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Thursday, October 27, 2011

One Man at a Time — Resolving the PSA Controversy — NEJM

One Man at a Time — Resolving the PSA Controversy — NEJM

Excerpt (follow link above for article):

"Our perspective is that this evidence of a possible small but finite benefit from the largest trial would best support a grade C recommendation for men 55 to 69 years of age. With a grade C recommendation, the task force would be recommending “against routinely providing the service” while indicating that “there may be considerations that support providing the service in an individual patient” and stipulating that “there would need to be at least moderate certainty that the net benefit is small.” The task force's suggestions for practice in the case of a grade C recommendation include the suggestion that they “offer/provide this service only if other considerations support offering or providing the service in an individual patient.”

A grade C recommendation would allow the patient to be involved in the decision to skip or choose a PSA screening test, after a discussion with a primary care provider about the magnitude of the known harms and the potential for some benefit. The patient could then provide his perspective on how he views the trade-off. Weighing the pros and cons to make a decision about PSA screening is an individual process, and different well-informed men will make different decisions."

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Single Nucleotide Polymorphism Associations With Response and Toxic Effects in Patients With Advanced Renal-Cell Carcinoma Treated With First-Line Sunitinib: A Multicentre, Observational, Prospective Study - OncologySTAT

Single Nucleotide Polymorphism Associations With Response and Toxic Effects in Patients With Advanced Renal-Cell Carcinoma Treated With First-Line Sunitinib: A Multicentre, Observational, Prospective Study - OncologySTAT

Excerpt: (for full story follow above link; may require login/registration which is free)

Abstract

Background: Sunitinib is a tyrosine kinase inhibitor with proven efficacy in renal-cell carcinoma, but some patients do not respond or need dose reductions due to toxicity. Because there are no validated molecular predictors of response or toxicity to sunitinib, we aimed to identify genetic markers predictive of outcome and toxic effects.

Findings: We enrolled 101 patients between Oct 10, 2007, and Dec 13, 2010. 95 of these patients were included in toxicity analyses and 89 in the efficacy analyses. Two VEGFR3 missense polymorphisms were associated with reduced PFS with sunitinib on multivariable analysis: rs307826 (hazard ratio [HR] per allele 3·57, 1·75—7·30; p unadjusted=0·00049, p adjusted=0·0079) and rs307821 (3·31, 1·64—6·68; p unadjusted=0·00085, p adjusted=0·014). The CYP3A5*1 (rs776746) high metabolising allele was associated in a multivariable analysis with an increased risk of dose reductions due to toxicity (HR per allele 3·75, 1·67—8·41; p unadjusted=0·0014, p adjusted=0·022). No other SNPs were associated with sunitinib response or toxicity.

Interpretation: Polymorphisms in VEGFR3 and CYP3A5*1 might be able to define a subset of patients with renal-cell carcinoma with decreased sunitinib response and tolerability. If confirmed, these results should promote interventional studies testing alternative therapeutic approaches for patients with such variants.

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Saturday, October 22, 2011

Study Finds No Cell Phone-Brain Cancer Link - in Oncology/Hematology, Brain Cancer from MedPage Today

Medical News: Study Finds No Cell Phone-Brain Cancer Link - in Oncology/Hematology, Brain Cancer from MedPage Today: "Action Points:


*Explain that an updated Danish study found that there was no association between central nervous system tumors and subscription to a mobile phone service.


*Point out that there also were no associations between central nervous system tumors and mobile phone use when assessed by length of subscription or tumor type."

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Medical News: ECTRIMS: Cancer Drug Wins in Early MS Trial - in Meeting Coverage, ECTRIMS from MedPage Today

Medical News: ECTRIMS: Cancer Drug Wins in Early MS Trial - in Meeting Coverage, ECTRIMS from MedPage Today:


"Action Points:

*Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.


*Explain that a low-dose regimen of the leukemia drug alemtuzumab (Lemtrada) decreased annualized relapse rates in patients with newly diagnosed multiple sclerosis compared with interferon-beta-1a (Rebif).


*Note that alemtuzumab was no better than interferon in the other primary outcome measure, the proportion of patients showing sustained six-month accumulation of disability."

'via Blog this'

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Wednesday, October 19, 2011

Cochrane Review: Hormonal therapy in advanced or recurrent endometrial cancer

Wiley Online Library: Book Abstract

Cochrane Review: (December 2010)
{Follow link above for full review}

Author's Conclusion:

"We found insufficient evidence that hormonal treatment in any form, dose or as part of combination therapy improves the survival of patients with advanced or recurrent endometrial cancer. However, a large number of patients would be needed to demonstrate an effect on survival and none of the included RCTs had a sufficient number of patients to demonstrate a significant difference. In the absence of a proven survival advantage and the heterogeneity of patient populations, the decision to use any type of hormonal therapy should be individualised and with the intent to palliate the disease. It is debatable whether outcomes such as quality of life, treatment response or palliative measures such as relieving symptoms should take preference over overall and PFS as the major objectives of future trials."

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Saturday, October 15, 2011

Vitamin Studies Spell Confusion for Patients - in Primary Care, Diet & Nutrition from MedPage Today

Medical News: Vitamin Studies Spell Confusion for Patients - in Primary Care, Diet & Nutrition from MedPage Today: "If it's Monday, it must be bad news about multivitamin day -- or was that Wednesday? No, Wednesday was good news about vitamin D, not so good news about vitamin E -- if you're confused, join the club.

The alphabet soup of vitamin studies making headlines in the last few weeks has left more than one head spinning, and most clinicians scrambling for answers.

As the dust begins to settle, physicians interviewed by MedPage Today and ABC News agreed on a bit of simple wisdom -- a healthy diet is more important than a fistful of supplements."

'via Blog this'

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Friday, October 7, 2011

Angiogenesis: A prognostic determinant in pancreatic cancer?

Angiogenesis: A prognostic determinant in pancreatic cancer?

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Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

Journal of Palliative Medicine - Table of Contents

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