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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.
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The tyrosine kinase inhibitor dasatinib was added to docetaxel in the treatment of advanced castration-resistant prostate cancer in a Phase 1-2 trial. The combination was shown to be generally well-tolerated and to result in markers of reduced bone turnover in the great majority of patients and in durable PSA responses in approximately 50%. The findings justify proceeding to Phase 3 clinical trial.
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For patients who have synchronous bilateral breast cancer, overall survival has been shown to be less favorable than for patients presenting with unilateral disease. In the current matched case-control series, overall survival was comparable. Clinicians are advised to prescribe systemic therapy based upon the more aggressive of the two lesions.
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A full panel of prognostic indicators was examined in 449 treatment-naïve CLL patients and it was found that serum light chain ratio was useful in confirming clonality. However, the sum of both k and l serum light chains proved of greater prognositc value in determining an early need to offer CLL treatment. A total (k + l) level of > 60.6 mg/mL was an independent predictor of limited treatment-free survival.
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A 57-year-old postmenopausal librarian, who is 1-year post diagnosis of a stage II invasive cancer of the right breast, is found to be estrogen- and progesterone-receptor positive, and Her2neu negative with one positive axillary node.
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New treatment for TB; safety of dabigatran; quality of antidepressants; systolic hypertension treatment; and FDA actions.