Large Review Study Says Avastin Offers Only Modest Benefits for Metastatic Breast Cancer

18th Wednesday, 2012  |   Breast Cancer  |  no comments

Avastin (chemical name: bevacizumab) is a targeted therapy that was approved in 2008 by the U.S. Food and Drug Administration (FDA) to be used in combination with Taxol (chemical name: paclitaxel) to treat metastatic, HER2-negative breast cancer that hadn’t yet been treated with chemotherapy. On Nov. 18, 2011, the FDA announced it had removed the breast cancer indication from Avastin because the medicine has not been shown to be safe and effective for that use.Avastin has not been removed from the market and doctors can choose to use Avastin to treat metastatic breast cancer whether or not that particular use is officially approved by the FDA. Results from a new large review study show that Avastin offers only modest benefits for stopping the growth and spread of metastatic breast cancer.
The study was published online on July 11, 2012 in The Cochrane Library. The Cochrane Library catalogues information from the Cochrane Collaboration, a highly respected program that helps doctors and patients decide on the best treatment approaches based on careful analysis of available research. Read the summary of “Treatments targeting blood vessels for metastatic breast cancer.” Studies involving more than 4,000 women that looked at combining Avastin with one of several chemotherapy medicines to treat metastatic breast cancer found that the time before the cancer grew or spread (progression-free survival) increased only a little, and that overall survival didn’t increase at all. This means that the women in the studies lived for about the same amount of time whether or not they got Avastin. Women who got Avastin also had more and more serious side effects, including heart problems, low white blood cell count, and blood clots.
Many doctors believe that the benefits of Avastin for certain women diagnosed with metastatic breast cancer are worth the risks and cost of treatment. In July 2011, a committee of experts from the National Comprehensive Cancer Network (NCCN) — an alliance of 21 of the world’s leading cancer centers — voted to continue to support the approval of Avastin in combination with Taxol to treat metastatic, HER2-negative breast cancer that hasn’t been treated with chemotherapy.
If you’ve been diagnosed with metastatic breast cancer, you and your doctor will develop a treatment plan that will likely include chemotherapy and possibly hormonal therapy and/or targeted therapy medicines. No matter which treatments are recommended for you, you may want to talk to your doctor about:
why each treatment is recommended (including any combinations)
treatment timing and sequence
the expected benefits, risks, and side effects of each treatment
If you’re already getting Avastin and are responding to treatment, you may want to ask your doctor about the Cochrane study. It’s likely that your doctor will recommend that you stick with your treatment plan unless it stops being effective or unacceptable side effects develop. If your insurance company will not cover the cost of your Avastin treatment, talk to someone on your medical team about your options for getting help to afford continuing treatment. Genentech, the maker of Avastin, remains committed to evaluating the use of Avastin to treat metastatic breast cancer. The company plans to conduct new research focusing on identifying the women who are most likely to benefit from Avastin treatment.
http://www.breastcancer.org/treatment/targeted_therapies/new_research/20120711.jsp

According to the department’s Single Use Retail Bag regulations

17th Tuesday, 2012  |   Uncategorized  |  no comments

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17th Tuesday, 2012  |   Uncategorized  |  no comments

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Antitumor activity and macrophage nitric oxide producing action of medicinal herb

16th Monday, 2012  |   Herb or Compound  |  no comments


Tomimori K, Nakama S, Kimura R, et al. BMC Complementary and Alternative Medicine 2012, 12:78 doi:10.1186/1472-6882-12-78
Background
Crassocephalum crepidioides, a plant distributed in Okinawa Islands, is known in folk medicine; however, its anticancer activity has not been investigated. The aim of this study was to determine the in vitro and in vivo antitumor activities of C. crepidioides on murine Sarcoma 180 (S-180) and related molecular mechanisms.
Methods
The antitumor effect of C. crepidioides was evaluated in S-180-cell-bearing mice. Cell growth was assessed using a colorimetric assay. Nitrite and nitrate levels were measured by colorimetry. The expression levels of inducible NO synthase (iNOS) in murine RAW264.7 macrophages was assessed by reverse transcriptase-polymerase chain reaction. Activation of iNOS promoter was detected by reporter gene. Activation of nuclear factor-kappaB (NF-kappaB) was evaluated by electrophoretic mobility shift assay. The role of NF-kappaB signaling was analyzed using inhibitors of NF-kappaB and dominant-negative mutants, and Western blot analysis.
Results
C. crepidioides extract delayed tumor growth in S-180-bearing mice. However, it did not inhibit S-180 cell growth in vitro. Supernatant of cultured C. crepidioides-stimulated RAW264.7 macrophages was cytotoxic to S-180 cells. This cytotoxicity was associated with nitric oxide (NO) production. NF-kappaB signaling pathway was crucial for the transcriptional activation of iNOS gene. Isochlorogenic acid, a component of C. crepidioides, induced NF-kappaB activation and iNOS expression.
Conclusions
The results highlight the oncolytic and immunopotentiation properties of C. crepidioides mediated through NF-kappaB-induced release of NO from macrophages.

Cost Savings in Inpatient Oncology Through an Integrative Medicine Approach

11th Wednesday, 2012  |   Others  |  no comments


Objectives: To evaluate the cost impact of an integrative medicine intervention on an inpatient oncology service.
Study Design: This study used nonrandomized, nonequivalent groups. A baseline sample of inpatient oncology patients at Beth Israel Medical Center admitted to the medical oncology unit before implementation of the Urban Zen Initiative were compared with patients admitted after the Urban Zen Initiative was in place.
Methods: The Urban Zen Initiative incorporated yoga therapy, holistic nursing techniques, and a “healing environment” into routine inpatient oncology care. Length of stay and medication use data were extracted from Beth Israel’s decision support electronic database. We compared length of stay, total medication costs, and costs of as-needed medications for both groups: the baseline sample of inpatient oncology patients and patients exposed to the Urban Zen healing environment initiative.
Results: We had complete cost data on 85 patients in our baseline group and 72 in our intervention group. We found no difference in length of stay between the 2 groups. We found a significant decrease in use of antiemetic, anxiolytic, and hypnotic medication costs as well as a decrease in total medication costs in the Urban Zen sample compared with the baseline group.
Conclusions: An integrative medicine approach including yoga therapy, holistic nursing, and a healing environment in the inpatient setting can decrease use of medications, resulting in substantial cost savings for hospitals in the care of oncology patients.
Source:
Kligler B, Homel P, Harrison LB, et al. Am J Manag Care. 2011. Vol.17, No.12 Pp.779-784