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  • Denosumab vs Zoledronic Acid for Patients with Prostatic Bone Metastases

    In a Phase 3 trial comparing the recently introduced monoclonal antibody denosumab with zoledronic acid for the treatment of patients with prostate cancer metastatic to bone, the incidence of skeletal events including pathological fracture, radiation, skeletal surgery, or cord compression was delayed on average by more than 3 months for those treated with denosumab. Adverse events were comparable. Denosumab is administered subcutaneously and can be given to patients with renal insufficiency. Clinicians have become familiar with zoledronic acid in this setting, and it remains unclear whether its role as the standard approach will be supplanted.
  • Quality of Life to Predict Outcome for Older AML

    Investigators prospectively assessed quality of life in newly diagnosed AML patients 60 years and older using the EORTC QLC-C30 and QOL-E surveys. Among the 113 patients enrolled, 42.4% underwent intensive induction chemotherapy and 57.6% received palliative treatment. Self-rated quality of life did not correlate with physician-rated performance status or induction chemotherapy. Lower self-report functional status predicted higher mortality, even after adjusting for age, treatment, and comorbidity. Patient-reported quality of life may be an independent prognostic factor for AML outcomes.
  • Clinical Briefs in Primary Care Supplement

  • Disseminated Prostate Cancer

    A 51-year-old man, a foreman for a local construction business, presented to the emergency department with progressive lower back pain of 2 weeks duration and shortness of breath. Initially mild, the pain had become incapacitating within the prior 48 hours.
  • Pharmacology Watch

    Calcium supplements and MI; birth control pills and VTE; ACE inhibitors and breast cancer risk; spending on pharmaceuticals; and FDA actions.
  • Radiofrequency Ablation for Primary and Secondary Malignancy in the Lung

    Patients with localized but non-resectable lung cancer generally are considered candidates for other types of therapy including external beam or stereotactic radiation therapy, chemotherapy, or percutaneous ablation.
  • Pharmacology Watch

    Anticholinergic drugs for COPD; pioglitazone for diabetes prevention; insulin degludec in Phase 3 trials; and FDA Actions.
  • Clinical Briefs in Primary Care Supplement

  • Gall Bladder Cancer

    A 71-year-old retired police officer was admitted through the emergency room with right upper quadrant pain and low-grade fever.
  • Transplant vs Imatinib for Accelerated Phase CML

    Limited data are available to guide the decision between up-front allogeneic hematopoietic cell transplantation (HCT) or imatinib on long-term outcomes for accelerated phase chronic myelogenous leukemia (CML).