Preventing Venous Thromboembolism: Apixaban More Effective With Solid Tumors

A preplanned post-hoc analysis of the AVERT trial, a randomized, placebo-controlled, double-blind clinical trial of apixaban for the prevention of venous thromboembolism (VTE), reveals that among ambulatory patients with cancer initiating chemotherapy, characteristics of both the patient and the cancer in question impact the efficacy of apixaban for VTE prophylaxis. "Patients with active cancer have an increased risk of venous thromboembolism (VTE) complications which is associated with morbidit...
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Breast Cancer: BRCA1/2 Mutations Enhance Chemotherapy’s Efficacy

Carriers of germline variants in the BRCA1 and BRCA2 genes are more likely to experience a pathologic complete response to two different chemotherapy regimens, according to a retrospective study now published in JAMA Oncology. This study was a secondary analysis of data from the GeparOcto multicenter prospective clinical trial, in which 945 women with different subtypes of high-risk, early-stage breast cancer were randomized to receive either sequential intense dose-dense epirubicin/paclitaxel/c...
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Testicular Cancer: Half the Chemotherapy, Same Efficacy

​One cycle of chemotherapy with bleomycin, etoposide, and cisplatin (BEP) works just as well as two cycles for the adjuvant treatment of high-risk, stage 1 nonseminomatous or combined germ cell tumors of the testis, report the investigators of a single-arm phase 3 study. Patients with testicular cancer, the most common cancer among American males between the ages of 15 and 35, often present with stage 1 disease. However, many nonseminomas and combined germ cell tumors of the testis have malignan...
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Olanzapine 5 mg Effective for Preventing CINV

In order to prevent chemotherapy-induced nausea and vomiting (CINV), 10 mg of olanzapine, an antipsychotic, is often added to standard antiemetic therapy including aprepitant, palonosetron, and dexamethasone. However, reducing the dose of olanzapine to 5 mg is recommended by guidelines to mitigate sedation, a common side effect of olanzapine. In this randomized, double-blind, placebo-controlled, phase 3 trial, researchers discovered that 5 mg of olanzapine is effective at treating CINV in patien...
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How Does Cancer Treatment Affect Immune Health in HIV Patients?

In people with HIV and cancer, antiretroviral therapy is often used during cancer treatment to mitigate complications of HIV progression. However, questions regarding long-term effects of cancer treatment in this patient population remain, such as the immunosuppressive effects on HIV RNA level and CD4 count, which are indicators of a patient's morbidity and mortality. Therefore, scientists sought to measure the link between these biomarkers and associated mortality after cancer treatment. They p...
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No Long-Term “Chemo Brain” Impact in Testicular Cancer

Cognitive changes have been associated with various cancer treatments. In studies, between 17% and 75% of breast cancer survivors have reported cognitive deficits after chemotherapy. Commonly known as "chemo brain," these symptoms have had reported durations of up to 20 years after receipt of breast cancer treatment. Fortunately, this is not the case for patients with testicular cancer: a new study shows no long-term cognitive impairment following chemotherapy. The prospective study, p...
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How Being Unmarried Impacts Cancer Treatment: An Interview With Joan DelFattore, PhD, MS

Studies have shown that unmarried patients with cancer are less likely to receive surgery and radiotherapy than their married counterparts; they are also less likely to survive their cancer. In a research-based perspective essay published in The New England Journal of Medicine, Joan DelFattore, PhD, MS, a survivor of stage IV gallbladder cancer, suggests that contrary to assumptions made by a number of researchers, the disparities in cancer treatment for individuals who are single may stem not f...
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Early Breast Cancer in Older Patients: Standard Chemotherapy Versus Capecitabine

In older women with early breast cancer, standard adjuvant chemotherapy is superior to capecitabine for recurrence-free survival. These results come from the 10-year follow-up of the Cancer and Leukemia Group B (CALGB) 49907 trial, which focused on patients age 65 and older. For this study, 633 patients were randomized to receive either standard adjuvant chemotherapy, consisting of physician's choice of cyclophosphamide/methotrexate/fluorouracil or cyclophosphamide/doxorubicin, or capecitabine. ...
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Endometrial Cancer: Chemoradiotherapy Versus Chemo Alone

​Because endometrial carcinoma is a heterogeneous disease, it is often difficult to treat, and women diagnosed with advanced disease are at risk for local and systemic recurrence. When researchers tested platinum-based chemotherapy plus radiation therapy against chemotherapy alone in patients with stage III or IVA endometrial carcinoma to see which treatment improved outcomes the most, they discovered that chemoradiotherapy did not improve outcomes more so than chemotherapy alone. This study, re...
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Optimizing Oral Chemotherapy Patient Education With Robin Esposito, RN, BSN, OCN®

​Because oral chemotherapy agents are administered by the patient at home without direct supervision from a nurse, patients often call with questions and concerns about their medications. Seeking to prevent lost time and patient confusion, Robin Esposito, RN, BSN, OCN®, undertook a project aimed at improving communication and education regarding oral chemotherapy agents for patients in ambulatory care settings. In this interview with i3 Health, Ms. Esposito discusses the implementation and resul...
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Adjuvant Capecitabine Effective in Biliary Tract Cancer

​With a five-year overall survival rate under 10%, the outlook is poor for individuals diagnosed with biliary tract cancer. Only 20% of patients are eligible for surgical resection with the intent to cure the disease. In addition, until this point, no studies have identified a beneficial adjuvant therapy. In order to remedy this problem, the researchers of the BILCAP study (EudraCT 2005-003318-13), a phase 3 clinical trial featuring a collaboration of 44 specialist hepato-pancreato-biliary cente...
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Adding Docetaxel to Androgen Suppression and Radiotherapy in High-Risk Prostate Cancer: An Interview With Seth A. Rosenthal, MD, FACR, FASTRO

Of the 20% of patients with prostate cancer who have high-risk disease, around 30% to 40% experience a relapse following initial treatment. Less than 50% of these patients are cured. A phase 3 clinical trial, the NRG Oncology trial NRG-RTOG 0521, reports a way to improve survival for patients with nonmetastatic, high-risk prostate cancer: adding docetaxel to a standard regimen consisting of radiotherapy (RT) and long-term androgen suppression (AS). In this interview with i3 Health, Seth A. Rosen...
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High-Risk Prostate Cancer: Adding Docetaxel Increases Survival

A phase 3 clinical trial reports that adding docetaxel to a standard regimen consisting of radiotherapy and long-term androgen suppression (AS) therapy improves outcomes for men with high-risk nonmetastatic prostate cancer. In the United States, prostate cancer is the second leading cause of cancer-related death among men. Of the 20% of patients whose prostate cancer is considered high risk, around 30% to 40% experience a relapse following initial treatment. Less than 50% of these patients are c...
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Nurses’ Hazardous Drug Handling Intervention

Without using proper personal protective equipment (PPE), health care providers who administer chemotherapy drugs to patients are at high risk of chemotherapy exposure, with the danger of inhaling drug vapors or touching surfaces contaminated by the drugs. Exposure to chemotherapy drugs increases the risk of developing leukemia, other cancers, adverse reproductive outcomes, and chromosomal damage. Therefore, wearing personal protective equipment (PPE) such as gloves or gowns is crucial while han...
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Glioblastoma: New First-Line Treatment Regimen Provides Hope

​A phase 3 clinical trial has shown that a regimen consisting of lomustine and temozolomide in combination with radiotherapy can improve survival for patients with previously untreated glioblastoma with MGMT promoter methylation. Glioblastoma, the most common form of primary brain tumor, is highly aggressive and extremely deadly, with a five-year survival rate of only 5.6%. Standard treatment is radiotherapy followed by chemotherapy with temozolomide, an alkylating agent (a drug that interferes ...
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Enhancing Chemotherapy and Protecting the Heart

Researchers at the University of Alberta Faculty of Medicine and Dentistry have found a way to increase chemotherapy's effectiveness while shielding the heart from its harmful side effects. Many chemotherapeutic drugs, including anthracyclines such as doxorubicin, are known to cause damage to the heart as a result of the activation of p53. This protein fights cancer by inducing apoptosis—programmed cell death—in tumors. However, it also induces apoptosis in other organs, including the heart, whe...
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Chemotherapy Agents Differ in Long-Term Cardiac Risks

​Although anthracyclines—chemotherapeutic agents that are extracted from Streptomyces bacterium—can be highly effective in the fight against various pediatric cancers, they carry a long-term risk of cardiovascular disease that continues to impact patients well into their adult lives. While this much is well known, the impact of specific anthracyclines on cardiac risk has not been adequately studied. In a study published in JAMA Oncology, researchers have now identified the relative long-ter...
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Hypodiploid Acute Lymphoblastic Leukemia: Improving Treatment

Around 2% of all pediatric patients with acute lymphoblastic leukemia (ALL) have hypodiploid ALL, a high-risk subtype in which leukemic cells have 25 to 44 chromosomes rather than the standard 46. Researchers have now found important clues that can help alter the poor prognosis for this condition. In a new study published in the Journal of Clinical Oncology, investigators performed a retrospective study of patients with hypodiploid ALL enrolled in research trials for 16 cooperative study groups ...
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PTUPB: A Key to Hindering Tumor Inflammation

Although chemotherapy is a potent treatment, it sometimes causes dying cancer cells to become inflamed, triggering the growth of more malignant cells. Researchers have discovered a new anti-inflammatory compound that decreases tumor inflammation and reduces cancer growth in ovarian tumors in mice. In these recent developments, published in Proceedings of the National Academy of Sciences, investigators discovered that first-line platinum- and taxane-based chemotherapies fuel a macrophage-derived ...
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“Sponge” Absorbs Excess Chemo Drugs to Avoid Side Effects

Chemotherapy can be highly effective at treating cancer, but doctors often cannot prescribe the optimal cancer-killing dose due to systemic toxic side effects. When chemotherapy is administered to a cancerous organ via intra-arterial infusion, 50% to 80% of the drug generally does not remain in that organ. The excess passes on to the veins that drain the organ, entering the circulatory system, where it gets distributed to the rest of the body. Researchers from the University of California, Berke...
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