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Audio Journal of Oncology Breast Cancer Special 2005
Reporting from:
- San Antonio Breast Cancer Symposium, December 8-11, 2004
- European Society for Medical Oncology Congress, October 29-November 10, 2004, Vienna
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne, Peter Goodwin
Correspondents: Peter Goodwin, Peter Beer, Derek Thorne
In this edition:
Raimund Jakesz discusses the results from a combined Austrian and German study, examining the effects of switching from tamoxifen to an aromatase inhibitor in approximately 3,000 women with breast cancer.
Tony Howell talks about latest results from the ATAC trial, designed to find out whether single-agent tamoxifen or single-agent anastrazole is better at five years. Dr. Howell reports on study results at 68 months of follow-up for more than 9,000 postmenopausal women.
Thomas B. Julian gives the latest findings from the large American NSABP B-32 trial, which compared sentinel node biopsy with conventional axillary dissection.
Robert Mansel reports results from the British ALMANAC study involving 1,031 patients. This longest-running study of sentinel node biopsy comparing the method with standard axillary treatment closed in 2003.
Ivo Olivotto addresses the question of which patients having mastectomy should receive radiation, particularly if a woman has one to three positive nodes. His group analyzed data on approximately 820 women referred between 1989 and 1997, treated with mastectomy.
Abstract 2
Raimund Jakesz, University of Vienna
A combined Austrian and German study has data on around 3000 patients who’d spent two years on tamoxifen and were then randomised to either continuing on tamoxifen or switching to anastrozole.
Abstract 1
Tony Howell, University of Manchester
The ATAC trial was designed to find out whether single agent tamoxifen or single agent anastrazole is better for five years. San Antonio Delegates heard what 68 months of follow up has discovered in this large multi-centre trial involving over 9000 postmenopausal women.
Abstract 6
Michael Gnant, University of Vienna
Data on the benefits of giving zoledronic acid to patients on hormone therapy - whether anastrozole or tamoxifen have emerged from a new study. This used the bisphosphonate following treatment with the LH-RH agonist, goserelin in nearly 400 patients.
Abstract P1
Paul Goss, Harvard Medical School, Boston
Delegates heard the state of the art as far as hormonal treatment with aromatase inhibitors is concerned at the plenary session in San Antonio.
Abstract 14
Thomas B. Julian, Allegheny General Hospital, Pittsburgh
Over the last five years or so, two large multi-center trials have been investigating prognosis, regional control and survival relating to sentinel node biopsy - and both these studies reported their latest findings to the San Antonio meeting. First, delegates heard from the large American NSABP B-32 trial, which compared sentinel node biopsy with conventional axillary dissection.
Abstract 18
Robert Mansel, Cardiff University
The British ALMANAC study is the longest running study of sentinel node biopsy and closed in 2003. Since then, the investigating team has been working through the data generated from the 1031 patients on the trial. The comparison was against standard axillary treatment and the latest data were presented in San Antonio.
Abstract 37
Kathy Albain, Loyola University, Chicago
Guidance on what you should do with your node positive, ER positive postmenopausal breast cancer patient was on hand in San Antonio. An update on the phase three SWOG inter-group trial of nearly 1500 patients, which had three arms: tamoxifen alone, tamoxifen scheduled sequentially with the CAF regimen of cyclophosphamide, doxorubicin and 5-FU, and finally CAF with concurrent tamoxifen.
Abstract 26
Harry Bear, Virginia Commonwealth University, Richmond
One of the big phase three trials reporting its latest results at the San Antonio meeting was NSABP B-27, which was investigating neoadjuvant docetaxel given to women with operable breast cancer. In the trial, nearly two and a half thousand women were randomized to receive either the AC regimen - doxorubicin and cyclophosphamide - alone, or AC followed by docetaxel before surgery, or AC given before surgery with docetaxel given afterwards.
Abstract 28
David Loesch, Central Indiana Cancer Centers, Indianapolis
In high risk breast cancer, paclitaxel has been under analysis. The objective of this two armed phase three trial in just over 1800 women was to compare AC followed by paclitaxel to an experimental arm of doxorubicin and paclitaxel followed by weekly paclitaxel.
Abstract 4
Trevor Powles, Parkside Oncology Clinic, London
The MORE trial showed that taking raloxifene for 4 years is effective in treating osteoporosis among postmenopausal women. It also showed a reduction of breast cancer incidence. Now an extension of MORE, called CORE, has looked specifically at this anti-cancer effect. As well as confirming previous findings it has shown that raloxifene prevents breast cancer regardless of whether the patient has previously received hormone replacement therapy.
COMMENTS: Jack Cuzick, Wolfson Institute, London
Abstract 4061
Charles Kunos, Case Western Reserve University, Cleveland
Given advances in chemotherapy and radiotherapy in recent years, how wide should margins be in breast conservation therapy? In particular, is 2mm sufficient these days? Or less? the team in Cleveland Ohio has been poring through data on just over 300 women treated with conservative surgery between 1996 and 2002.
Abstract 4066
Ivo Olivotto, British Columbia Cancer Agency, Victoria
One of the poster presentations in San Antonio attempted to address the issue of which mastectomy patients you should give radiation to - especially if the woman has one to three positive nodes. The Canadian group has analyzed around 820 women referred between 1989 and 1997, treated with mastectomy.
Controversy session, ESMO
Michael Baum, University of London
Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York
At the Vienna conference there was a debate on breast adjuvant therapy. The motion was: “For the majority of hormone receptor positive breast cancer patients in the adjuvant setting, the addition of chemotherapy to best endocrine therapy adds nothing to patient benefit”.
Audio Journal of Gastrointestinal Cancer Special Edition 2005
Reporting from:
- Gastrointestinal Cancers Symposium, January 27-29, 2005, Hollywood, Florida
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
Correspondents: Peter Goodwin, Peter Beer, Derek Thorne
In this edition:
Bruce Giantonio and Robert Mayer discuss the Eastern Cooperative Oncology Group study in which bevacizumab was added to an oxaliplatinbased regimen for the management of advanced colorectal cancer previously treated with chemotherapy.
Heinz-Josef Lenz reports on an investigation showing single-agent cetuximab to be effective in the treatment of advanced colorectal cancer that is refractory to all of the usual cytotoxic drugs.
Malcolm Moore’s trial involving patients with advanced pancreatic cancer, in which gemcitabine standard therapy has been supplemented with erlotinib (a drug targeting the epidermal growth factor pathway), has shown a small but definite improvement in survival and disease control. Robert Mayer discusses the results.
Daniel Haller explains how his ONCOSURGE decision-making system for the treatment of colorectal cancer metastases can be applied to potentially extend life and even cure patients by helping clinicians decide which strategies to use in each particular clinical situation.
Abstract 169a
Bruce Giantonio, University of Pennsylvania, Philadelphia
Chemo-naive patients with advanced colorectal cancer have already been shown to have improved overall survival by receiving further treatment with bevacizumab plus cytotoxic chemotherapy. But the benefit of adding the new targeted therapy to pre-treated patients was not known. At the gastrointestinal cancers symposium results from the Eastern Cooperative Oncology Group study in which bevacizumab was added to an oxaliplatin-based regimen in patients who had already received chemotherapy also showed an improvement in survival.
COMMENT: Robert Mayer, Dana-Farber Cancer Institute, Boston
Abstract 167
Aimery de Gramont, Hopital Saint Antoine, Paris
The latest findings on adjuvant chemotherapy for colorectal cancer from the French MOSAIC trial might give strength to the case for treating patients with Stage II tumors as well as those with Stage III disease. The trial, which now has a median follow up of 4 years, randomised over 2000 patients to either 5-FU/leucovorin or the FOLFOX4 regimen.
COMMENT: Robert Mayer, Dana-Farber Cancer Institute, Boston
Abstract 225
Heinz-Josef Lenz, University of Southern California, Los Angeles
Among patients with advanced colorectal cancer who are already refractory to all of the usual cytoxic drugs, single agent cetuximab, also known as erbitux, has been found to be effective. That’s according to a new study discussed at the gastrointestinal cancers symposium by Heinz-Josef Lenz.
Abstract 35
Ernest Rosato, Thomas Jefferson University Hospital, Philadelphia
In patients with cancer of the distal esophagus and the the gastroesophageal junction, a trial of about 70 patients has suggested that neoadjuvant chemotherapy with 5-FU, carboplatin and paclitaxel given together with radiation can markedly improved survival as compared with using surgery alone.
Abstract 77
Malcolm Moore, Princess Margaret Hospital, Toronto
Patients with advanced pancreatic cancer may receive gemcitabine as standard therapy given that the disease is inoperable and incurable. But now a phase III study combining gemcitabine with erlotinib - a drug targeting the epidermal growth factor pathway - has shown a small but definite improvement in survival and disease control.
COMMENT: Robert Mayer, Dana-Farber Cancer Institute, Boston
Abstract 76
Randall Brand, Evanston Northwestern Healthcare, Glenview
An elegant analysis of data from over 27 000 patients presented at the symposium seems to show that smoking can play a role in the early stages of pancreatic cancer.
Education section Page 54
Todd Baron, Mayo Clinic, Rochester
Patients with cholangiocarcinoma, or bile-duct cancer, need to have the duct obstruction cleared by intervention. As compared with stenting, the new method of photodynamic therapy - using a photo-sensitizer and a laser - has shown a clear advantage.
Abstract 140
Jason Foster, Roswell Park Cancer Institute, Buffalo
Gallbladder cancer now, and according to a retrospective study presented at the symposium, T2 and T3 stage tumours can benefit from radical resection rather than just cholecystectomy.
Abstracts 183 & 184
Nancy Kemeny, Memorial Sloan-Kettering Cancer Center, New York
For colorectal cancer patients with liver metastases, can a hepatic arterial infusion pump improve survival as compared with systemic chemotherapy? Nancy Kemeny’s group had data from two randomised trials which addressed this question: an intergroup CALGB study in 135 patients who did not receive surgery, and a slightly larger trial, in which all patients were resected.
COMMENT: Robert Mayer, Dana-Farber Cancer Institute, Boston
Abstract 162
Daniel Haller, University of Pennsylvania Abramson Cancer Center, Philadelphia
Because the management of liver metastases in colorectal cancer patients can potentially extend life and even cure patients, a group led from Philadelphia has developed a decision-making tool - called ONCOSURGE - that helps clinicians decide which strategies to use in a particular clinical situation.
Education section Page 74
Steven Curley, M D Anderson Cancer Center, Houston
The management of colorectal cancer patients with disseminated disease was a big theme at the gastrointestinal cancers conference. Steven Curley gave a review of all the available strategies.
Audio Journal of Hematologic Malignancy Special Edition 2005
Reporting from:
- Annual Meeting of the American Society of Hematology, December 4-7, 2004, San Diego
- Lymphoma: The Next Questions, April 8-9, 2005, Fort Lauderdale
- Journal of Clinical Oncology
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
In this edition:
The newer the better, so they say. But not this time, as we hear from Tony Green. He was looking into the treatment of essential thrombocythemia with the new agent, anagrelide. His group has discovered that superiority lies with the old treatment hydroxyurea.
Where can we go when imatinib stops working? Charles Sawyers is lighting the way for patients with chronic myeloid leukemia with the targeted therapy BMS 354 825.
Another reason has emerged why imatinib may not be the end of the road for patients with chronic myeloid leukemia who have become resistant. Francis Giles discusses the option of using the new agent AMN 107, which targets the BCR-ABL molecule in a new way.
Current proven treatment for multiple myeloma is still single agent dexamethozone, but is there scope for other therapies to be used up-front? S. Vincent Rajkumar has been working on two trials: one with thalidomide, and the other using a new drug lenalidomide.
J Clin Oncol 22:3269
Steven Schey, Guy’s Hospital, London
New findings suggest a role for the thalidomide analog CC-4047, also known as actimid, in the treatment of relapsed, refractory multiple myeloma. A phase I-II study investigated dose and produced findings on patient response.
Abstract 607 ASH 2004
Owen O’Connor, Memorial Sloan-Kettering Cancer Center, New York
A group of heavily pre-treated patients with a variety of non-Hodgkin’s lymphomas have been treated with bortezomib. Over half of the mantle cell lymphoma patients achieved responses. Showing an apparent superiority over the alternative existing treatments.
COMMENT: George Canellos, Dana-Farber Cancer Institute Boston
Abstract 157 ASH 2004
Michael Pfreundschuh, Universitätskliniken des Saarland, Homburg-Saar
French investigations have shown that adding rituximab to CHOP therapy has improved the outlook for older patients with diffuse large B-cell lymphoma. The German study has now added rituximab to CHOP in over 800 younger patients.
COMMENT: George Canellos, Dana-Farber Cancer Institute Boston
Abstract 2637 ASH 2004
Michael McDonald, Seattle Genetics, Bothel
A new anti-CD 30 monoclonal antibody has achieved responses in anaplastic large cell lymphoma.
COMMENT: George Canellos, Dana-Farber Cancer Institute Boston
Abstract 6 ASH 2004
Tony Green, University of Cambridge
Now a study of essential thrombocythemia has found that the old treatment - hydroxyurea - was better than a new agent - anagrelide - about which there had been a presumption of superiority.
COMMENT: George Canellos, Dana-Farber Cancer Institute Boston
Abstract 1307 & 1308 ASH 2004
Volker Diehl, University Hospital of Heidelberg
The German HD 10 and HD 11 trials of Hodgkin’s Disease have found that reduce long term toxicity without losing efficacy.
COMMENT: George Canellos, Dana-Farber Cancer Institute Boston
ASH2004 Abstract 1
Charles Sawyers, University of California, Los Angeles
Responses to a new drug have been achieved among patients whose chronic myeloid leukemia has relapsed after treatment with imatinib. A phase I study using BMS 354 825 in a group of 29 patients so far has raised hopes that further targeted therapy can be effective after the development of resistance to imatinib.
COMMENT: Stanley Schrier, Stanford University School of Medicine
ASH2004 Abstract 22
Francis Giles, M D Anderson Cancer Center, Houston
Another new compound designed to be used among patients with chronic myeloid leukemia whose disease is resistant to imatinib was presented at the ASH conference. Like imatinib AMN 107 targets the BCR-ABL molecule, though with a different mechanism. Only 21 patients have been treated so far, but could AMN 107 already be on its way into the mainstream?
ASH2004 Abstract 205
S. Vincent Rajkumar, Mayo Clinic, Rochester
Current proven treatment for multiple myeloma is still single agent dexamethazone, even though in the last few years other agents have shown promising activity in advanced disease. But can any of these candidate drugs be used up-front? The San Diego conference heard about two trials: one with thalidomide, and the other using the new drug lenalidomide.
ASH2004 abstract 7
Martin Dreyling, Hospital Grosshadern, Munich
A randomized study by the European Mantle Cell Lymphoma network looking at consolidation treatment after a CHOP-like induction regimen found that myeloablative radiochemotherapy followed by autologous stem cell transplantation was better than conventional interferon maintenance in 260 patients.
ASH2004
John Sweetenham, Arizona Cancer Center, Tucson
Radioimmunotherapy has now been tried for treating low-grade folicular lymphoma. The Yttrium 90-labeled ibritumomab tiuxetan - otherwise known as Zevalin - followed by rituximab maintenance has been investigated as be a potential new approach for treating follicular lymphoma.
COMMENT: Stanley Schrier, Stanford University School of Medicine
ASH2004 Abstract 1383
Bertrand Coiffier, Centre Hospitalier Lyon- Sud
It is now four years since initial results of the GELA study showed the addition of rituximab to standard CHOP therapy in elderly patients with diffuse large B-cell lymphoma gave clear advantages over CHOP alone. The 400-patient study now has five years of follow up, and the results continue to favor the rituximab-containing regimen.
John Sweetenham, Arizona Cancer Center, Tucson
We hear news, from the Lymphoma the Next Questions meeting, on proteasome inhibition, targeted therapies for Waldenstrom’s macroglobulinemia, primatised monclonal antibodies and radioimmunotherapy for indolent lymphoma.
Audio Journal of Prostate Cancer Special Edition 2005
Reporting from:
2005 Multidisciplinary Prostate Cancer Symposium, February 17-19, Hyatt Grand Cypress, Orlando, Florida
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
In this edition:
Will they or won’t they relapse? For patients with prostate cancer, their PSA velocity before radical prostatectomy best pinpoints the risk of relapse, according to Deep Patel.
Brachytherapy, rather than external beam radiation, may be the best option for patients with intermediate-risk prostate cancer, according to Vinai Gondi.
David Dearnaley has been using the latest precision radiotherapy tool, Intensity Modulated Radiotherapy - IMRT, successfully to treat affected nodes in locally advanced prostate cancer.
A new study reveals the possibility of extending life among patients with androgen independent prostate cancer. Eric Small discusses the final survival data from a phase-three trial of the vaccine APC 8015.
Abstract 68
Deep Patel, Stanford University School of Medicine
In an investigation of 200 patients with prostate cancer the rate of change of prostate specific antigen levels before radical prostatectomy proved to be an independent prognostic factor for the risk of relapse.
Abstract 74
Vinai Gondi, Columbia University, New York
An investigation of brachytherapy found that it gave superior biochemical disease-free survival among 350 patients diagnosed as having intermediate-risk prostate cancer.
Abstract 58
Carl Rossi, Loma Linda University Medical Center
The use of a proton-beam boost -as part of a high-dose conformal radiotherapy schedule - has brought big advantages among patients with low or intermediate risk prostate cancer.
COMMENT: Mack Roach, UCSF Comprehensive Cancer Center, San Francisco
Abstract 59
Joycelyn Speight, UCSF Comprehensive Cancer Center
A study of 2 000 patients found no difference in sexual dysfunction between the treatment options available for prostate cancer patients by the time follow up goes out to four years. But brachytherapy still had the least impact on quality of life early on in treatment.
COMMENT: Mack Roach, UCSF Comprehensive Cancer Center, San Francisco
Abstract 179
David Dearnaley, Royal Marsden Hospital, Institute of Cancer Research, Surrey
Intensity Modulated Radiotherapy - IMRT has been used successfully to treat affected nodes in locally advanced disease.
Abstract 264
Eric Small, University of California, San Francisco
The possibility of extending life among patients with androgen independent prostate cancer has emerged from a new study. The final survival data presented from a phase-three randomized placebo-controlled trial of the vaccine APC 8015 show a positive benefit.
Abstract 268
Matthew Smith, Massachusetts General Hospital, Boston
Among patients with non-metastatic disease, rising PSA despite androgen deprivation therapy is still consistent with an indolent natural history. Baseline PSA, however, along with PSA velocity, independently predicts bone metastasis and survival.
Abstract 282
Pierre Major, McMaster University, Ontario
Palliative use of bisphosphonates off-study has now been investigated by a multiple event analysis which allows for changing event rates and varying patient survival. Using zoledronic acid can significantly reduce the need for bone irradiation in patients with advanced disease.
Abstract 62
Mack Roach, UCSF Comprehensive Cancer Center, San Francisco
Predicting aggressive disease may be easier following results from a study looking at the tumor suppressor gene p53. Mingxin Che from Wayne State University in Detroit presented data on disease progression and survival among nearly 800 patients with locally advanced prostate cancer. Mack Roach discusses the significance of Dr Che’s results.
Audio Journal of Oncology 14.2, March 2006
Reporting from:
American Society of Hematology Meeting, Atlanta, 10-13 December 2005
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
In this edition:
It is not necessary to use rituximab along with standard CVP (cyclophosphamide, vincristine, predinsone) induction therapy among patients with advanced follicular lymphoma. So said Sandra Horning at a packed lymphoma meeting during the ASH confderence. According to the findings of a new study reported to the ASH conference, however, the use of rituximab mainenance, after the induction therapy, brings strong improvements in clinical outcome.
The original IRIS study showing the runaway superiority of imatinib after one year over standard treatment for cronic myeloid leukemia has now been followed up to maturity. John Goldman told the ASH audience the study results strongly endorses the use of imatinib as the gold standard treatment.
Michael Keating told the Atlanta conference that adding rituximab to standard fluydarabine plus cyclophosphamide therapy for chronic lymphocytic leukemia has helped patients survive longer.
Sandra Horning
Abstract 349
Sandra Horning, Stanford University Medical Center
It is not necessary to use rituximab along with standard CVP (cyclophosphamide, vincristine, predinsone) induction therapy in patients with advanced follicular lymphoma. However, the use of rituximab maintenance, after induction therapy, brought clear benefits among patients in the study.
Marinus Van Oers
Abstract 353
Marinus Van Oers, Academic Medical Center, Amsterdam
The use of rituximab as part of both induction and maintenance therapy for relapsed non-Hodgkin’s lymphoma has now been endorsed.
Philippe Solal-Celigny
Abstract 350
Philippe Solal-Celigny, Centre Jean Bernard, Le Mans
Rituximab contributed to improvements in clinical outcomes among patients with follicular non Hodgkin’s lymphoma who were treated first line with this immunotherapy combined with standard CVP chemotherapy. But an additional and greater benefit was found among patients randomized to receive further maintenance immunotherapy with rituximab.
Hagop Kantarjian
Abstract 37
Hagop Kantarjian, MD Anderson Cancer Center, Houston
Although imatinib brings control to more than 90% of patients with chronic myeloid leukemia, the drug does not suppress disease in other patients. One of the two leading alternative agents, however, AMN 107, has now given promising responses among patients whose disease evades the effects of imatinib.
Andreas Hochhaus
Andreas Hochhaus, University of Heidelberg, Manheim
Another tyrosine kinase inhibitor targeting the BCR ABL pathway, dasatinib, has also achieved positive results among patients whose chronic myeloid leukemia is resistant or refractory to imatinib.
John Goldman
John Goldman, Imperial College, London
The original IRIS study compared imatinib with the combination of interferon plus cytarabine for the treatment of chronic myeloid leukemia. The runaway superiority of imatinib (noticed after one year) has now confirmed at four years of follow up, strongly endorsing the use of imatinib as the gold standard treatment.
Monica Bocchia
Abstract 167
Monica Bocchia, University of Siena, Italy
A vaccine targeting a protein junction of BCR ABL has achieved partial, complete, and even molecular remissions among patients with chronic myeloid leukemia, raising hopes of yet another weapon in the armory for patients whose disease is resistant to imatinib.
Abstract 1849
Richard Schlenk, University of Ulm
The addition of gemtuzumab to a salvage regimen appears to bring benefits among patients with acute myeloid leukemia who have failed other therapies.
Bella Patel, Royal Free Hospital, London
Imatinib has achieved improvements in clinical outcomes among patients with Philadelphia positive acute lymphoblastic leukemia.
Abstract 2118
Michael Keating, MD Anderson Cancer Center, Houston
Adding rituximab to standard fluydarabine plus cyclophosphamide therapy for chronic lymphocytic leukemia has helped patients survive longer.
John Gribben, St Bartholomew’s Hospital, London
The use of stem cell transplantation, antisense, and the new drug alemtuzumab all bring promise of better outcomes for salvage therapy in chronic lymphocytic leukemia.
Ajay Gopal
Abstract 487
Ajay Gopal, Fred Hutchinson Cancer Research Center, Seattle
Radioimmunotherapy at myeloablative doses may hold the key to treating patients with lymphoma over the age of 60 who would otherwise be denied transplants on grounds of the treatment being too harsh for their age.
John Pagel
Abstract 397
John Pagel, University of Washington, Seattle
Reduced intensity conditioning, sometimes called “mini transplants” offer an option which could safely be used to treat older patients with multiple myeloma.
Meletios Dimopoulos
Abstract 6
Meletios Dimopoulos, University of Athens, Greece
58% of patients with heavily pre-treated multiple myeloma responded to a combination of the thalidomide analog lenalidomide combined with the standard drug dexamethazone, as compared with only 22% treated with dexamethazone alone. The study of 700 patients found better response rates and time to progression in the lenalidomide-treated group.
Audio Journal of Cardiovascular Medicine 12.1, January 2006
Reporting from:
American Heart Association Annual Scientific Sessions November 13-16, 2005, Dallas
Scientific Editors:
Michael Petch, Papworth Hospital, Cambridge
Man Fai Shiu, Walsgrave Hospital, Coventry
James Tcheng, Duke University, Durham
Harvey White, Green Lane Hospital, Auckland
Producer: Derek Thorne
In this edition:
Bryan Williams told American Heart Association attendees that measuring blood pressure with a cuff around the arm does not always give a clear picture of what’s happening in the aorta. The CAFE study found that central pressure can differ according to which agent is used, even though various drugs may give the same brachial blood pressure.
Withholding the use of abciximab infusion following stenting may cause no harm, provided the usual bolus administration of the drug has been used, according to Olivier Bertrand, who gave results of the EASY study at the Dallas meeting.
Lytics should not be given before primary PCI: so said Frans Van de Werf, who reported near-complete data from the ASSENT-4-PCI trial.
And in the real world, too, primary angioplasty is suprior to the use of lytic therapy for acute myocardial infarction except in cases where treatment is applied withing two hours - at which stage both approaches are equivalent. This was the finding from a study of 21 000 patients discussed by Ulf Stenestrand at the Dallas conference of the AHA.
Drug-eluting stents: bring no benefit in saphenous vein grafts, according to Jeff Trost. He made this conclusion from a registry analysis presented to the American Heart Association conference.
Milton Packer, University of Texas, Dallas
In the REVIVE trial the inotropic agent levosimendan has improved short-term outcome in acutely decompensated heart failure. Milton Packer from the University of Texas.
COMMENT: Gordon Tomaselli, Johns Hopkins University, Baltimore
Bryan Williams, Leicester University
Measuring blood pressure with a cuff around the arm does not always give a clear picture of what’s happening in the aorta. The CAFE study found differences in aortic pressure lowering between regimens based on beta blockers as compared with calcium antagonists, but no differences in brachial pressure. Leicester University’s Bryan Williams told the AHA.
Volker Schächinger, University of Frankfurt
Regeneration of the heart has been achieved by using bone-marrow derived stem cells after myocardial infarction among 200 patients.
Olivier Bertrand, Hôpital Laval, Quebec
The use of abciximab perfusion after stenting was questioned at the American Heart Association meeting in Dallas. The EASY study found bolus administration of glycoprotein 2B3A inhibition was sufficient and gives the possibility of sending patients home early.
Fr
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Audio Journal of Cardiovascular Medicine 11.3, October 2005
Reporting from:
European Society of Cardiology Congress September 3-7, 2005, Stockholm
Scientific Editors:
Michael Petch, Papworth Hospital, Cambridge
Man Fai Shiu, Walsgrave Hospital, Coventry
James Tcheng, Duke University, Durham
Harvey White, Green Lane Hospital, Auckland
Producer: Derek Thorne
In this edition:
The RITA-3 trial - focussing on how to manage patients with acute coronary syndromes - reported 5-year data at this year’s ESC Congress. Keith Fox talked about new evidence that strengthens the case for aggressive management of patients.
The conference also heard the latest on the Endeavor stent, which elutes the sirolimus analogue ABT-578. Jean Fajadet from Toulouse discussed the ENDEAVOR-2 study.
A future option for treating in-stent restenosis by coating a balloon with an anti-proliferative drug and inflating it inside the newly-occluded stent was discussed at the ESC Congress by Bruno Scheller who presented the first study of such a device in humans.
In the treatment of acute myocardial infarction, the 24-country ASSENT-4 study seems to show an overall increase of risk if you use thrombolysis before primary PCI. Frans Van de Werf gave the 30 day analysis. Kim Fox comments.
Shamir Mehta, McMaster University, Hamilton Ontario
Shamir Mehta of McMaster University told Audio Medica in Stockholm about the OASIS-5/MICHELANGELO results comparing the new anti-thrombotic therapy, fondaparinux, with enoxaparin among patients with acute coronary syndromes. For a comment on Shamir Mehta’s presentation at the ESC meeting, Audio Medica questioned Freek Verheugt of Nijmegen.
COMMENT: Freek Verheugt, Academisch Ziekenhuis, Nijmegen, The Netherlands
Shamir Mehta:
Freek Verheugt:
Keith Fox, Edinburgh Royal Infirmary
The RITA-3 trial - focussing on how to manage patients with acute coronary syndromes - reported 5-year data at this year’s ESC Congress. Keith Fox from Edinburgh told Audio Medica about new evidence that strengthens the case for aggressive management.
Peter Sever, Imperial College, National Heart & Lung Institute, London
Jean Fajadet, Unite de Cardiologie Interventionnelle, Toulouse
The ESC heard the latest on the Endeavor stent, which elutes the sirolimus analogue ABT-578. Jean Fajadet from Toulouse told Audio Medica about the findings from ENDEAVOR II study of around 1200 patients.
Audio Journal of Oncology 14.1, February 2006
Reporting from:
San Antonio Breast Cancer Symposium 2005
Scientific Editors:
George Canellos, Dana-Farber Cancer Institute, Boston
Gordon McVie, European Institute of Oncology, Milan
Pat Price, Christie Hospital, Manchester
Gianni Bonadonna, Istituto Nazionale Tumori, Milan
Producer: Derek Thorne
In this edition:
The targeted drug trastuzumab may be used in place of anthracyclines for breast adjuvant chemotherapy regimens, according to the findings of Dennis Slamon, who announced the BCIRG 006 study findings to the San Antonio conference. Norman Wolmark commented.
Kathy Miller gave the Breast Cancer conference early data showing that the anti-vascular endothelial growth factor agent, bevacizumab, has improved survival among patients with metastatic breast cancer.
Dose-dense chemotherapy should be considered mainly in hormone receptor negative breast cancer patients, so said Clifford Hudis, while Martine Piccart warned against over-enthusiasm for cytotoxic chemotherapy among patients who could benefit more from endocrine treatment.
Switching from tamoxifen to anastrozole brought clear benefits according to a meta-analysis presented in San Antonio by Walter Jonat. And ductal carcinoma in situ should be treated with radiation according to Nina Bijker’s report to the conference.
Dennis Slamon, UCLA School of Medicine, Los Angeles
It may be reasonable to replace the anthracycline component of adjuvant chemotherapy with carboplatin in HER-2 positive patients with early breast cancer - provided agents such as docetaxel and trastuzumab are also included, according to the findings of the BCIRG 006 trial reported at the San Antonio breast cancer symposium.
COMMENT: Norman Wolmark, NSABP foundation, Pittsburg
Richard Gelber, Harvard Medical School, Boston
Latest findings from the HERA study show that Trastuzumab (Herceptin) gave significantly lower rates of local recurrence among patients with breast cancer in whom this targeted agent was added after standard adjuvant therapy.
Edith Perez, Mayo Clinic, Jacksonville
In a study of some 3 000 patients the use of trastuzumab in adjuvant therapy for breast cancer gave significant benefits with acceptable cardiac toxicity.
Kathy Miller, Indiana University School of Medicine, Indianapolis
Adding the anti-vascular endothelial growth factor (VEG-F) inhibitor, bevacizumab, gave a marked improvement of survival among women with recurrent or metastatic breast cancer.
Stephen Jones, US Oncology Research, Houston
Docetaxel did better than doxorubicin when added to cylcophosphamide therapy for patients with early breast cancer.
Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York
Patients with estrogen-receptor negative breast cancer derived some benefit from dose dense schedules of chemotherapy.
Joseph Sparano, Albert Einstein College of Medicine, New York
No difference was found between the benefit of regimens including paclitaxel as compared with docetaxel among patients with early breast cancer receiving adjuvant chemotherapy.
Martine Piccart, Jules Bordet Cancer Institute, Brussels
Adjuvant therapy needs to be individualised for each patient, and the use of cytotoxic chemotherapy may often be avoided in favour of endocrine therapy among patients whose tumours have been shown to be sensitive to hormone modulators.
Ivo Olivotto, University of British Columbia, Victoria
Three decades of cancer statistics show that adjuvant therapy has greatly benefited patients with breast cancer since the 1970s.
Paul Goss, Massachusetts General Hospital, Boston
Post menopausal patients with breast cancer whose endocrine therapy was switched from tamoxifen to letrozole showed a benefit in the NCIC MA17 study among 5 000 women.
Lois Shepherd, Queen’s University, Kingston, Ontario
The NCIC trial of the aromatase inhibitor, letrozole, has also shown that patients whose tumours are positive for both oestrogen and progesterone receptors benefit from letrozole, whereas those with ER positive and PGR negative do less well and could be considered for other therapies after initially receiving 5 years of tamoxifen.
Walter Jonat, University of Kiel
A meta-analysis of patients switching after 2 years from tamoxifen to treatment with aromatase inhibitors (including letrozole and anastrozole) showed benefits over patients remaining on tamoxifen therapy.
Michael Gnant, University of Vienna
Among patient who receive conservative surgery for their low risk endocrine-responsive breast cancer there is still a benefit locally from using adjuvant radiation.
Nina Bijker, Netherlands Cancer Institute, Amsterdam
Patients who had excision of ductal carcinoma in situ (DCIS) gained longer freedom from recurrence if they received radiotherapy, according to findings from an EORTC trial. All sub-groups of patients benefited from radiation.
Amit Agrawal, Nottingham City Hospital
The epidermal growth factor receptor (EGFR) inhibitor gefitinib brought benefit to patients with advanced or metastatic breast cancer. Curiously, those with more modest expression of EGFR had the best responses.
Audio Journal of Cardiovascular Medicine 10.3, May 2004
Reporting from:
European Society of Cardiology Congress, Munich, August 28-1 September, 2004
Scientific Editors:
Michael Petch, Papworth Hospital, Cambridge
Man Fai Shiu, Walsgrave Hospital, Coventry
James Tcheng, Duke University, Durham
Harvey White, Green Lane Hospital, Auckland
Producer: Derek Thorne
Correspondents: Richard Black, Graham Easton & Peter Goodwin
In this edition:
Philip Poole-Wilson has the latest results from the ACTION trial, which looked at the safety and efficacy of nifedipine in the treatment of angina. Michael Petch comments.
The cannabinoid receptor blocker rimonabant can help people with risk factors related to the metabolic syndrome that’s according to Alain Golay, who presented findings from the RIO-LIPIDS trial at the ESC annual congress in Munich.
Robert Kiss talks about a large prospective study from Hungary, which appears to show that aspirin resistance represents a higher risk of mortality among cardiovascular patients continuing to take aspirin for secondary prevention. Richard Conti gives his thoughts on the trial.
The ARTS trial, the largest study comparing bypass surgery to percutaneous intervention in patients with multi-vessel disease, is now five years old. Patrick Serruys describes the latest findings.
Philip Poole-Wilson, Royal Brompton Hospital, London
The ESC meeting saw the results of a major trial on the safety and efficacy of nifedipine in the treatment of angina. The ACTION trial enrolled eight thousand people with chronic angina, and randomised them to either placebo or the long-acting GITS formulation of nifedipine.
COMMENT: Michael Petch, Papworth Hospital, Cambridge
Robbert de Winter, University of Amsterdam
The early use of Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting in the majority of high risk unstable angina patients was not endorsed by a new trial from Amsterdam called ICTUS.
Marc Brouwer, University of Nijmegen
A meta-analysis from Nijmegen has produced similar findings to the ICTUS trial - that early invasive therapy may not always bring a better outcome in acute coronary syndromes.
Robert Kiss, University of Budapest
A large prospective study from Hungary appears to show that aspirin resistance represents a higher risk of mortality among cardiovascular patients continuing to take aspirin for secondary prevention.
COMMENT: Richard Conti, University of Florida, Gainesville
John McMurray, Western Infirmary, Glasgow
New data presented in Munich suggests that cardiologists may not be paying enough attention to glucose status in their patients. John McMurray says that it may now be time to consider checking glycaemic status in all patients with cardiovascular disease or even just risk factors.
Caroline Daly, Royal Brompton Hospital, London
In a session on intensive treatment for diabetes, delegates heard about a study that sheds some light on the impact of metabolic syndrome on patients with coronary disease.
COMMENT: Man Fai Shiu, Walsgrave Hospital, Coventry
Michael Petch, Papworth Hospital, Cambridge
One of the big studies presented at the Munich conference was the Interheart Study - a massive investigation of the risk factors for heart disease with some important clinical implications.
Alain Golay, University Hospital, Geneva
One option for helping people with risk factors related to the metabolic syndrome would appear to be the cannabinoid receptor blocker rimonabant. The RIO-LIPIDS investigated the effect of the drug in 1000 overweight or obese patients.
Chaime Lotan, Hadassah Hospital, Jerusalem
Drug-eluting stents have proved their worth in a number of lesion types but how effective are they in chronic total occlusion? Drawing on data from the e-CYPHER registry, researchers from Jerusalem have been aiming to find out.
Patrick Serruys, Erasmus University, Rotterdam
The ARTS trial, the largest study comparing bypass surgery to percutaneous intervention in patients with multi-vessel disease, is now five years old. It randomised around 1200 subjects eligible for either treatment, and in Munich, delegates heard the latest results.
Tony Barnett, Birmingham Heartlands Hospital
For the growing number of patients with type 2 diabetes, hypertension and early neuropathy, should physicians be using angiotensin converting enzyme inhibitors, or angiotensin receptor blockers? The 5-year DETAIL study provided the first comparative evidence, and suggests that an ARB, telmisartan, is equivalent to enalapril in providing renal protection in these patients.
Anselm Gitt, Heart Centre, Ludwigshafen
A number of studies in the last few years have indicated the primacy of primary PCI over thrombolysis. But there may be a reluctance to give this invasive procedure to elderly patients. According to data from a German registry, MITRA-plus, it’s well worthwhile.
Audio Journal of Cardiovascular Medicine 11.1, January 2005
Reporting from:
American Heart Association Scientific Sessions, New Orleans, November 7-10, 2004
Scientific Editors:
Michael Petch, Papworth Hospital, Cambridge
Man Fai Shiu, Walsgrave Hospital, Coventry
James Tcheng, Duke University, Durham
Harvey White, Green Lane Hospital, Auckland
Producer: Derek Thorne
Correspondents: Richard Black & Derek Thorne
In this edition:
In severe heart failure, Teresa De Marco told delegates at the American Heart Association meeting, vasodilators bring better survival rates as first line therapy than inotropes.
Marc Pfeffer’s results show that adding extra medications such as ACE inhibitors may not improve outcomes - contradicting received wisdom from another recent study.
A synthetic jacket acting like a support stocking can bring benefit to the failing heart, according to Douglas Mann who described his investigation at the New Orleans conference.
Anthony Gerschlick has discovered that in centres where lytic therapy for infarction is the first line of attack, patients needing further rescue should receive angioplasty and not repeat lysis.
David Malenka told the conference how his team found that bypass grafting was better than angioplasty in three-vessel disease.
The idea of getting barbers to screen for blood pressure was raised at the New Orleans conference by Paul Hess following a successful trial conducted by his group.
Shamir Mehta, McMaster University Medical Center, Hamilton
Reviparin has shown increased survival in patients who’ve just had an MI in a new study called: CREATE.
COMMENT: Comparison with Enoxaparin -