– October 1, 2005
October 1, 2005
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Clinical Briefs in Primary Care supplement
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Pharmacology Watch
The Use of Prophylactic Antibiotics for Neutropenia; Is It Hot In Here?; Homeopathy vs Conventional Medicine; FDA Actions -
Weekly Neoadjuvant Paclitaxel for Breast Cancer
Paclitaxel, administered weekly, compared to once-every-3-weeks in a trial of primary systemic (neoadjuvant) treatment for operable breast cancer was shown by Green and colleagues at M.D. Anderson and Brown University to provide comparable clinical responses but superior rates of pathological complete response (pCR) and breast conservation. Both the weekly and q3 week regimens were followed by 4 cycles of fluorouracil/doxorubicin/cyclophosphamide (FAC). -
Prognostic Indexes in Follicular Lymphoma: A Comparison of Different Prognostic Systems
In this series, all 3 indexes, IPI, ILI, and FLIPI, were useful to classify FL patients into differentiated risk groups, although the FLIPI identified a larger proportion of high-risk patients than the IPI and ILI. -
DIC and Hemolysis after WinRho Treatment for ITP
Summarizing adverse events reported to the FDA, 6 definite cases of intravascular hemolysis (hemoglobinuria/hemoglobinemia and/or DIC) are detailed after administration of anti-D IGIV (WinRho). Several patients developed intravascular hemolysis after previously uncomplicated anti-D IGIV. Five patients were adults and all died. This study not only demonstrates that potentially fatal acute intravascular hemolysis may occur after anti-D IGIV and the importance of post-marketing surveillance. -
Second-Line Irinotecan and Carboplatin for Advanced Ovarian Cancer: Phase 1
In a phase I trial for patients with advanced ovarian cancer, irinotecan and carboplatin were administered at 6 different dose levels to determine maximum tolerated dose. The dose-limiting toxicity was hematologic (neutropenia and thrombocytopenia). The recommended dose for the Phase II study was irinotecan 60 mg/m2 on Days 1, 8, and 15 and carboplatin 5 mg/mL (AUC) on day 1, repeated every 4 weeks. Of note, of the ten patients with measurable disease, criteria for treatment response were achieved in 5. This level of response bodes well for this combination. -
Low-Income Women, Breast and Gynecologic Cancer, and Depression and Anxiety
The prevalence of depression among low-income, ethnic minority women with breast or gynecologic cancer is largely unknown, but limited formal screening programs and restricted access to effective therapies would suggest the number to be high. The trial by Ell and colleagues represents a unique insight into the scope of the problem. -
Are Fertility-Sparing Procedures Safe for Women with Ovarian Borderline Tumors? Probably.
Fertility-sparing surgery for ovarian LMP tumors is an option for motivated patients. Preservation of the contralateral adnexa increases the risk of recurrence, but surgical resection is usually curative.