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Decitabine for acute myelogenous leukemia – pro

Dacogen (decitabine) is a new drug, a DNA methyltransferase inhibitors (DMTI) that approved by the FDA for use in all French- American British (FAB) categories for MDS. The response rates for Dacogen were 30% (9% CR, 8% PR, 13% HI). Median TTP was prolonged from 7.8 months to 12.1 months compared to supportive care (p=0.1). Higher response rates have been reported in a single institution trial using lower doses of Dacogen. This drug is now FDA approved

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Oxycodone – pro

Oxycodone is a full opioid agonist with no antagonist properties whose principal therapeutic action is analgesia. It has an affinity for kappa, mu and delta opiate receptors in the brain and spinal cord. Oxycodone is similar to morphine in its action. Other pharmacological actions of oxycodone are in the CNS (respiratory depression, antitussive, anxiolytic, sedative and miosis), smooth muscle (constipation, reduction in gastric, biliary and pancreatic

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Vectibix in combination – pro

Panitumumab (Vectibix, Amgen) was approved by the FDA for the treatment of patients with EGFR-expressing, metastatic colorectal carcinoma with disease progression on or following fluoropyrimidine-, oxaliplatin-, or irinotecan-containing regimens. The NCCN Colon Cancer panel added panitumumab as alternate option to cetuximab after first or second progression on previous therapy. This addition came with a recommendation that patients should not be

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MVAC for bladder cancer – pro

Systemic chemotherapy is the only modality that has been shown in phase 3 trials to improve survival in responding patients with advanced bladder cancer).The M-VAC regimen, first reported in 1985 by investigators from Memorial Sloan-Kettering Cancer Center, revealed that urothelial carcinoma was sensitive to chemotherapy. Patients with measurable lesions were found to have a remarkably high response rate of 72%, and 36% attained complete response.

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Interferon for VIPoma – pro

The VIPoma syndrome is rare and difficult to treat and for this reason, ti is not well studied. It is usually caused by a neuroendocrine tumor located in the pancreas or other organs and present primarily with diarrhea. Treatment relies on resection and octreotide but occasionally interferon or steroids can be used as adjuncts (Best Practice, Eppocrates). On the other hand, other reviews do not mention interferon or mention it in combiantion with

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Oncotype in node positive women – pro

  The Intergroup Trial E2197 reported that Oncotype DX identifies women with hormone positive, HER2-negative breast cancer with 0-3 positive axillary nodes who are at a 3-4 fold increase in the risk of relapse despite standard chemotherapy and hormonal therapy. These results were presented at the 2007 annual meeting of the American Society of Clinical Oncology (ASCO) and it involved 465 women who had received chemotherapy and hormonal therapy for

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Laparascopic liver resection for benign lesions – pro

It is a fairly rare for benign liver lesions to cause pain and there are no specific guidelines for how to treat such situations. However, the literature contains many reports of laparoscopic partial liver resections for non-cancer diagnosis. In experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Perioperative morbidity and mortality and long-term survival after laparoscopic resection  appear to be comparable

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Hepatocellular carcinoma and Folfox – pro

It is a fairly rare for benign liver lesions causing pain and there are no specific guidelines for thist. However, the literature contains many reports of this procedure being performed for non-cancer diagnosis(2,4). In experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Perioperative morbidity and mortality and long-term survival after laparoscopic resection  appear to be comparable to those after open

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Lidoderm for cancer pain syndromes – pro

The development of a lidocaine 5% patch (Lidoderm®; Endo Laboratories; Chadds Ford, PA) has facilitated the topical application of local anesthetics. This formulation is approved in the U.S. for the treatment of postherpetic neuralgia; however, there are a variety of case reports and small studies of its use in cancer syndromes. Clinical experience supports its use for other neuropathic pain conditions. There are a number of phase II studies that

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Osteonecrosis in patients previously radiated for head and neck cancer – pro

Osteonecrosis is rare in patients who receive less than 60 gray (Gy) radiation therapy. Patients with ORN who receive less than 60 Gy and more than 50 Gy have been reported, but these cases are extremely rare. The overall incidence of ORN has decreased over the last 3 decades. In general, studies from prior to the 1970s showed an ORN incidence from 5.4-11.8%. More recent studies, however, have placed the incidence closer to 3.0%. The true frequency

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