Benefit Of Aspirin For Healthy People Is Uncertain
May 31, 2009
Researchers say the benefits of taking asprin don’t outweigh the risks
A new study has shown that, while taking aspirin is beneficial in preventing heart attacks and strokes among people with established cardiovascular disease (secondary prevention), its benefits don’t clearly outweigh the risks in healthy people (primary prevention).
Researchers at the Clinical Trial Service Unit at the University of Oxford analysed data from a number of primary and secondary prevention trials that had compared long-term aspirin use against controls. The findings are published in The Lancet.
In the primary prevention trials, aspirin reduced the risk of a non-fatal heart attack by about one fifth. This corresponds to five fewer such episodes each year for every 10,000 people treated. This is offset by a comparable increase in bleeds with long-term aspirin use. One extra stroke is caused by bleeding and three extra gastrointestinal bleeds occur each year per 10,000 treated.
Two-Drug Combination Appears Safe and Active in Metastatic Kidney Cancer
May 31, 2009
Fox Chase Cancer Center investigators report that a two-drug blockade of mTOR signaling appears safe in metastatic kidney cancer in a phase I trial. Early data suggests that a combination of temsirolimus and bryostatin may be active in patients with rare forms of renal cell cancer, which are less likely to respond to other targeted therapies.
Elizabeth Plimack, MD, MS, a medical oncologist and attending physician at Fox Chase will report the trial results on Sunday, May 31 at the annual meeting of the American Society of Clinical Oncology.
“We have certainly seen sustained responses with this combination which are encouraging,” Plimack says.
One of the patients with an extended response has papillary renal cell cancer, which is a rare form of the disease that does not respond well to standard therapies. “Patients with non-clear cell renal cell cancer, including papillary renal cancer, don’t respond as well to tyrosine kinase inhibitors, such as sunitinib and sorafenib, as patients with clear cell renal cell. So there is an unmet need for therapy for these patients. We’ve seen that this combination may be active to some degree for them.”
Study Shows Drug Combination Improves Outcome for Advanced Non-Small Cell Lung Cancer
May 30, 2009
A new, international study found that the combination of two drugs delays disease progression for patients with advanced non-small cell lung cancer (NSCLC). Results from the Phase III “ATLAS” trial were presented today by Dr. Vincent Miller of Memorial Sloan-Kettering Cancer Center (MSKCC) at the American Society of Clinical Oncology Annual Meeting.
The goal of the study was to determine whether adding erlotinib (Tarceva®), a targeted agent, to maintenance therapy with bevacizumab (Avastin®), an agent commonly used as a component of treatment for advanced NSCLC would delay disease progression. Maintenance therapy involves using one or more agents of a chemotherapy regimen, but not the entire regimen, to delay disease progression and possibly improve survival after patients have previously received stronger standard chemotherapy, which can have significant side effects.
In total, 768 patients were randomized to receive bevacizumab plus erlotinib or bevacizumab plus placebo after initial cytotoxic chemotherapy with bevacizumab. There was a 29 percent reduction in the risk of progression for those patients treated with erlotinib, and the median progression-free survival (the time it took for the cancer to get worse) was 4.8 months for the combination versus 3.7 months for the bevacizumab-placebo group. Because a statistically significant improvement in efficacy was found in the erlotinib group, the trial was stopped early. The combination was also found to be safe and well tolerated.
Cottonseed-Based Drug Shows Promise Treating Severe Brain Cancer
May 28, 2009
An experimental drug derived from cottonseeds shows promise in treating the recurrence of glioblastoma multiforme, widely considered the most lethal brain cancer, said researchers at the University of Alabama at Birmingham (UAB).
The new results are from a Phase II clinical trial of AT-101, a pill manufactured from a potent compound in cottonseeds that overcomes the abnormal growth patterns of tumor cells. This cottonseed-based agent must be properly dosed and monitored by physicians.
In clinical tests, AT-101 halted the cancer’s progression in many of the 56 patients, said John Fiveash, M.D., an associate professor in the UAB Department of Radiation Oncology and the lead researcher on the new study.
Despite undergoing other treatments, including surgery, chemotherapy and radiation, the trial patients’ brain cancer had begun to grow again prior to starting AT-101 treatments. The trial-monitored patients took only AT-101 daily for three out of four weeks. Glioblastomas are more common in adults and are considered fast-growing brain tumors that are very difficult to treat, Fiveash said.
Discovery May Lead To New Antibiotic
May 28, 2009
As superbugs become increasingly resistant to the best drugs, McMaster University researchers have discovered a completely different way of looking for a new antibiotic.
In a paper to be published in tomorrow’s (May 29) Chemistry and Biology journal, with colleagues in Germany and at Wilfrid Laurier University, they report on work with the bacteria Staphylococcus aureus, the leading cause of infections in hospitals and the second most common community-acquired infection. Fewer and fewer antibiotics are effective against this bacteria.
Cell wall-active antibiotics, such as penicillin, kill bacteria by blocking production of the cell wall.
Dementia Drugs May Put Some Patients At Risk
May 28, 2009
Side effects associated with several commonly-prescribed dementia drugs may be putting elderly Canadians at risk, says Queen’s University Geriatrics professor Sudeep Gill.
Cholinesterase inhibitors (Aricept, Exelon and Reminyl) are often prescribed for people with Alzheimer’s disease and related dementias because they increase the level of a chemical in the brain that seems to help memory. Although such drugs are known to provoke slower heart rates and fainting episodes, the magnitude of these risks has not been clear until now.
“This is very troubling, because the drugs are marketed as helping to preserve memory and improve function,” says Dr. Gill, who is an Ontario Ministry of Health and Long-term Care Career Scientist, working at Providence Care’s St. Mary’s of the Lake Hospital in Kingston. “But for a subset of people, the effect appears to be the exact opposite.”
Can We Afford the Cancer Care of the Future?
May 27, 2009
When a cancer patient and his or her doctor discuss the value of a treatment option, the conversation usually centers on a consideration of the treatment’s medical benefits versus its possible side effects for the patient. Increasingly, however, as the already high costs of cancer care continue to rise, a full view of the patient’s welfare must also take into account the economic impact of the treatment on the patient and his or her family.
Additionally, beyond its clear impact on patients, the increasing cost of cancer care also presents challenges to other stakeholders involved in the development and delivery of care.
“Cancer care is one of the most expensive areas of health care today, and the cost of that care is increasing steadily, for patients and for society as a whole,” says Neal J. Meropol, MD, director of the gastrointestinal cancer and gastrointestinal tumor risk assessment programs at Fox Chase Cancer Center. Meropol, who is also a member of the American Society of Clinical Oncology (ASCO) Cost of Care Task Force and lead author on the upcoming ASCO Guidance Statement on the Cost of Cancer Care, offered his analysis of the problem in a talk presented at the ASCO annual meeting in Orlando today.
Diabetes Drug Shows Promise Against Multiple Sclerosis
May 27, 2009
A drug currently FDA-approved for use in diabetes shows some protective effects in the brains of patients with relapsing remitting multiple sclerosis, researchers at the University of Illinois at Chicago College of Medicine report in a study currently available online in the Journal of Neuroimmunology.
In a small, double-blinded clinical trial, patients with relapsing remitting multiple sclerosis were assigned to take pioglitazone (a drug commercially known as Actos used to treat type-2 diabetes) or a placebo. Patients continued their normal course of therapy during the trial.
Standard neurological tests were done initially, as were MRI scans to provide baseline values for lesions typically seen in MS patients. The patients were evaluated every two months, and blood samples were taken. Repeat MRI scans were done after five months and again after one year.
Patients taking pioglitazone showed significantly less loss of gray matter over the course of the one-year trial than patients taking placebo. Of the 21 patients who finished the study, patients taking pioglitazone had no adverse reactions and, further, found taking pioglitazone, which is administered in an oral tablet, easy.
Green Tea Extract Shows Promise in Leukemia Trials
May 27, 2009
Mayo Clinic researchers are reporting positive results in early leukemia clinical trials using the chemical epigallocatechin gallate (EGCG), an active ingredient in green tea. The trial determined that patients with chronic lymphocytic leukemia (CLL) can tolerate the chemical fairly well when high doses are administered in capsule form and that lymphocyte count was reduced in one-third of participants. The findings appear today online in the Journal of Clinical Oncology.
“We found not only that patients tolerated the green tea extract at very high doses, but that many of them saw regression to some degree of their chronic lymphocytic leukemia,” says Tait Shanafelt, M.D., Mayo Clinic hematologist and lead author of the study. “The majority of individuals who entered the study with enlarged lymph nodes saw a 50 percent or greater decline in their lymph node size.”
CLL is the most common subtype of leukemia in the United States. Currently it has no cure. Blood tests have enabled early diagnosis in many instances; however, treatment consists of watchful waiting until the disease progresses. Statistics show that about half of patients with early stage diseases have an aggressive form of CLL that leads to early death. Researchers hope that EGCG can stabilize CLL for early stage patients or perhaps improve the effectiveness of treatment when combined with other therapies.
Less Toxic Drug Prolongs Survival in Metastatic Breast Cancer
May 27, 2009
Research from the Northwestern University Feinberg School of Medicine has found that a less toxic, solvent-free chemotherapy drug more effectively prevents the progression of metastatic breast cancer and has fewer side effects than a commonly used solvent-based drug.
A national study led by William Gradishar, M.D., director of breast medical oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, found that the drug Abraxane prolonged progression-free survival by almost seven months compared with Taxotere, which is part of a class of solvent-based drugs called taxanes.
“It nearly doubled progression-free survival,” said Gradishar, who also is a professor of medicine at Northwestern’s Feinberg School and a physician at Northwestern Memorial Hospital.
The study will be published May 26 in the Journal of Clinical Oncology.