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FDA issues multiple drug safety alerts; ARBs and cancer risk; and FDA actions.
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In a trial of two platinum-based chemotherapy regimens for non-small-cell lung cancer in older patients, pretreatment assessment of physical function and quality of life predicted certain different adverse outcomes but neither treatment assignment was superior to the other with regard to improved "global" quality of life.
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ACEI/ARB therapy for AS; safety alert issued for dronedarone; statins and cancer risk; nesiritide and heart failure; and FDA actions.
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In a multicenter randomized (not blinded) Phase 3 study of erlotinib vs chemotherapy for EGFR-mutation positive non-small cell lung cancer (NSCLC), progression-free survival was both significantly greater and toxicity less for patients treated with erlotinib. The findings suggest that erlotinib should be considered first-line therapy for patients with advanced EGFR mutation-positive NSCLC.
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In a case-control study, patients with prostate cancer and matched controls were asked to recall whether they experienced male-pattern baldness by 20, 30, or 40 years of age. Prostate cancer patients were twice as likely to have alopecia at age 20 than controls. Early-age alopecia was not associated with early diagnosis of prostate cancer or with markers of disease aggressiveness. Thus, men with male-pattern baldness at age 20 may be at higher risk for the development of prostate cancer and perhaps more aggressive screening or other disease preventing interventions might prove beneficial for this population.
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In a retrospective analysis of risk factors for the development of cerebral metastases in patients with known metastatic breast cancer, several factors including ER, HER-2, patient age, and site of first metastatic recurrence were found to be predicted. Using a cumulative incidence model employing competing-risk regression analysis, small initial tumor size, and the absence of metastatic disease at the time of diagnosis appeared to be independent risk factors.
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Preclinical data suggest bortezomib and rituximab have synergy for mantle cell lymphoma (MCL). The authors studied bortezomib, rituximab, and dexamethasone in relapsed and refractory MCL using 1.3 mg/m2 of bortezomib on days 1, 4, 8, and 11 with rituximab on day 1 and 40 mg of dexamethasone on days 1-4.
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A 57-year-old, postmenopausal African American schoolteacher was found by annual screening mammogram to have a suspicious irregularity. Follow-up ultrasound did not reveal cystic disease so a repeat "spot" mammogram-assisted biopsy was obtained and a grade 1 invasive ductal carcinoma with tubular elements was found.
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In a retrospective review, delay beyond 60 days in initiating adjuvant chemotherapy after surgery for colorectal cancer was associated with poorer overall survival. Although factors such as surgical complications or the existence of comorbidities may explain the delays for some of the cases, other "administrative" factors, such as delays resulting from insurance authorizations or referral setbacks, are to be avoided, if at all possible.