Monthly Archives: October 2013

Rituxan or Rituxan with cladribine for Variant Hairy Cell Leukemia – pro
doc at microscope

Recent literature suggests that a subgroup of Hairy Cell Leukemia(NCL), sometimes called Variant Hairy Cell Leukemia(HCL-V)l  my in fact be a different disease not related to HCL at all and which my respond to rituximab to a much higher extent than common Hairy Cell does. It is thought that this variant is what used to be called Leukemic Reticuloendotheliosis in the past. It is an uncommon disorder accounting for approximately 0.4% of chronic lymphoid

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Velcade for Graft Versus Host DIsease – pro
Cancer Cells

Koreth found that Velcade was beneficial in GVHD; but his was a phase II trial and other phase II trials are ongoing. He found that i the 45 patients who were treated in the study; 89% of patients were treated with a one-locus and 11% of patients were treated with a two-loci mismatch. With a median follow-up of 3 years, the 180-day cumulative incidence of grade 2 to 4 acute GVHD was 22%, and the 1-year cumulative incidence of chronic GVHD was 29%.

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Tamoxifen and endometrial cancer – pro
image8 - breast

Tamoxifen is a venerable drug that revolutionized breast cancer care when it was first introduced. More recently, it has been largely supplanted by aromatase inhibitors(AI), but tamoxifen is still useful in pre-menopausal women, in whom AIs do not work. Tamoxifen has a variety of bothersome side effects, related mostly to forced early menopause. In addition, a rare complication of tamoxifen is uterine lining overgrowth, which can proceed to endometrial

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T-SPOT TB test – pro

T-SPOT is an assay used for tuberculosis diagnosis. It which belongs to the group of interferon-gamma release assays. The test is manufactured by Oxford Immunotec in the UK.and it counts the number of anti-mycobacterial effector T cells, white blood cells that produce interferon-gamma, in a sample of blood. This gives an overall measurement of the host immune response against mycobacteria, which can reveal the presence of infection with Mycobacterium

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Prophylactic mastectomy and oophorectomy for BRCA mutation carriers – pro

Prophylactic bilateral mastectomy is the surgical removal of both breasts to help prevent breast cancer. Prophylactic mastectomy is a controversial procedure among members of the medical community. Based on recent scientific findings that show prophylactic mastectomy to be effective at preventing breast cancer, some physicians think that it is  sometimes recommended even without evidence of genetic causation.  According to the American Cancer Society

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SPrycel for melanoma – pro

Sprycel (dasatinib) is an attractive drug for use in melanoma because it affects mutations that re sometimes expressed in melanoma cells, A recent phase II study (Kluger et al) found that it had minimal activity in melanoma, except in patients with the C-KIT mutations. Thirty-nine patients were enrolled, 36 of whom were evaluable for activity and toxicity. Five, 4, and 3 patients had acral-lentiginous, ocular, or mucosal primaries, respectively.

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Adcetris – pro

The Food and Drug Administration (FDA) has approved Adcetris (brentuximab vedotin) for treating patients with Hodgkin lymphoma who have already had a stem cell transplant or are not eligible for one. The drug was also approved for patients with systemic anaplastic large-cell lymphoma (ALCL), who have not improved with at least one previous therapy.  Adcetris is a newer type of drug known as an antibody-drug conjugate: a manmade antibody that targets

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Afirma test for thyroid nodules: ACEG – pro

The majority of FNAs of tyroid nodules show benign histological findings but some are indeterminate or non-diagnostic. In an attempt to separate out patients with a worse prognosis, Afirma has develoiped a proprietory tests, Benign Gene Expression Classifier.  In 2010, two modest-sized validation studies showed that the AGEC test could identify a benign gene expression signature in indeterminate cytology thyroid FNA samples with a negative predictive

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Bone scan in staging prostate cancer- pro

Staging of any cancer requires an assessment of distant metasases. At the same time, for most cancer types, groups that have too low of a chance of having metastatic diseae can be defined, and generally these groups can be spared the cost and discomfort of imaging to look for them. The American Urological Association (AUA) and the European Association of Urology (EAU)  and NCCN provide guideliens that have a bearing on this question in prostate

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