New Chemotherapy, Cabazitaxel (Jevtana), for Advanced Prostate Cancer

Posted on July 4, 2010 by wngai
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NewspaperA new chemotherapy, Cabazitaxel (Jevtana) has been approved in the United States to treat men who have advanced hormone-refractory prostate cancer and have failed docetaxel.

The approval was based on the results of the phase 3 TROPIC clinical study, which involved 755 advanced hormone-refractory prostate cancer patients who were randomized to receive either cabazitaxel or mitoxantrone, both in combination with prednisone.  Furthermore, all this patients must have failed docetaxel before enrollment.

The results indicated that cabazitaxel was able to significantly improve the median overall survival when compared with mitoxantrone (15.1 months with cabazitaxel and 12.7 months with mitoxantrone (P < .0001).

The tumor response rate was also higher in the cabazitaxel group than the mitoxantrone group (14.4% versus 4.4% respectively, P = .0005).

The most common adverse reactions were neutropenia, anemia, leukopenia, thrombocytopenia, diarrhea, fatigue, nausea, vomiting, constipation, asthenia, abdominal pain, hematuria, back pain, anorexia, peripheral neuropathy, pyrexia, dyspnea, dysguesia, cough, arthralgia, and alopecia.

To monitor the occurrence of neutropenia, frequent blood cell counts should be performed.  Also, patients with neutrophil counts of 1500 cells/mm3 or less should not be given cabazitaxel.

This certainly is good news for patients with hormone and chemotherapy refractory prostate cancer patients.  There is another drug to extend their life span.

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Source: http://en.sanofi-aventis.com/press/press.asp

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Nuts improves lipid levels

Posted on July 4, 2010 by wngai
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NutsEating any type of nuts (almonds, walnuts and pecans) may lower total- and LDL-cholesterol levels, according to the results of a study published in the May 11, 2010 issue of the Archives of Internal Medicine.

In 2003, the Food and Drug Administration (FDA) issued a claim stating that the consumption of specific nuts—almonds, hazelnuts, pecans, pistachios, walnuts, and peanuts—might reduce the risk of heart disease.

In this meta-analysis, the researchers examined the effect of nut consumption on blood lipid levels.  25 studies including 583 men and women with normal lipid levels and blood pressure who were not taking lipid-lowering medications were included in the analysis.

The results indicated that consuming 67 g of nuts per day reduced total- and LDL-cholesterol levels by 10.9 mg/dL and 10.2 mg/dL, respectively.  Nuts, however, have no effects on HDL-cholesterol levels and triglycerides.

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Want to Cure Your Asthma for Good? – Weather-based Moxibustion 天灸療法 (A special Form of Moxibustion) might be an Option.

Posted on June 27, 2010 by wngai
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Heat patches used for heaven punctureTraditional Chinese Medicine (TCM) emphasizes that men needs to live in harmony with the heaven (weather) and the earth (environment) (天人合一).  Thus, when practicing medicine, TCM doctors make their therapeutic decisions (acupuncture, moxibustion or herbal medicine) not only on the patient’s characteristics but also on the weather conditions. 

Within the moxibustion procedures, there is a special kind of moxibustion, called Weather-based Moxibustion, which applied medicated heat patches (not needles) to puncture points at the back for 2-4 hours during the hottest days of the year. 

The use of weather-based moxibustion is based on the Chinese Medicine theory that “prevention of winter disease such as asthma should start in the summer” and “summer is the best time to absorb Yang (陽)to strengthen the body.”

The medicated heated patches stimulate the blood flow at puncture sites, resulting in a stronger immune system.  Applying moxibustion during the hottest days allows the body to absorb and stored enough Yang (warmth) to ward off the disease during the winter.

In the Chinese Lunar Calendar, there are 3 special days (三伏天) every year when the temperatures are the highest or the Yang is the strongest.  These are the best days to undergo weather-based moxibustion. 

This year, the hottest days are July 19, 2010, July 29, 2010 and August 18, 2010.

Indications

Weather-based moxibustion is indicated to treat chronic bronchitis, asthma, emphysema, seasonal allergy and tuberculosis.

I have heard two cases when patients with chronic asthma have been were successfully cured after 3 years of treatment with weather-based moxibustion. 

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Why do Women get Bossy when they get Older but Men become Couch Potatoes?

Posted on June 26, 2010 by wngai
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Yin and YangWives always complain their husbands of getting uninterested as they get older while husbands criticize their wife of being too energetic or bossy.  Why is that so?

According to the Chinese medicine, everything in the Universe is governed by Yin and Yang.  The world requires a balance of Yin and Yang in order to run smoothly.  For example, daytime is considered the Yang and needs to be balanced by Yin or nighttime.

Likewise, men are considered Yang on this earth and women are considered Yin.  This designation, however, does not mean men only have Yang and women only have Yin.  Yang and Yin exist in both men and women, but Yang is stronger than Yin in men and the vice versa is true for the women (Yin is stronger than Yang in women).

As men get older, men will gradually lose their Yang.  The lack of Yang makes them sleepier or lethargic.

On the other hand, women lose the Yin when they get older.  However, as the Yin gets smaller, the relative level of Yang becomes bigger or stronger.  As a result, women become more energetic when they get older.

How to get more Yang or Yin?  To get more Yang, men need to continue to do outdoor exercise as they get older, while women might need herbal medicine to supplement their Yin.

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New Hope for Heavily Pretreated Metastatic Breast Cancer Patients

Posted on June 26, 2010 by wngai
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A new chemotherapy agent, eribulin (developed by Eisai), was shown to improve significant survival benefit in heavily pretreated breast cancer, according to the EMBRACE study presented at the American Society of Clinical Oncology (ASCO) 2010 Annual Meeting.

The new drug was extracted from sea sponge, and belongs to a new chemical class of halichondrins.

The phase 3 clinical trial involved 762 patients with metastatic breast cancer who had been heavily pretreated with previous chemotherapy regimens (median of 4) that included an anthracycline and a taxane.

Patients were randomized to either eribulin or a treatment of physician’s choice (TPC), where the oncologist decided which drug to use. Many chose to use vinorelbine, gemcitabine, or capecitabine.

The results showed that eribulin significantly improved overall survival than TPC (13.12 vs 10.65 months, a difference of 2.47 months; hazard ratio, 0.81; P = .041), even though the response rate of the new drug was lower than TPC (12.2% with eribulin vs 4.7% with TPC; P = .002). The 1-year survival was 53.9% with eribulin and 43.7% with TPC.

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Another New Anticoagulant, Apixaban, Shown to Provide Stroke Reduction Benefit in Patients with Atrial Fibrillation:AVEROSE

Posted on June 26, 2010 by wngai
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Heartbeat

The Apixaban versus Acetylsalicylic Acid to Prevent Strokes (AVERROES) trial, a study that compared the safety and effectiveness of apixaban (Pfizer/Bristol-Myers Squibb) and aspirin in patients with atrial fibrillation, has been stopped early after a predefined interim analysis by the independent data monitoring committee indicated that the new drug reduced stroke and systemic embolism and atrial fibrillation patients.

The AVERROES trial was conducted by McMaster University, in Hamilton, ON, and consisted of 5600 patients from 36 countries with all types of atrial fibrillation who were intolerant of or unsuitable for warfarin.  Patients were randomized to either 5 mg of apixaban or 81 to 324 mg of aspirin for up to 36 months or until the end of the study.

Even though the full details of the results are not yet available, it is believed that this drug will provide the same benefits (no need for routine blood monitoring) as the long-waited dabigatran, Pradaxa.

Apixaban is an oral factor Xa inhibitor that is being tested in a number of different types of patients

Source: Pfizer/Bristol-Myers Squibb. AVERROES study of investigational agent apixaban closes early due to clear evidence of efficacy. June 9, 2010.

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Pradaxa is as Effective as Lovenox in Preventing VTE-event in Patients Setting Undergoing Hip Surgery: RE-NOVATE 2 study

Posted on June 26, 2010 by wngai
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In a randomized trial that was reported at the 2010 Congress of the European Hematology Association (EHA), the oral anticoagulant dabigatran (Pradaxa, Boehringer Ingelheim) was found to be as effective as subcutaneous enoxaparin (Lovenox, Sanofi-Aventis) in preventing venous thromboembolism (VTE) or death (p<0.0001 for noninferiority) in patients undergoing total hip-replacement surgery

In the clinical trial, patients were randomized to either oral dabigatran 220 mg once daily (n=1010) or 40 mg subcutaneous enoxaparin (n=1003) for an average of 32 days after total hip replacement.

Dabigatran was found to be as effective and safe as injected enoxaparin in preventing total VTE and all-cause mortality (7.7% and 8.8%, respectively) but more effective in preventing major VTE or VTE-related death (2.2% and 4.2%, respectively, p=0.03 for superiority).

Even though dabigatran was not found to be more efficacious than enoxaprin in total VTE and death, its oral form is more convenient and easier for patient compliance than subcutaneous administration of an anticoagulant.  Furthermore, there is no need for blood parameters is monitoring, thereby cutting costs.

Dabigatran is currently not available in the US, but is expected to get approval in the fall of 2010.

Source; 2010 Congress of the European Hematology Association (EHA)

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Violent Video Games Linked to Aggression And Diminished Cognitive Function

Posted on June 26, 2010 by wngai
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Male players of violent video games, particularly first person shooter games (FPSG), have more feelings of aggression than nonplayers, according to a small study presented at the American Psychiatric Association (APA) 2010 Annual Meeting.

The study involved 28 men who were splitted into 2 groups.  One group (14 men with mean age of 25 years) played the game Counter Strike for a median of 5 hours daily, while the control group (14 men with mean age of 23 years) did not play any type of violent video games.

All participants were then asked to complete the FAF, a German questionnaire on aggression, and the Interpersonal-Reactivity Index, and underwent functional magnetic resonance imaging (fMRI).

Players who played the FPSG games (Counter Strike) showed significantly higher levels of aggression, as shown in higher FAF scores, than did those in the control group (P < .05).

Furthermore, brain image obtained fMRI showed clustering which correlated positively with the impulsiveness [ratio = 0.394] and the self aggression [ratio = 0.533] scale of the FAF.

This study suggested extended use of violent games can lead to increased aggressiveness and should be avoided in children.

Source: American Psychiatric Association (APA) 2010 Annual Meeting: Poster Abstract NR3-12. Presented May 24, 2010.

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Is Shark Cartilage Helpful For Cancer Patients?

Posted on June 26, 2010 by wngai
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SharkShark cartilage has been touted as a potential alternative or complementary cancer treatment for several decades. Dozens of shark cartilage products are sold as dietary supplements, but none have been studied in humans.

A recently published study indicated that adding a drug derived from shark cartilage to standard cancer treatments did not improve survival among patients with late-stage lung cancer.

In the trial, 400 patients with inoperable non-small-cell lung cancer (NSCLC) in the study were randomized to receive either 1) standard chemotherapy and radiation or 2) standard treatment and the shark cartilage drug, known as AE-941.

AE-941 is a carefully formulated and regulated liquid shark cartilage product that is developed as a drug, rather than one of the commercially available supplements.

At the end of the study, there was no difference was seen in overall survival, progression-free survival, time-to-disease progression, and tumor response rates between the two groups.

In fact, patients who got the shark cartilage treatment lived for an average of 14.4 months, which was a month less than the average survival of patients who did not take shark cartilage.

Even though the shark cartilage study proved disappointing, investigator White indicated that other alternative treatments still show promise for the treatment of cancer. Among them, he says, are green tea extract and curcumin, which is derived from the spice turmeric.

Source: Lu, C. Journal of the National Cancer Institute, published online May 26, 2010.

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Avastin Boosts Progression-Free Survival in Ovarian Cancer Patients

Posted on June 26, 2010 by wngai
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Adding bevacizumab (Avastin) to chemotherapy, followed by bevacizumab as maintenance therapy, can significantly prolong progression-free survival in women with advanced ovarian cancer. 

The study consisted of 1873 women with newly diagnosed stage III (macroscopic residual disease) or stage IV ovarian, primary peritoneal, or fallopian tube cancer, who were enrolled from September 2005 to June 2009.

Patients were randomly assigned to 3 treatment groups: 1) paclitaxel plus carboplatin;   2) paclitaxel plus carboplatin and concurrent bevacizumab; and 3) paclitaxel plus carboplatin plus concurrent bevacizumab plus maintenance bevacizumab.

Study Results

There was no difference in progression-free survival between the 1st two groups (10.3 vs. 11.2 months for pacliataxel plus carboplatin and paclitaxel plus carboplatin and concurrent bevacizumab, respectively).

However, the addition of bevacizumab as maintenance therapy to bevacizumab plus chemotherapy significantly extended progression-free survival (14.1 vs 10.3 months or a 28% reduction in cancer progression) when compared with paclitaxel plus carboplatin.

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