June 26, 2007
Antipsychotics raise elderly death rates, study finds
Proving again the dangers of antipsychotics, a new study finds that the drugs increase the risk of death among older patients.
Both newer atypical antipsychotics and older conventional drugs increased death rates by as much as one-and-a-half times among elderly patients with dementia, according to Canadian researchers. Conventional antipsychotics seemed to be the more dangerous of the two types of drugs, they found. Antipsychotics, which typically treat conditions such as schizophrenia, are often used to treat behavioral problems associated with dementia.
While the risk for individual patients is slight, the findings likely indicate that older patients are more vulnerable to the adverse effects of antipsychotics, study author Dr. Sudeep Gill said. The study appeared in the Annals of Internal Medicine.
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June 25, 2007
Diabetes costs warrant prevention efforts
Medicare and other payers could do more to reduce the number of people with diabetes, a new study finds.
The federal government spent upwards of $80 billion in fiscal year 2005 on diabetes care, according to the study by Mathematica Research. A larger focus on prevention, early detection and early treatment, as well as better cooperation between federal programs, could have reduced these costs, researchers say. Diabetes is linked to health problems affecting the heart, kidney and circulatory system.
Appropriate screening and early detection of diabetes should be a priority in all federal programs, particularly Medicare and Medicaid, the study said. In FY 2005, one out of eight federal healthcare dollars went towards diabetes-related treatment.
An Opportunity for Federal Leadership: A Study of Federal Spending on Diabetes is available at http://www.ncdp.com/projects/federalSpending.aspx
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June 8, 2007
New Cancer Drug Shows Promise
Swiss firm Novartis' experimental targeted anti-cancer drug appears to be active against neuroendocrine tumors that arise in the abdomen.
James Yao, assistant professor of gastrointestinal medical oncology at the University of Texas M.D. Anderson Cancer Center, said that RAD001 or everolimus, a type of drug known as an mTOR inhibitor, interferes with the ability of cancer cells to replicate.
Patients on the drug experienced shrinkage of tumors in cancers that are resistant to most traditional anti-cancer therapies.
We still have no effective treatment for these diseases, Yao said at the 43rd annual meeting of the American Society of Clinical Oncology in Chicago, but the diagnoses of these tumors is on the rise.
In the study, researchers enrolled 60 patients to receive two different doses of RAD001 for treatment of carcinoid tumors and islet cell tumors.
In the study patients were treated with octreotide -- Novartis' Sandostatin -- which can manage the symptoms associated with the cancers, but does not control tumor growth.
Overall, Yao said tumors shrank in 20 percent of patients, and 72 percent of patients saw their disease stabilize. The median progression-free survival was 59 weeks, he said.
Yao also said that patients entering the study with their disease already progressing fared worse that those who entered the trial with stable disease. The patients who were progressing at the start achieved a 50-week progression- free survival while those who were stable at the beginning of the study achieved a 73-week progression free survival.
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June 4, 2007
Study: Liver Cancer Breakthrough Found
CHICAGO - For the first time, doctors say they have found a pill that improves survival for people with liver cancer, a notoriously hard to treat disease diagnosed in more than half a million people globally each year.
The results in a multinational study of 602 patients with advanced liver cancer are impressive and likely will change the way patients are treated, cancer specialists including the study authors say.
Patients got either two tablets daily of a drug called sorafenib or dummy pills in the study, which started in March 2005. Some patients are still alive, although on average, sorafenib patients survived 10.7 months versus almost 8 months for those on dummy pills.
That type of survival advantage "has never happened" with liver cancer "and is a major breakthrough in the management of the disease," said Dr. Josep Llovet, the lead author.
"That may not sound like a lot of time," but for liver cancer, "this is actually a quite impressive gain," said Dr. Nancy Davidson of Johns Hopkins' Bloomberg School of Public Health. "It is the first effective systemic treatment for liver cancer, which is such a huge problem internationally."
Sorafenib attacks cancer with a targeted double-barreled approach. It zeros in on malignant cells themselves and cuts off the blood supply feeding the tumor. It is believed to work on tumors within the liver and those that have spread elsewhere.
In the study, tumors didn't shrink or disappear but in many cases they also didn't grow.
"You are not curing the disease but you are delaying the progression of the disease significantly and strikingly," said Llovet, of Mount Sinai School of Medicine in New York and Hospital Clinic of Barcelona, Spain.
The study was halted early, in February, because of the good results, and patients on dummy pills were switched to sorafenib.
"This is a very good step forward in this disease," said Dr. Emily Chan of Vanderbilt-Ingram Cancer Center in Nashville, Tenn.
Results were prepared for release Monday in Chicago at the American Society of Clinical Oncology's annual meeting.
The drug, sold under the brand name Nexavar, is approved in the United States and dozens of other countries to treat advanced kidney cancer. It is marketed by Bayer Pharmaceuticals Corp. and Onyx Pharmaceuticals Inc., which funded the liver cancer study. They hope to receive approval for liver cancer use from U.S. and foreign regulators.
Llovet has done consulting for the sponsors.
Liver cancer is diagnosed in about 19,000 Americans annually but is much more common elsewhere and is the fifth most common cancer globally. Risk factors include chronic liver infections and some forms of hepatitis. The disease is common in China and countries without widespread use of the hepatitis B vaccine, which is routinely given to U.S. infants.
Liver cancer doesn't respond well to conventional chemotherapy and is often diagnosed too late for surgery to be an option. Many patients die within a year of diagnosis.
Robert Throckmorton, a 73-year-old attorney in Orange County, Calif., said his doctor told him "You better get your affairs in order" after he was diagnosed with inoperable liver cancer last August.
But then the doctor offered sorafenib off-label, and Throckmorton readily agreed. He did not take part in the study.
After nine months on the drug, Throckmorton said his cancer shows no sign of progression and he has no significant side effects. He said he walks three miles six days a week to stay active and feels fine.
Instead of thinking about wills and funerals, Throckmorton is looking forward to get-togethers with his eight children and 18 grandchildren, and even a possible church trip to Uruguay with his wife.
"I have good energy," Throckmorton said. "We are optimistic."
American Society of Clinical Oncology: http://www.asco.org
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