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Rectal Cancer - Stage IV
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Vectibix® plus Chemotherapy Improves Progression-free Survival After Initial Treatment of Metastatic Colorectal Cancer (9/30/2009)
Researchers involved in the international randomized trial, PRIME, have reported that the addition of Vectibix® (panitumumab) to FOLFOX4 chemotherapy improves progression-free survival (PFS) compared with FOLFOX4 alone in patients with previously untreated metastatic colorectal cancer. This benefit was only observed in patients whose tumors did not contain a mutation in the KRAS gene (those with wild type). These results were presented at the Joint ECCO 15 -34th ESMO Multidisciplinary Congress in Berlin, September 20-24, 2009.
Vectibix® Improves PFS in Second-line Therapy of Colorectal Cancer with FOLFIRI (9/23/2009)
Researchers involved in an international randomized trial have reported that the addition of Vectibix® (panitumumab) to FOLFIRI (5-fluorourcil, Camptosar® [irinotecan], and leucovorin) improves progression-free survival (PFS) in patients with colorectal cancer with wild-type KRAS receiving second-line therapy. The details of this study were presented at the Joint ECCO 15-34th ESMO Congress in Berlin, September 20-24.
Addition of Vectibix® to Second-line Chemotherapy Improves Progression-free Survival in Metastatic Colorectal Cancer (8/27/2009)
A press release from Amgen has reported that patients with previously treated metastatic colorectal cancer with KRAS wild-type have delayed cancer progression following treatment with Vectibix® (panitumumab) and chemotherapy.
FDG-PET Scans Reduce Number of Futile Surgeries for Hepatic Colorectal Metastases (8/25/2009)
Researchers from the Netherlands have reported that the use 18F-FDG PET scans reduced the number of futile surgeries for hepatic metastases from 45% to 28%. The details of this study appeared in the July 2009 issue of the Journal of Nuclear Medicine.
Addition of Vectibix® to First-line Chemotherapy Improves Progression-free Survival in Metastatic Colorectal Cancer (8/11/2009)
Among patients with metastatic colorectal cancer, the addition of the targeted therapy Vectibix® (panitumumab) to chemotherapy delayed cancer progression. This benefit was only observed in patients whose tumors did not contain a mutation in the KRAS gene. These results were made available in a press release from Amgen.
Preemptive Skin Treatment Reduces Skin Toxicity Associated with Vectibix® in Patients with Metastatic Colorectal Cancer (6/10/2009)
Researchers affiliated with a U.S. multicenter trial have reported that skin treatment that is initiated prior to the start of treatment with Vectibix® (panitumumab) reduces the incidence and severity of skin toxicity and improves quality of life in patients with metastatic colorectal cancer. The details of this study were presented at the 2009 annual meeting of the American Society of Clinical Oncology in Orlando, Florida, on June 1.
Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer (6/4/2009)
Researchers from the Memorial Sloan-Kettering Cancer Center have reported that patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications. The details of this study were presented at the 2009 Annual Meeting of the American Society of Clinical Oncology in Orlando, Florida, on March 31.
Erbitux® plus FOLFIRI Reduces Time to Recurrence as First-line Treatment of Metastatic Colorectal Cancer (4/3/2009)
Researchers affiliated the CRYSTAL trial have reported that the addition of Erbitux® (cetuximab) to FOLFIRI chemotherapy reduces the risk of progression in patients with metastatic colorectal cancer. The details of this study were published in the April 2, 2009 issue of the New England Journal of Medicine.
TheraSphere® Shows Promise in Treatment of Liver Metastases (3/19/2009)
Researchers from Northwestern University have reported that radioembolization of colorectal hepatic metastases with TheraSphere® (yttrium-90 microspheres) appears to produce sustained stable disease in some patients. Results of this Phase II trial appeared early online in Cancer on March 6, 2009.
Addition of Erbitux® to Avastin®-based Chemotherapy Harmful to Patients with Metastatic Colorectal Cancer (2/12/2009)
Researchers from the Netherlands have reported that the addition of Erbitux® (cetuximab) to the established regimen of Avastin® (bevacizumab), Xeloda® (capecitabine), and Eloxatin® (oxaliplatin) reduces progression-free survival and quality of life in patients with metastatic colorectal cancer. The details of this study appeared in the February 5, 2009 issue of the New England Journal of Medicine.
Avastin® plus Fluorouracil-based Chemotherapy Effective in Elderly with Metastatic Colorectal Cancer (1/27/2009)
Researchers from Duke University have reported that patients 65 years of age or older benefit as much from Avastin® (bevacizumab) and fluorouracil-based chemotherapy as younger patients with metastatic colorectal cancer. The details of this analysis appeared in the January 10, 2008 issue of the Journal of Clinical Oncology.
The Evolving Role of EGFR Inhibitors in Colorectal Cancer—A Report from ASCO 2008 (1/23/2009)
Results from the 2008 annual meeting of the American Society of Clinical Oncology (ASCO), held May 30–June 2 in Chicago, Illinois, revealed significant steps towards the improvement of outcomes for patients with varying types of cancers. As seen during the past few years, attention has turned towards individualizing patient care through targeted therapies, optimizing patient selection for specific therapies, as well as a focus on quality of life and survivorship issues.
Patients with Metastatic Colorectal Cancers with KRAS Mutations do not Benefit from Erbitux® (10/24/2008)
Researchers involved with a randomized study of Erbitux (cetuximab) versus best supportive care have reported that patients with locally advanced or metastatic colorectal tumors that have a mutated KRAS do not benefit from single-agent Erbitux. The details of this study were reported in the October 23, 2008 issue of the New England Journal of Medicine.
Radiofrequency Ablation Effective for Lung Tumors (7/22/2008)
Researchers involved in a multicenter international trial have reported that the use of radiofrequency ablation for the treatment of lung cancer or pulmonary metastases provides an effective and safe therapeutic option for selected patients. These results were recently published in the July 7, 2008 issue of Lancet Oncology.
Erbitux®/Avastin® Combo Not Effective in Colorectal Cancer (7/7/2008)
Researchers affiliated with the CAIRO2 trial reported that the addition of Erbitux® (cetuximab) to Avastin® (bevacizumab), Eloxatin® (oxaliplatin), and Xeloda® (capecitabine) did not provide a clinical benefit and actually reduced progression-free survival in metastatic colorectal cancer. These findings are consistent with results from other trials indicating that the combination of agents targeting the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor receptor (VEGF) pathways does not provide clinical benefit. These results were recently presented as a late-breaking abstract at the 2008 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Illinois.
Patients with KRAS Mutation Do Not Benefit from EGFR Inhibitors (6/20/2008)
Several presentations at the 2008 annual meeting of the American Society of Clinical Oncology (ASCO) reported confirmatory data that treatment with epidermal growth factor receptor (EGFR) inhibitors such as Erbitux® (cetuximab) and Vectibix® (panitumumab) is only effective among patients with the normal KRAS gene, while those with a mutated KRAS gene demonstrate virtually no response to these agents. In essence, global consent was achieved at this year’s ASCO that all patients eligible for EGFR-targeted therapies should first undergo KRAS testing prior to initiation of therapy.
Pre-existing Antibodies Explain Severe Hypersensitivity Reactions to Erbitux® (5/6/2008)
Researchers from Vanderbilt University have reported that hypersensitivity reactions to Erbitux® (cetuximab) are related to the presence of IgE antibodies present before therapy. The details of this study appeared in the March 13, 2008 issue of the New England Journal of Medicine.
Neoadjuvant Avastin®, Xeloda®, and Eloxatin® Safe in Patients with Colorectal Hepatic Metastases (4/21/2008)
Researchers from Austria have reported that a neoadjuvant regimen of Avastin® (bevacizumab), Xeloda® (capecitabine), and Eloxatin® (oxaliplatin) is well tolerated and effective in patients with colorectal metastases to the liver. The details of this study appeared in the April 10, 2008 issue of the Journal of Clinical Oncology.
EGFR FISH Assay May Identify Patients with Refractory Colorectal Cancer Who Benefit from Erbitux® (4/16/2008)
Researchers from Italy have reported that patients with refractory colorectal cancer who have high EGFR (epidermal growth factor receptor) gene copies by FISH (fluorescence in situ hybridization) are more likely to respond to treatment with Erbitux® (cetuximab). Details of the study were published in the April 2008 issue of the Annals of Oncology.
Erbitux® and Camptosar® Improves Outcomes of Metastatic Colorectal Cancer Patients (4/15/2008)
Researchers affiliated with an international randomized study (EPIC) have reported that the addition of Erbitux® (cetuximab) to Camptosar® (irinotecan) was more effective than Camptosar alone in patients with epidermal growth factor receptor (EGFR)-positive metastatic colorectal cancer who had failed fluoropyrimidine and Eloxatin® (oxaliplatin) therapy. The details of this study appeared in an early online publication on April 7, 2008 in the Journal of Clinical Oncology.
Perioperative Chemotherapy Improves Outcome of Metastases to the Liver (3/25/2008)
Researchers involved in an international multicenter randomized trial have reported that perioperative chemotherapy improves outcomes of patients with colorectal cancer metastases to the liver. The details of this study appeared in the March 22, 2008 issue of The Lancet.
Cetuximab (Erbitux®) Combinations Evaluated in Rectal and Esophageal Cancer (1/2/2007)
Two recent studies presented at the 2006 meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) suggest that cetuximab can be added safely to combination chemotherapy regimens for rectal and esophageal cancer.
European Study Suggests Xeloda® is Cost Effective Compared to 5-FU-LV for Colon Cancer (5/2/2006)
Researchers from the UK have determined that Xeloda (capecitabine) is more economical to administer that 5-fluorouracil/leucovorin (5-FU/LV) for the treatment of metastatic colorectal cancer. The details of this analysis appeared in the April 24, 2005 issue of the British Journal of Cancer.
Chemoradiotherapy Improves Local Control of T3-4 Rectal Cancer (11/1/2005)
A multicenter French trial has determined that neoadjuvant chemoradiotherapy is more effective than neoadjuvant radiotherapy alone for treating T3-4 rectal cancer.
Local Control of Rectal Cancer Better with Pre than with Post-Operative Chemoradiotherapy (10/27/2004)
Researchers affiliated with the German Rectal Cancer Study Group have reported that preoperative chemoradiotherapy was associated with improved local control and reduced toxicity when compared with postoperative chemoradiotherapy in patients with locally advanced rectal cancer, but did not appear to improve overall survival. The details of this report appeared in the October 21, 2004 issue of the New England Journal of Medicine. Preliminary results of this study were presented at the 45th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in October of 2003.
Bevacizumab (Avastin™) plus Chemotherapy Improves Survival of Patients with Metastatic Colorectal Cancer (6/7/2004)
A multicenter randomized trial has shown that the addition of Avastin™ to irinotecan, 5-FU and leucovorin improves outcomes of newly diagnosed patients with metastatic colorectal cancer. The details of this report appeared in the June 3, 2004 issue of the New England Journal of Medicine.
Promising Results Combining Alimta® with Other Agents in Advanced Colorectal Cancer (11/20/2003)
Based on the single agent activity of Alimta®, Eloxatin®, and Camptosar® in the treatment of locally advanced or metastatic colorectal cancer (CRC), investigators are now evaluating combinations of these drugs. According to a presentation at the Chemotherapy Foundation Symposium XXI, one study combining Alimta® and Eloxatin® has already suggested efficacy as first-line treatment and further studies are ongoing.
Aspirin Suppresses Earliest Pre-malignant Lesions in the Colon (11/13/2003)
Researchers from Israel have reported that aspirin use is associated with a reduction in the density of aberrant crypt foci (ACF) of the colon. These observations may explain why aspirin use is associated with a lower incidence of colon cancer. The results of this study appeared in the November 2003 issue of Gut.
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Avastin™ Plus Gemzar®: An Active Regimen for Pancreatic Cancer (6/23/2003)
At the 2003 meeting of the American Society of Clinical Oncology, researchers from the University of Chicago presented the results of a phase II study of bevacizumab (Avastin ") and
Gemzar® for the treatment of pancreatic cancer. The observed a one year survival of 54% which was considered “encouraging”.
Beta Carotene Increases Colorectal Adenoma Incidence in Smokers and Drinkers but is Preventative in Abstainers (5/21/2003)
Researchers from Dartmouth, USC, University of Minnesota, and the Cleveland Clinic reported in the May 21, 2003 issue of the
Journal of the National Cancer Institute that supplementation with beta carotene increased the incidence of colorectal adenomas in smokers and drinkers but decreased incidence in abstainers.
Rectal Cancer Outcomes Improve when Institutions Treat More Patients (5/21/2003)
Researchers reported an inverse relationship between the number of patients treated for rectal cancer and outcome as measured by permanent colostomies, 30 day survival, and 2 year survival. These results are based on analysis of data from California hospitals and were published in the May 21, 2003 issue of the
Journal of the National Cancer Institute. (1)
Randomized Trial Does Not Show Benefit For Intra-Arterial Chemotherapy For Colorectal Cancer Metastatic to Liver (2/3/2003)
The liver is the most frequent site of metastasis for patients with colorectal cancer and is the second most frequent cause of cancer death in this patient population. There have been a variety of treatments used for the majority of patients with colorectal cancer metastatic to the liver who are inoperable, including: intravenous chemotherapy, intra-arterial chemotherapy, interferon-alfa, conformal radiation therapy, radioactive lipitiol, liver transplantation, embolization, chemoembolization, cryotherapy, radiation-delivering microspheres and radiofrequency ablation. The most commonly used methods are intravenous chemotherapy with 5-FU and folinic acid or the same drugs administered intra-arterially. There are theoretical reasons to suggest that direct intra-arterial chemotherapy should be more effective and less toxic than intravenous administration. However, intra-arterial infusions require placement of a catheter into the hepatic artery and maintenance of this catheter for the duration of treatment.
Radiofrequency Ablation Superior to Cryosurgery for Treatment of Inoperable Primary or Secondary Liver Cancer (1/9/2003)
Currently, the only curative treatment option for primary or secondary liver cancer is surgical resection. However, only a small percentage of patients are eligible for surgery because the majority of patients have cancer that has replaced too much of the liver or spread outside the liver to other parts of the body. There are several non-surgical options for palliative treatment of inoperable primary or secondary liver cancer including percutaneous cryosurgery and percutaneous radiofrequency ablation. Cryosurgery utilizes extremely low temperatures to destroy cancers while radiofrequency ablation entails the use of an electric current that is passed into the area of cancer. Both techniques use ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) to place a needle probe into the cancer. Although both cryosurgery and radiofrequency ablation have been shown to be effective treatments for inoperable primary or secondary liver cancer, there have been no direct comparisons of these techniques. In the December 2002 issue of
Archives of Surgery, French researchers have compared the two techniques and concluded that percutaneous radiofrequency ablation produces more long lasting remissions than percutaneous cryosurgery.
Bevacizumab (Avastin"), a Monoclonal Antibody Against Vascular Endothelial Growth Factor (VEGF), Active in Colon Cancer (1/6/2003)
There is compelling evidence that angiogenesis plays a major role in the growth and spread of many cancers. Vascular endothelial growth factor (VEGF) is a factor that regulates normal and pathologic angiogenesis and has been implicated in the growth or several types of cancer including colon cancer. These observations have led to the development of antibodies that inhibit VEGF. There is evidence from animal models that anti-VEGF antibodies and chemotherapy are more effective than either modality alone. Avastin" is a recombinant humanized monoclonal antibody to VEGF which is currently being tested in number of clinical trials.
Intensive Eloxatin™, Camptosar®, 5 FU and Leucovorin Regimen Promising for Metastatic Colon Cancer (9/30/2002)
For the past two decades, the standard palliative treatment for patients with metastatic colon cancer has been 5 FU and leucovorin. Over the past several years, Camptosar® has been evaluated and found to be equivalent or better than 5-FU/leucovorin. More recently, Eloxatin" has also emerged as a very active agent for the treatment of colon cancer. The exact sequence of administration of these active drugs for the treatment of patients with colon cancer is unknown. One approach is to administer all active drugs up front in order to obtain the maximum initial response. In some situations, a maximum initial response to chemotherapy could allow some inoperable patients to become operable. Researchers in Italy have evaluated a regimen of intensive treatment with the combination of Eloxatin", Camptosar®, 5 FU and leucovorin. They reported their results in the October 2002 issue of the
Journal of Clinical Oncology.
Dutch Prospective Study Confirms Increased Risk of Colorectal Cancer with Low Dietary Folate Intake (9/24/2002)
An adequate intake of folic acid is achieved by eating fresh fruits and vegetables. In previous retrospective studies, researchers have documented an approximate 35% increase in the risk of colorectal cancer in persons who consume the lowest amount of folic acid, compared to persons who consume the highest amount of folic acid. These observations have led to three large ongoing clinical trials evaluating chemoprevention of colorectal cancer with folic acid supplements. In the September 2002 issue of Cancer, Dutch researchers report the first prospective study of dietary folic acid intake on the incidence of colon and rectal cancer. This study started in 1986 and has a 7.3 year follow-up. Since 1986, the researchers have followed 120,852 men and women aged 55-69 years. There were 760 colon cancers and 411 rectal cancers during the follow-up period. For men and women, the risk of colon cancer was reduced by 27% in persons with the highest folic acid intake, compared to the lowest intake. For rectal cancer there were no differences in women, but men with high folic acid intake had a 34% reduction of cancer rates. The researchers found no differences in outcomes when they analyzed for the form of folic acid (i.e. whether it was in the form of polyglutamates or monoglutamates). They also found suggestive evidence that men who consume higher amounts of alcohol combined with inadequate intakes of folate and methionine are at a higher risk of developing rectal carcinoma.
Obesity is a Risk Factor for Colorectal Cancer in Premenopausal but not Postmenopausal women (9/19/2002)
Obesity in men has been associated with an increased incidence of colorectal cancer. However, studies in women have failed to show this association. Researchers from the Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine believe that the failure to show an association between obesity and colorectal cancer in women is because age has not been taken into consideration. In the August 2002 issue of the journal
Gut, researchers report that premenopausal obese women have a two-fold increase in the incidence of colorectal cancer.
Swiss Study Confirms Ability of Virtual Colonoscopy to Detect Lesions 10 mm or Greater in Size (9/5/2002)
Virtual colonoscopy, also called colonography, is a technique that uses rapid computerized tomography (CT) scanning with conventional or electron beam (EB) machines combined with sophisticated computer programs. Patients undergoing virtual colonoscopy have the same extensive bowel purging as those undergoing actual colonoscopy and have the same insufflation of air to outline the bowel. The important part of this approach is the computer programs that can produce images of the colon that mimic an actual colonoscopy. Virtual colonoscopy has been evaluated more and more over the past several years in order to determine how virtual colonoscopy compares to actual colonoscopy. This is important since actual colonoscopy is the best way to detect and monitor pre-malignant polyps, but is limited by the need for heavy sedation or anesthesia and a small but definite risk of perforation of the bowel. In addition, there are not enough skilled physicians to perform colonoscopy on all individuals who should have it done for screening for colon cancer. A previous study from the U.S. clearly demonstrated that almost all lesions in the colon that were 10 mm or greater could be detected by virtual colonoscopy, but not smaller lesions.
St. John's Wort (SJW) Interferes With the Metabolism of Irinotecan (8/23/2002)
One of the major concerns about the use of alternative or complimentary medicines is the interactions with conventional treatments for cancer. Patients and physicians have to be cognizant of the interactions of alternative or complementary therapies with chemotherapeutic agents used to treat cancer. St. John's Wort (SJW) is an herbal medicine used to treat depression. Unfortunately, SJW has an effect on the cytochrome P450 enzyme system and drug-transporting proteins. St. John’s Wort induces the expression of the cytochrome P450 CYP3A4 isoform in intestinal and hepatic cells and induces the expression of MDR1 P-glycoprotein in intestinal cells. Irinotecan is eliminated via CYP3A4- and P-glycoprotein-mediated routes. Thus, SJW could interfere with the action of irinotecan in patients with colon cancer. Researchers in Holland determined the effects of SJW on the metabolism of irinotecan in 5 patients and reported their results in the August 20, 2002 issue of the
Journal of the National Cancer Institute. They concluded that patients with colon cancer receiving irinotecan should not receive SJW.
Eloxatin® (Oxaliplatin) Approved for Colorectal Cancer in the United States (8/15/2002)
The Food and Drug Administration approved Eloxatin® (oxaliplatin) for the treatment of colorectal cancer. The standard chemotherapy combination for metastatic colorectal cancer is 5-FU/LV plus Camptosar® (irinotecan). Eloxatin® is approved for use in combination with 5-fluorouracil (5-FU)/leucovorin (LV) for advanced colorectal cancer that has progressed or recurred following therapy with Camptosar®/5-FU/LV.
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Virtual Colonoscopy Detects Larger Neoplasms of Colon (8/6/2002)
Virtual colonoscopy is a technique that uses rapid computerized tomography (CT) scanning with conventional or electron beam (EB) machines combined with sophisticated computer programs. Patients undergoing virtual colonoscopy have the same extensive bowel purging as those undergoing actual colonoscopy and have the same insufflation of air to outline the bowel. The important part of this approach is the computer programs that can produce images of the colon that mimic an actual colonoscopy. Virtual colonoscopy has been evaluated more and more over the past several years in order to determine how virtual colonoscopy compares to actual colonoscopy. This is important since actual colonoscopy is the best way to detect and monitor pre-malignant polyps, but is limited by the need for heavy sedation or anesthesia and a small but definite risk of perforation of the bowel. In addition, there are not enough skilled physicians to perform colonoscopy on all individuals who should have it done for screening for colon cancer.
Raltitrexed and Oxaliplatin (TOMOX) is an Effective and Easy to Administer Regimen for Patients with Colorectal Cancer (6/19/2002)
Standard palliative treatment regimens for patients with advanced and metastatic colorectal cancer usually include 5-fluorouracil and leucovorin. However, new drug combinations continue to be evaluated. Italian researchers from 13 cancer centers recently reported the results of treating newly diagnosed patients with metastatic colorectal cancer with the combination of raltitrexed and oxaliplatin (TOMOX).
A Regimen of Camptosar®, Oxaliplatin, 5-Fluorouracil (5-FU) and Leucovorin is Highly Active for the Treatment of Metastatic Colorectal Cancer (6/6/2002)
Treatment of patients with metastatic colorectal cancer remains palliative, stimulating the development of new treatment regimens. Bolus and continuous infusion of 5-FU with leucovorin until recently was the most active regimen. Two new chemotherapy agents that have demonstrated anti-cancer effects for colorectal cancer are Camptosar® and oxaliplatin. Camptosar® has recently been approved by the Food and Drug Administration for treatment of colorectal cancer and the combination consisting of Camptosar®/5-FU/LV is now considered the standard initial chemotherapy treatment for patients with advanced colorectal cancer. Oxaliplatin is approved for the treatment of colorectal cancer in Europe and Asia and is currently in the last phases of clinical trials in the United States.
Capecitabine and Oxaliplatin is an Active Drug Combination for Treatment of Advanced Colorectal Cancer (4/24/2002)
The results of a Swiss study evaluating the combination of capecitabine and oxaliplatin for treatment of advanced colorectal cancer were recently published in the
Journal of Clinical Oncology.
Advanced Age is not a Contraindication to Adjuvant Chemotherapy for High-Risk, Resected Colon Cancer (4/22/2002)
Researchers in Pennsylvania have concluded that advanced age is not a barrier to receiving adjuvant chemotherapy for high risk cancer of the colon. Adjuvant chemotherapy is the standard of care for patients with stage III cancer of the colon. However, it is unclear whether or not toxicities outweigh benefits in elderly patients. Thus, elderly patients with resected stage III colon cancer often do not receive adjuvant chemotherapy.
Gene Therapy with ONYX-015 Shows Responses in Patients with Colon Cancer Metastatic to the Liver (4/19/2002)
ONYX-015 is a tumor-selective, modified adenovirus that has been genetically engineered to replicate in and kill cancer cells that have abnormal p53 pathway while sparing normal cells that have functioning p53 protein. P53, a protein that protects the cell from developing into a tumor cell, is the most commonly altered gene in human cancer.
Mortality from Major Cancer Surgery and Morbidity From Prostate Surgery Lower in High Volume Hospitals Than in Low Volume Hospitals (4/16/2002)
There were two reports in the April 11 issue of the
New England Journal of Medicine which strongly support the concept that patients facing major cancer surgery should select a high volume hospital near where they live.
St John’s Wort Interferes with Action of Camptosar® in Patients with Colorectal cancer (4/12/2002)
Camptosar® (CPT-11) is an important drug for the treatment of advanced colorectal cancer. Its metabolism is extremely complex, with the involvement of several enzymes and drug-transporting proteins. Cytochrome P450 isozyme 3A4 (CYP3A4) mediated oxidation of CPT-11 is the principal elimination route of CPT-11 and leads to the formation of a series of inactive compounds, including APC.
Four Weeks of Anticoagulation Better Than One Week Following Cancer Surgery (4/5/2002)
Researchers from Sweden, Italy, England and Israel have reported in the March 28 issue of the
New England Journal of Medicine that prolonged anticoagulation versus one week of anticoagulation is better for patients undergoing abdominal cancer surgery.
Plasma Free Metanephrines Best Test for Excluding or Confirming Pheochromocytoma (4/3/2002)
A multicenter international study has determined that plasma free metanephrines provide the best test for excluding or confirming the diagnosis of pheochromocytoma. The data establishing this was published in the March 20 issue of the
Journal of the American Medical Association.
Women Experience Greater Toxicity With 5-FU-Based Chemotherapy for Colorectal Cancer (3/21/2002)
Researchers from the US and Canada have evaluated the toxicities in men and women associated with fluorouracil (5-FU)–based chemotherapy given on 5 consecutive days at doses of 370 to 450 mg/m2. They analyzed data from 1,093 women and 1,355 men treated with 5-FU. They found an increased incidence of stomatitis, leukopenia, alopecia and diarrhea but not of nausea, and vomiting in women. Half of the women experienced severe toxicity compared to only a third of the men (P < .0001). The differences were consistent across treatment cycles. Response rates and survival distributions were the same for both sexes. These researchers concluded that women experience toxicity more frequently and with more severity than men following 5-FU–based chemotherapy in a 5-day bolus schedule. They also suggest “these data raise the question of whether the recommended initial dose of 5-FU–based chemotherapy for women shouldbe lower than that for men”.
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