Articles
BRCA mutation carriers who have had breast cancer are at increased risk of developing contralateral breast cancer, according to a study presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. In fact, women with a BRCA1 or BRCA2 mutation had a greater than 10% risk of developing contralateral breast cancer, and the risk was strongly associated with younger age at diagnosis and a diagnosis of triple-negative (estrogen receptor–negative, progesterone receptor–negative, and HER2-negative) breast cancer.
Although management of lymphoma during pregnancy is not well studied, a retrospective review at 10 academic centers in the United States suggests that in selected cases, lymphoma can be treated with minimal maternal and fetal complications, and that treatment can be deferred until after giving birth in patients with low-risk lymphomas. The study was presented at the 53rd Annual Meeting of the American Society of Hematology held December 2011 in San Diego, California.
Administering gemtuzumab ozogamicin (GO) on a new schedule achieved impressive progression-free survival (PFS) and overall survival (OS) compared with standard chemotherapy in older patients with acute myeloid leukemia (AML) with favorable cytogenetics, according to a phase 3 study presented at the Plenary Session of the 53rd Annual Meeting of the American Society of Hematology (ASH). GO was taken off the market in 2010 due to toxicity concerns and is no longer available in the US.
In 2011, the American Cancer Society projected there would be 20,520 cases of newly diagnosed multiple myeloma (MM) and 10,610 deaths from the disease that year.1 MM is an incurable hematologic cancer marked by great heterogeneity, in terms of its biology and clinical course. Morbidity and survival rates vary widely, even in the age of novel, molecularly based targeted therapies. Many factors account for differences in prognoses among patients with MM, including genomic aberrations in the plasma cells of the myeloma neoplasm.
In a randomized phase 2 study of metastatic breast cancer patients, peripheral neuropathy (PN) was less likely to occur in patients receiving eribulin mesylate than with ixabepilone.
“Peripheral neuropathy is a big problem in the treatment of breast cancer. Across the spectrum, patients have it, and we don’t know how to treat it,” said Linda T. Vahdat, MD, of Weill Cornell Medical College in New York, who presented the study at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium (Poster P5-19-02).
I will say right up front that I am all in favor of specialty pharmacy training and the subsequent board certification. The real questions are: how much training is enough? how much is too much? and what options are available? I’ve been in the oncology business for over 30 years now and began when there was no real specialty training to speak of. In fact, my introduction into the specialty just happened; it wasn’t planned at all. I wanted to stay in Madison, Wisconsin, when I finished my hospital pharmacy residency, but I was actually more interested in emergency care.
Dr Hansen’s article brings to light financial aspects of healthcare that we do not often consider. A recent economic analysis showed the total cost of cancer care in the US reached $209.9 billion in 2005.1 The high costs of chronic cancer care come in second to cardiac disease (23% and 38%, respectively).2,3 However, increased costs do not yield longer life.
It is well documented that healthcare costs and spending have been growing at staggering rates. Healthcare accounts for ~17% of total gross domestic product (GDP) in the United States. In comparison, in 1960, healthcare only accounted for about 5% of GDP. Our current level of spending is nearly double the average percentage of GDP of every other country in the world. Total healthcare spending comes from many sources, including but not limited to hospital care, physician and clinical services, nursing home care, administrative costs, and prescription drugs.
The evolution of drug research and development toward oral therapies for cancer over the past decade has created a number of questions for the oncology healthcare provider. Will insurance companies pay for these exceptionally expensive medications? How and when will patients receive their medication? Who will be responsible for ensuring patient education and monitoring to maximize safe drug administration and patient compliance?