Biological Therapies

Zoledronate in prostate cancer – pro

Zoledronic acid (Zometa) is an intravenously administered bisphosphonate that has been approved by the Food and Drug Administration (FDA) for the treatment of hypercalcemia of malignancy and bone mets of solid cancers. The 4mg monthly dose is the one FA indicated. In two placebo-controlled clinical studies in patients with bone metastases from prostate cancer (n=643), meaning that 643 patien were enrollled on one arm, or from other solid tumors (n=773),

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Yttrium-90 spheres for HCC – pro

Lay Summary: Theraspheres are being investigated for liver cancer and colon cancer metastases. It is considered investigational at this time. TheraSphere -- a therapy that consists of millions of microscopic, radioactive glass microspheres (20-30 microns diameter) -- is infused into the arteries that feed inoperable liver tumors, bathing the malignancy in high levels of extremely localized radiation. In some studies of highly selected pateints the

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Anemia factor guidelines – pro

Lay Summary: Procrit and Aranesp are being heavily regulated based on the guidelines presented here. In order to provide a framework for erythropoietin therapy, several evidence-based guidelines have been developed, differing in scope and methodological rigor. Evaluation of iron stores is essential to proper application of these guidelines. In iron deficiency, erythropoietic factors are presumed not to be effective and the guidelines aim to avoid

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BCR/ABL Monitoring of chronic myelogenous leukemia on Gleevec – pro

There have been no studies that demonstrate that followup with BCR/ABL assists with actual clinical management of CML but it has become standard based on a guideline recommendation.It is not clear what the best monitoring stategy of imatinib might be; however, bcr/abl analysis would be a part of any finally accepted strategy. Unfortunately no trials of such strategies have been eprfomred but there is guidance from expert consensus. Some physicians

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Gleevec for glioblastoma and astrocytoma – pro

Lay Summary: Gleevec is not active in glioblastoma but may have promise in combination with other drugs. Despite optimal treatment, the prognosis of patients with malignant gliomas remains poor. Patients with glioblastoma multiforme have a median survival of 9 to 14 months, whereas those with anaplastic astrocytomas have a median survival of 24 to 36 months. Once patients develop tumor progression, conventional chemotherapy is generally ineffective,

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Taxol, carboplatin, Erbitux for stage IV head and neck cancer – pro

For the treatment of recurrent and/or metastatic head and neck cancer, therapeutic options include re-irradiation and salvage surgery and chemotherapy, with best supportive care for patients unable or unwilling to undergo treatment. Palliative chemotherapy has demonstrated survival advantages over best supportive care, and the most commonly used agents are cisplatin and carboplatin, generally in combination regimens with infusional fluorouracyl or

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G-CSF (Neupogen) for Hepatitis C neutropenia – pro

Pegylated interferons have been associated with a greater decrease in absolute neutrophil counts than standard interferons, requiring dose reduction secondary to neutropenia in 18-20% of treated patients. While neutropeniais common, rarely is the neutropenia severeenough to warrant permanent discontinuationof therapy. If the neutrophil count drops below0.75 x 109 / L, the pegylated interferon doseshould be reduced by 50%. If the neutrophilcount falls

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Avastin for renal cell cancer – pro

Avastin is an effective treatment for renal cell carcinoma. It is FDA approved for the treatment of metastatic renal cell carcinoma in combination with interferon alfa. This is based on the AVOREN study, which revealed that the addition of Avastin® (bevacizumab) to interferon improves progression-free survival when used as initial therapy among patients with metastatic renal cell carcinoma(mRCC). The details of this randomized trial were presented

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Pancreatic cancer – gemcitabine + other drugs but not oxaliplatin – pro

Lay Summary: Gemcitabine is a standard drug for pancreatic cancer. Combining it with other drugs may make it work better but that is not yet completely clear. Locally advanced and metastatic pancreatic adenocarcinomas carry a very poor prognosis. In patients treated with the standard palliative treatment gemcitabine (GEM), median survival still remains only 6 months. Over the last several years, many trials have been designed combining GEM with various

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Nexavar for melanoma – pro

Lay Summary:Nexavar has not been proven to be effecive for melanoma. Nexavar has not been proven to be effective for melanoma. A Phase III trial administering Nexavar® (sorafenib) or placebo tablets in combination with the chemotherapeutic agents carboplatin and paclitaxel in patients with advanced melanoma did not meet its primary endpoint of improving progression-free survival (PFS). The treatment effect was comparable in each arm. The international

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