Monthly Archives: November 2012

Votrient (pazopanib) for Gastrointenstinal Stromal Tumors (GIST)

Pazopanib(Votrient)  is a new drug that is approved for kidney cancer  and acts in ways that may be effective in GIST. These are important pathways for GIST tumors and several trials are avaluating this drug in GIST, including: Efficacy of Pazopanib in Gastrointestinal Stromal Tumors (GIST), NCT Number: NCT01323400, Pazopanib in Imatinib Refractory or Intolerant Gastrointestinal Stromal Tumors (GIST)  NCT Number: NCT01391611 and Pazopanib in Advanced

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Votrient for GIST – pro

Pazopanib(Votrient) is an oral angiogenesis inhibitor targeting vascular endothelial growth factor receptor (VEGFR), platelet derived growth factor receptor (PDGFR), and KIT. These are important pathways for GIST tumors and several trials looked into using pazopanib for GIST. Although initial studies suggested that the drug is not effective for GIST, more recently a phase II study of 25 patients and a randomized study of 86 patients suggest that

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Xarelto

Xarelto is the first oral blood thinner approved for anti-coagulation in 60 years, since Warfarin (coumadin) was approved. A variety of injectable options are available; however, the oral route is preferred by many physicians and patients.  Xarelto joins the much older Coumadin as an oral medication. Previouwly Xarelto was only approved for Reduction of Risk of Stroke and Systemic Embolism in Nonvalvular Atrial Fibrillation. In November 2012, the

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Xarelto: Now approved for DVT and PE – pro
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  Xarelto (varoxaban, a factor Xa inhibitor) is the first oral anti-coagulant approved for anti-coagulation in 60 years, since Warfarin (coumadin) was approved. A variety of parenteral options are available; however, the oral route is preferred by many physicains and patients. In November 2012, the U.S. Food and Drug Administration expanded the approved use of Xarelto (rivaroxaban) to include treating deep vein thrombosis (DVT) or pulmonary

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Topotecan with Avastin in ovarian cancer

Topotecan is an old drug that can be used in second line( after failure of the initial drugs) treatment of ovarian cancer.  In ovarian cancer, topotecan has demonstrated activity in both platinum-and Taxol resistant tumors. In a randomized, phase III study, patients like this had similar response rates with topotecan or Taxol. That phase III study, and earlierphase II studies, established topotecan as an important treatment option for patients

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Topotecan and Avastin for ovarian cancer – pro
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Topotecan is a water-soluble, semisynthetic analogueof camptothecin that inhibits the nuclear enzyme topoisomeraseI. Topotecan has been approved by the U.S. Food and DrugAdministration (FDA) for the treatment of recurrent epithelialovarian cancer and relapsed small cell lung cancer,and has also demonstrated activity in hematologic malignancies and solid tumors including non-small cell lung, cervical, and colon cancers. In ovariancancer, topotecan

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How often to scan the brain after radiosurgery

How to follow a patient with brain mets after radiosurgery is becoming a more and more common question becasue treatments that control cancer in the rest of the boady are getting to be more and more effective and patients are living longer before cancer comes back in the brain or in the body. One does not want to overmonitor but also not to miss metastses when they come back. Many patietns remain disease free for many months even years after radiosurgery

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How to follow brain metastases after radiosurgery – pro
Concept of medical education with book and stethoscope

How to follow a patient with treated brain metastases is becoming a more and more actual clinical problem as treatments that control systemic disease continue to improve. It is not uncommon now to follow a patient for many months or even years after treatment of metastatic disease without new metastases developing. One study reported a median time of 8.8 months to new metastasis after radiosurgery. Patients with 3 or more lesions and cancer histologies

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Temodar for Kidney Cancer

Personalized medicine approach tests individual cancers and chooses treatments based on this testing. Temodar is one of the drugs that is usually included in chemosensitivity panels. Sometimes, it is recommended to renal cell cancer patients based on such testing. Unfortunately, this new paradigm does not "fit" well with the existing approaches and methods for weighing and evaluating evidence supporting cancer treatments, and new approaches to do

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Temodar for renal cell carcinoma – pro
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Personalized medicine approach relies heavily on chemosensitivity testing and genetic profiling of individual cancers. Temodar is one of the drugs that is usually included in chemosensitivity panels. Unfortunately, the new paradigm does not "fit" well with the existing approaches and methods for weighing and evaluating evidence supporting cancer treatments, and new approaches to do so have not yet been developed. Temodar has some supporting, albeit

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