance status and comorbidities were important treatment decision factors. Disease recurrence rates were not different for those who received adjuvant treatment vs those who did not, but 1-year and 5-year survival was significantly better for the treated group. The difference at 5 years remained apparent in multivariate analysis controlling for age, performance status, and comorbidities.
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In this study, the authors studied the prognostic value of plasma Epstein Barr virus (EBV) DNA levels at diagnosis and 6 months post-treatment in patients with advanced Hodgkin lymphoma treated on the North American Cooperative Intergroup Trial E2496.
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In a single institutional study (M.D. Anderson), 60 older patients with chronic lymphocytic leukemia were treated with lenalidomide. Thirty-five of the 60 patients had a response lasting > 36 months, and compared with those who did not have such a durable response, those who did had lower pretreatment ß-2 microglobulin levels and were more likely to have favorable cytogenetics. Lenalidomide treatment was associated with improvement in circulating immunoglobulin levels and T-lymphocyte numbers.
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Evidence-based updates in primary care medicine By Louis Kuritzky, MD
