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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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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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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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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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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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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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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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New indication for rivaroxaban; new study on warfarin testing; medications causing adverse drug events; niacin as an add-on therapy; and FDA actions.
