Clinical Oncology Alert 2008-02-01

Lenalidomide Active for Non 5q-Low Risk MDS

Lenalidomide is highly effective for low risk MDS associated with a deletion(5q). Raza and colleagues report on lenalidomide for low to intermediate-1 (int-1) risk MDS who were transfusion dependent but without a deletion(5q). Patients received 10 mg daily of lenalidomide either continuously or 21 out of 28 days. Grade 3 and 4 neutropenia and thrombocytopenia occurred in 25 and 20% respectively. Among the 214 patients, 43% responded of which 26% became transfusion independent and the hemoglobin exceeded 10 g/dL. Lenalidomide is an option for red blood cell transfusion dependent low risk MDS, even in patients without a 5q-deletion.

Bevcizumab Plus Interferon Alfa 2a for Metastatic Renal Carcinoma

In a European multicenter trial of interferon alfa with or without bevacizumab for treatment of metastatic renal carcinoma, response rate and progression free survival was superior for those receiving the combination. Future trials, particularly those intending to measure long-term survival will need to also include the newly available tyrosine kinase inhibitors.

Confirming a Role for Adjuvant XRT in the Management of Pancreatic Cancer

Two recent reports examining NCI-SEER registry data demonstrate improved overall survival when external beam radiation therapy is applied in an adjuvant setting for those with pancreatic cancer.

Statins and Breast Cancer: Yes, No, or Maybe

Statin drugs have been increasingly used for management of hypercholesterolemia. Preclinical studies indicated an antiproliferative effect in vitro and in rodent models of breast cancer. The current report is one of several that indicate a lack of evidence for reduction in breast cancer risk among statin users. However, the overall use of drugs in this class in the study cohort (7%) and the relatively short duration of use (approximately 4 years) suggest that the question is not completely resolved.

Docetaxel for Advanced Prostate Cancer

A randomized multicenter trial conducted almost a decade ago and reported in 2004 showed docetaxel plus prednisone to be superior to mitoxantrone plus prednisone for patients with hormone refractory prostate cancer.

Pharmacology Watch

Rosiglitazone (Avandia) implicated in yet another study; Prilosec and Nexium not associated with cardiac events; Anastrozole (Arimidex) shown more effective than tamoxifen for treatment of early-stage breast cancer; antibiotics show no effect on sinusitis; FDA actions.

– February 1, 2008

February 1, 2008