– September 1, 2012
September 1, 2012
View Archives Issues
-
Finally, Demonstrable Improvement in Remission Induction for Adult Acute Myelogenous Leukemia
A multi-institutional study examined the addition of a purine analog, either cladribine or fludarabine, to the standard induction regimen ("7 & 3") in adult patients 60 years of age and younger with acute myelogenous leukemia, and found improved outcomes for those receiving cladribine. The added benefit from cladribine appears to be the result of a reduction in the incidence of resistant disease. The study arm containing cladribine, daunorubicin, and cytaribine yielded an overall survival at 3 years of 45% while conventional "7 & 3" therapy was only 33% at 3 years. Cladribine added to daunorubicin and cytarabine during remission induction improves leukemia control and patient survival for those 60 years of age and younger. -
Adjuvant Management of Uterine Leiomyosarcoma
A 78-year-old female had been generally well with no known chronic medical conditions and was taking no medications when she presented to her primary care physician with lower abdominal pain and urinary frequency of one month's duration. Physical examination at the time revealed a well-appearing woman with normal vital signs and no abnormal physical findings except a palpably enlarged uterus by bimanual pelvic examination. CT scan confirmed the presence of a uterine mass suspicious for malignancy. She was referred to a gynecologic oncologist and had a total abdominal hysterectomy and salpingo-oophorectomy with partial infracolic omentectomy and pelvic debulking of what appeared to be a large (15 cm) tumor mass. Final pathology was high-grade leiomyosarcoma with microscopic invasion of the colon and bladder. -
Adjuvant Chemotherapy for Older Patients
Four large data sets were analyzed to evaluate the effect of adjuvant treatment on survival in patients with stage III colon cancer diagnosed after age 75. While adjuvant chemotherapy was associated with a survival benefit, oxaliplatin-based regimens offered no more than a small incremental benefit over non-oxaliplatin-containing regimens. -
Pemetrexed in the Treatment of Relapsed/Refractory Primary Central Nervous System Lymphoma
In this Phase 2 trial, 11 patients with relapsed/refractory primary central nervous system lymphoma after high-dose, methotrexate-based regimen were treated with pemetrexed 900 mg/m2 every 3 weeks, dexamethasone 4 mg bid, folate, and B12 supplementation. The treatment had an overall response rate of 55%, disease control rate of 91%, median progression free survival of 5.7 months, and median overall survival of 10.1 months. Toxicities were more than expected with the standard pemetrexed dose (500 mg/m2) and were primarily hematologic and infectious, which were easily managed. Although single-agent activity of pemetrexed in this study is novel and promising, optimal dosing and efficacy need to be studied further. -
Dietary Lignan Intake and Breast Cancer Risk
In this case-control study, dietary lignan intake was inversely associated with risk of breast cancer in both premenopausal and postmenopausal women. Also noted were more favorable prognostic characteristics associated with lignan intake, especially in premenopausal women. -
Pharmacology Watch: Does Finasteride Cause Permanent Sexual Side Effects?
Side effects of finasteride; new ruling on pharmaceutical companies paying generic manufacturers; and FDA actions. -
Clinical Briefs in Primary Care Supplement