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Study spells end for high-dose dex in first-line myeloma pts
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In newly diagnosed multiple myeloma patients, lenalidomide (Revlimid) plus low-dose dexamethasone led to superior overall survival, compared with the standard regimen of lenalidomide plus high-dose dexamethasone
Source: ConsultantLive - March 1, 2008 Category: Internal Medicine Source Type: news
Umbilical cord blood transplant alternative for older ptsEmail this article to a colleague.
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While reduced-intensity conditioning allows hematopoietic stem cell transplant (HSCT) in older cancer patients who cannot tolerate standard conditioning regimens, only about one-third of such patients have an HLA-matched related donor available. For these patients, stem cells derived from unrelated umbilical cord blood (UCB) may provide a suitable and convenient alternative
Source: ConsultantLive - March 1, 2008 Category: Internal Medicine Source Type: news
Frontline alemtuzumab promising for high-risk CLL ptsEmail this article to a colleague.
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A novel frontline regimen has shown efficacy in high-risk patients with chronic lymphocytic leukemia, with no significant increase in hematologic toxicity, compared with historical data on the standard regimen
Source: ConsultantLive - February 29, 2008 Category: Internal Medicine Source Type: news
Stage set for further trials of rIL-2 in younger AML ptsEmail this article to a colleague.
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Preliminary results suggest that immunotherapy with recombinant interleukin-2 (rIL-2) may prolong survival in younger patients with acute myeloid leukemia in first remission. However, the high rate of refusal or discontinuation of such therapy presents challenges for its acceptance
Source: ConsultantLive - February 29, 2008 Category: Internal Medicine Source Type: news
VTD induction boosts CRs in newly diagnosed myelomaEmail this article to a colleague.
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;In patients with newly diagnosed multiple myeloma, the addition of bortezomib (Velcade) to thalidomide (Thalomid) and dexamethasone significantly increased response rates, compared with thalidomide plus dexamethasone alone, when used as induction therapy prior to autologous stem cell transplant (ASCT
Source: ConsultantLive - February 29, 2008 Category: Internal Medicine Source Type: news
Inaccurate lab reports put breast cancer patients at riskEmail this article to a colleague.
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Studies show that thousands of women may be receiving the wrong breast cancer treatment because of faulty laboratory reports. More disturbing, this trend was identified years ago. A 2006 study led by Genentech found 14% to 16% of HER2 tests were false positive and 18% to 23% were false negative.
Source: ConsultantLive - February 29, 2008 Category: Internal Medicine Source Type: news
Large adjuvant trial shows no benefit of adding a taxaneEmail this article to a colleague.
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Sequential docetaxel (Taxotere)-based chemotherapy did not lead to better outcomes than standard anthracycline-based chemotherapy among women with resected breast cancer in the Taxotere as Adjuvant Chemotherapy Trial (TACT), the largest primary adjuvant trial of taxanes to date.
Source: ConsultantLive - February 29, 2008 Category: Internal Medicine Source Type: news
Sequential Rx effective, less toxic in metastatic breast caEmail this article to a colleague.
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As first-line treatment for metastatic breast cancer in HER2-positive patients, trastuzumab (Herceptin) can be given as a single agent, followed by docetaxel (Taxotere) upon progression, without compromising time to recurrence and providing a better toxicity profile
Source: ConsultantLive - February 28, 2008 Category: Internal Medicine Source Type: news
Assay has high sensitivity for hard-to-detect SLN metsEmail this article to a colleague.
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A rapid molecular assay outperforms frozen sections when it comes to detecting breast cancer metastases in sentinel lymph nodes (SLNs), new data show. Moreover, the assay tends to perform better in cases where detection of metastases by frozen section is known to be difficult, such as cases of lobular carcinoma.
Source: ConsultantLive - February 28, 2008 Category: Internal Medicine Source Type: news
Good nilotinib responses in imatinib-resistant AP-CMLEmail this article to a colleague.
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Among Ph+ chronic myelogenous leukemia patients in accelerated phase with imatinib (Gleevec) resistance or intolerance, treatment with nilotinib (Tasigna) rapidly produced significant responses and was generally well tolerated in an open-label pivotal phase II study
Source: ConsultantLive - February 28, 2008 Category: Internal Medicine Source Type: news
Mutational status affects nilotinib responses in CP-CMLEmail this article to a colleague.
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In a significant proportion of imatinib (Gleevec)-resistant chronic-phase chronic myelogenous leukemia patients with Bcr-Abl mutations, nilotinib (Tasigna) treatment results in hematologic, cytogenetic, and molecular responses
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Rituximab effective in first-line CLLEmail this article to a colleague.
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In a pivotal phase III study, rituximab (Rituxan) in combination with standard chemotherapy significantly increased time to progression in patients with previously untreated chronic lymphocytic leukemia
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Whole body staging can miss melanoma and lung metsEmail this article to a colleague.
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In a surprising discovery, reported at RSNA 2007, researchers from Germany have found that whole-body staging of patients with recently diagnosed malignant melanoma using either MRI or PET/CT could miss a substantial number of metastatic lesions
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Are HBV and HPV infection only the tip of the iceberg?Email this article to a colleague.
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Modern medicine has made most infectious diseases of bacterial origin easily managed. However, research has shown that chronic infections caused by a handful of viruses, bacteria, and parasites play a significant role in the development of certain cancers.
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Virus linked to Merkel cell carcinomaEmail this article to a colleague.
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University of Pittsburgh Cancer Institute researchers have discovered a previously unknown virus strongly associated with Merkel cell carcinoma, a rare but aggressive skin cancer that typically affects elderly and immunosuppressed individuals
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
FDA approves new adjuvant indication for HerceptinEmail this article to a colleague.
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The FDA has approved a new indication for Genentech's Herceptin (trastuzumab) as a single agent for the adjuvant treatment of HER2-overexpressing, node-negative (ER/PR-negative or with one high-risk feature) or node-positive breast cancer, following multimodality anthracycline-based therapy.
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
FDA reviewing sBLA for Pegintron for melanomaEmail this article to a colleague.
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Schering-Plough Corporation has announced that FDA has granted priority review to its supplemental Biologics License Application for Pegintron (pegylated interferon alfa-2b) as adjuvant therapy for patients with stage III melanoma.
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
M.D. Anderson and AstraZeneca form neuropathic pain allianceEmail this article to a colleague.
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M.D. Anderson Cancer Center and AstraZeneca will collaborate to help advance the understanding of neuropathic pain caused by cancer chemotherapy.
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Kosan opens TIME-1 pivotal trial of tanespimycin in myelomaEmail this article to a colleague.
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Kosan Biosciences Incorporated has announced that the Tanespimycin in Myeloma Evaluation (TIME-1) pivotal phase III trial for its Hsp90 inhibitor tanespimycin as a potential treatment for multiple myeloma is open for enrollment
Source: ConsultantLive - February 27, 2008 Category: Internal Medicine Source Type: news
Exelixis/BMS to develop XL139, hedgehog pathway inhibitorEmail this article to a colleague.
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Exelixis, Inc. and Bristol-Myers Squibb Company will collaborate to co-develop and co-commercialize Exelixis' compound XL139, a small molecule inhibitor of the hedgehog pathway, in the United States.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Five-SNP test may predict the risk of prostate cancerEmail this article to a colleague.
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In a group of 2,893 Swedish men with prostate cancer, five gene variants plus family history accounted for 46% of cases
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Minimally invasive methods accurately stage lung cancerEmail this article to a colleague.
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Two minimally invasive staging methods used together may be an accurate substitute for mediastinoscopy for some lung cancer patients with suspected metastatic mediastinal lymph nodes
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
MRI shows second-hand smoke damageEmail this article to a colleague.
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A new MRI technique—inhaled hyperpolarized helium-3 diffusion MRI—shows lung damage in nonsmokers exposed to second-hand smoke
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Dasatinib effective in imatinib resistant/intolerant CMLEmail this article to a colleague.
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Study results presented at ASH 2007 showed efficacy of the novel tyrosine kinase inhibitor dasatinib (Sprycel) in imatinib (Gleevec) resistant or intolerant chronic myelogenous leukemia patients in chronic, accelerated, and blast phase
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Study ends adjuvant controversy?Email this article to a colleague.
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Overall survival after pancreatic resection can be markedly improved with adjuvant chemoradiation therapy, according to investigative groups who presented encouraging data on two different regimens at the 2008 Gastrointestinal Cancers Symposium.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Diagnostic Dilemma: DermatologyEmail this article to a colleague.
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A 31-year-old man presented in May 2007 with generalized painful, ulcerated, and necrotic papules and plaques worsening for the last few months. He had been diagnosed with mycosis fungoides in October 2005. Treatments included topical corticosteroids and psoralen with ultraviolet A light therapy (PUVA), with the latter being discontinued because of the development of blisters. For the last 6 months, he had been treated with oral bexarotene (Targretin), with initial improvement of his skin lesions.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Danish researchers claim possible 'cure' of MCLEmail this article to a colleague.
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Use of intensive immunochemotherapy plus purged stem-cell support can result in long-term survival in patients with mantle cell lymphoma, suggesting that MCL could be considered as curable. Christian Geisler, MD, PhD, of Rigshospitalet, Copenhagen, Denmark, presented this provocative idea, based on final results of the MCL2 study, at ASH 2007 (abstract LB1), speaking on behalf of the Nordic Lymphoma Group.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Study may answer critics' fears about preop breast MRIEmail this article to a colleague.
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Greater utilization of dynamic contrast-enhanced MRI at the University of California, San Diego, over a 6-year period helped improve surgery planning for tough breast cancer cases without hiking mastectomy rates
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
For resectable liver mets: Preop chemotherapy or not?Email this article to a colleague.
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When colorectal cancer metastasizes to the liver, hepatic resection can offer a survival benefit and even a "cure" in a fraction of patients. Five-year overall survival in some recent series approaches 60%. But the role of neoadjuvant chemotherapy in this group of patients has not been well established
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Plerixafor boosts stem cell mobilization in myeloma ptsEmail this article to a colleague.
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Patients with multiple myeloma are more likely to mobilize sufficient numbers of hematopoietic stem cells (HSCs) when plerixafor (AMD3100) is given with G-CSF (Neupogen) than with G-CSF alone.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
New machine approved for adaptive RTEmail this article to a colleague.
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Siemens Medical Solutions announced it has received FDA 510(k) marketing clearance for its ARTISTE Solution, a linear accelerator engineered specifically for Adaptive Radiation Therapy (ART).
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Making faster, better, more cost-effective clinical trialsEmail this article to a colleague.
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Over the past few years, the number of new cancer drugs approved by FDA has been dwindling. Critics generally cite exorbitant costs, lack of accrual to trials, conflicts of interest, and government regulations as the primary reasons for the dearth of new molecular compounds.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
ACCC views 2008 as a year of economic challengesEmail this article to a colleague.
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Since the passage of the Medicare Modernization Act of 2003, community cancer centers around the country have been struggling to balance the delivery of optimum care with an ever-tightening reimbursement climate. Cancer Care & Economics (CC&E) talked with the Association of Community Cancer Centers (ACCC) Manager of Provider Economics & Public Policy, Matthew Farber, MA, about the challenges of the upcoming year.
Source: ConsultantLive - February 25, 2008 Category: Internal Medicine Source Type: news
Masters of hematology/oncology ONI sits down with Dr. Vincent DeVitaEmail this article to a colleague.
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As a young boy, Vincent DeVita dissected frogs on the front steps of his parents' house in Yonkers. In the eyes of his encouraging mother, he was already a budding physician fascinated by the internal complications of life.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
A bold proposal to streamline clinical trialsEmail this article to a colleague.
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If therapeutic agents are documented to be more effective than standard therapies in the advanced breast cancer setting, they will also be effective in the adjuvant setting. This renders randomized phase III adjuvant trials unnecessary in many cases, and means that undue delays in moving new agents up-front are costing lives
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
NLST article not balanced, critic of screening trial assertsEmail this article to a colleague.
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"Researchers defend NLST protocol against its critics" (ONI, January 2008, page 14) quoted three individuals in the United States who strongly support the NLST [National Lung Screening Trial] and no one on the other side of the issue.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
ONI remembers Judah Folkman, founder of angiogenesisEmail this article to a colleague.
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On January 14, Dr. Judah Folkman, founder of the field of angiogenesis, died unexpectedly at age 74 in Denver, while en route to Vancouver for a lecture. Dr. Folkman was founder and director of the Vascular Biology Program at Children's Hospital, Boston, and professor of pediatric surgery and cell biology at Harvard.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
FDA approves IV antiemetic Emend for chemo patientsEmail this article to a colleague.
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A new formulation of Emend has entered oncology's antiemetic armamentarium. Emend (fosaprepitant dimeglumine, Merck) for Injection received US Food and Drug Administration approval in late January for use in combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with initial and repeated courses of moderate- or high-emetogenic chemotherapies, including high-dose cisplatin.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
ONI names four deputy editors to advisory boardEmail this article to a colleague.
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Oncology News International has named four deputy editors to its editorial advisory team, Editor-in-Chief Steven Rosen, MD, announced. The new deputy editors represent a spectrum of interests, including genitourinary and breast tumors, surgical oncology, and radiation oncology. Monica Bertagnolli, MD, Derek Raghavan, MD, PhD; Andrew D. Seidman, MD; Joel Tepper, MD, a radiation oncologist and professor at the University of North Carolina School of Medicine. He is a former president and chairman of the board for ASTRO and currently sits on the board of directors for ASCO.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
Rheumatoid Arthritis: Treatment of Newly Diagnosed DiseaseEmail this article to a colleague.
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NSAIDs help control the pain and inflammation of rheumatoid arthritis (RA) but do not affect disease progression; they are recommended for patients with newly diagnosed RA only as an adjunct to disease-modifying antirheumatic drug (DMARD) therapy.
Source: ConsultantLive - February 24, 2008 Category: Internal Medicine Source Type: news
Renal Infarction: An Unusual Complication of Cocaine AbuseEmail this article to a colleague.
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A 63-year-old African American man presented with severe epigastric pain of 1 day's duration. The pain was sharp and continuous and radiated toward the left flank. There were no aggravating or relieving factors or previous similar episodes.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
A Photo Quiz to Hone Dermatologic SkillsEmail this article to a colleague.
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Dermclinic
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
SSRIs and Triptans: Safe as Combination Therapy?Email this article to a colleague.
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Depression was diagnosed 6 years earlier in a 37-year-old woman; it has been successfully managed since then with fluoxetine and outpatient psychotherapy. Since her teenage years, the patient has also experienced sporadic (fewer than 3 or 4 per year) mild or occasionally severe headaches, which she has usually self-treated with over-thecounter (OTC) agents or "just slept off."
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
WIN-R Is Winning as New Protocol for Hepatitis CEmail this article to a colleague.
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Several recent studies from Europe and the United States confirm that tailoring the dosage and duration of pegylated interferon alfa 2b and ribavirin therapy can optimize treatment of hepatitis C virus (HCV) infection.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
Latest Guidelines on Community-Acquired Pneumonia: Part 2, Empirical TherapyEmail this article to a colleague.
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New guidelines for community-acquired pneumonia (CAP) issued jointly by the Infectious Diseases Society of America and the American Thoracic Society emphasize the need for communities to adapt the recommendations to local conditions.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
Middle-Aged Woman With Epistaxis, Facial Pain and Swelling, and OtalgiaEmail this article to a colleague.
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For 2 weeks, a 49-year-old woman has had mild, intermittent epistaxis with left-sided facial pain, swelling, and otalgia; the severity of the bleeding has increased during the past 24 hours. She also has congestion of the left naris of 1 month's duration.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
Woman With Edema, Vomiting, and DiarrheaEmail this article to a colleague.
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A 22-year-old woman has had chronic nausea, emesis with green vomitus, and diarrhea for the past 10 months. The diarrhea is frequent (about 3 to 8 times daily) and does not resolve with starvation.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
End-of-Life Discussions: The Art of Delivering Bad NewsEmail this article to a colleague.
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An 84-year-old woman with progressive stenosis of the cervical spinal canal, type 2 diabetes mellitus, hyperlipidemia, gastroesophageal reflux disease, hypertension, and stable angina presents to her primary care physician after an appointment with the orthopedist who is monitoring her chronic degenerative joint disease.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
Might Rare Familial Cancer Syndrome Be Cause of Cold and Flushing?Email this article to a colleague.
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The recent "Consultations & Comments" exchange titled "What Cause of Cold and Flushing in a Basketball Player?" (CONSULTANT, November 2007) attracted my attention.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
Ruptured Abdominal Aortic AneurysmEmail this article to a colleague.
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An obese 61-year-old man with a history of heroin abuse was brought to the hospital after he had fallen onto his buttocks on a sidewalk.
Source: ConsultantLive - February 15, 2008 Category: Internal Medicine Source Type: news
