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In a muti-institutional prospective trial conducted from 2003-2005, 74 patients with unresectable pancreatic adenocarcinoma were randomly assigned to receive GEM alone (at 1,000 mg/m /wk for weeks 1-6, followed by 1 week rest, then for 3 of 4 weeks) or GEM (600 mg/m /wk for weeks 1-5, then 4 weeks later 1,000 mg/m /wk for 3 of 4 weeks) plus radiotherapy for a total of 50.4 Gy. Measurement of quality of life also was performed. Patients enrolled in Arm B (GEM plus radiation) had a higher incidence of grades 4 and 5 toxicities (41% vs 9%), but grades 3 and 4 toxicities combined were similar in both arms. No statistical difference was noted in quality of life. The primary endpoint of survival was improved with the addition of radiotherapy with 11.1 months for Arm B and 9.2 months for Arm A.
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New indication for rivaroxaban; new study on warfarin testing; medications causing adverse drug events; niacin as an add-on therapy; and FDA actions.
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This prospective multicenter study presents an 11-item model for predicting chemotherapy toxicity in older adults with cancer. Its stratification schema identified older adults at low (30%), intermediate (52%), or high (83%) risk for chemotherapy toxicity.
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An 88-year-old woman with history of hypertension, chronic kidney disease with baseline creatinine of 1.8 meq/dL, and osteoarthritis was seen in the emergency room for worsening pain in the right shoulder and fatigue over 2 weeks. Her son denied any recent illnesses, falls, changes in appetite, or change in urinary or bowel habits.
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In an analysis of a subset of breast cancer patients enrolled in the ATAC trial, it was apparent that age influences the risk of recurrence, and age and comorbidities significantly influence the risk of death without recurrence. The authors suggest assessment of comorbidities should be incorporated into decisions regarding adjuvant therapies.
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