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Capecitabine and radiotherapy as neoadjuvant treatment for rectal cancer
American Journal of Clinical Oncology, 01/14/08

Edgar B-J - Emerging data from Phase II trials of neoadjuvant regimens in which capecitabine has been substituted for 5-Fluorouracil (5-FU) are encouraging. Methods A review article to describe that Capecitabine may be as effective as 5-FU in colorectal cancer Results 5-Fluorouracil (5-FU)-based neoadjuvant chemoradiotherapy is used in rectal cancer to prolong survival, downsize tumors prior to surgery, and allow for sphincter-sparing surgery Capecitabine is an oral fluoropyrimidine that generates 5-FU preferentially within the tumor It has been shown to be as effective as 5-FU and well tolerated in the metastatic and adjuvant settings in colorectal cancer Capecitabine is more convenient for patients than 5-FU, and it avoids the risks of infection and thromboembolism associated with intravenous administration It was also shown to reduce the use of medical resources, healthcare professionals' time, and cost of therapy

Body-mass index and incidence of cancer

Body-mass index and incidence of cancer

 

Renehan AG et al. - In a trial to assess the strength of associations between body-mass index (BMI) and different sites of cancer and to investigate differences in these associations between sex and ethnic groups, it was found that increased BMI is associated with increased risk of common and less common malignancies

Methods

• Electronic searches on Medline and Embase were done and reports were searched to identify prospective studies of incident cases of 20 cancer types
• Random-effects meta-analyses and meta-regressions were done of study-specific incremental estimates to determine the risk of cancer associated with a 5 kg/m2 increase in BMI

Results

• 221 datasets, including 282,137 incident cases were analyzed
• In men, a 5 kg/m2 increase in BMI was strongly associated with oesophageal adenocarcinoma and with thyroid, colon, and renal cancers
• In women, strong associations were recorded between a 5 kg/m2 increase in BMI and endometrial, gallbladder, oesophageal adenocarcinoma, and renal cancers
• Weaker positive associations were noted between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes
• Associations were stronger in men than in women for colon cancer
• Associations were generally similar in studies from North America, Europe and Australia, and the Asia–Pacific region
• Stronger associations were found in Asia–Pacific populations between increased BMI and premenopausal and postmenopausal breast cancers

Proton pump inhibitors and the risk of colorectal cancer

Proton pump inhibitors and the risk of colorectal cancer

 

van Soest EM et al. - In a study to investigate the association between the use of proton pump inhibitors (PPI) and the risk of colorectal cancer (CRC), it seems that no association was found between PPI use and the risk of CRC

 

Methods
Cases with CRC were matched with up to 20 controls on age, gender, calendar time, and duration of follow-up prior to diagnosis
Cumulative exposure to PPIs was assessed in the 5 yr prior to diagnosis with a 1-yr lag time analysis
Adjusted odds ratios (OR) were calculated with 95% confidence intervals using multivariate, conditional logistic regression analysis
Results
Within the source population of 457,024 persons, 595 CRC cases were identified
The odds of CRC were not increased among pts ever using PPIs compared with pts who never used PPIs
Use of PPIs for >365 days was not associated with a greater risk of CRC compared with nonusers
The odds of CRC in neither the right nor the left hemicolon were significantly increased in pts using PPIs

A randomised phase III study on capecitabine, oxaliplatin and bevacizumab with or without cetuximab in first-line advanced colorectal cancer, the CAIRO2 study of the Dutch Colorectal Cancer Group (DCCG). An interim analysis of toxicity

Tol J et al. – For first-line treatment of advanced colorectal cancer (ACC), cetuximab addition to capecitabine, oxaliplatin and bevacizumab is safe and feasible with no observed excessive or unexpected toxicity in the cetuximab treatment arm

 

Methods

 

Study to evaluate the effect of adding cetuximab to capecitabine, oxaliplatin and bevacizumab in first-line treatment of ACC (CAIRO2 study)
Randomization of 755 pts to treatment with capecitabine, oxaliplatin and bevacizumab with or without cetuximab
Primary end point: progression-free survival
Toxicity results for first 400 pts reported

 

Results
Incidence of overall grade 3–4 toxicity was significantly higher in arm B (81%) vs arm A (72%)
Toxicity difference is fully attributed to cetuximab-related skin toxicity
Addition of cetuximab did not increase gastrointestinal toxicity or treatment-related mortality