Effect of Noncytotoxic Second-Line Regimen for Metastatic Pancreatic Cancer

This phase 2 randomized clinical trial compares selumetinib and MK-2206 vs modified FOLFOX chemotherapy in patients with metastatic pancreatic cancer for whom gemcitabine-based therapy had failed.

http://ift.tt/2gQ46u5

Approach to hypersensitivity reactions from intravenous iron preparations

Abstract

Hypersensitivity reactions (HSRs) to intravenous iron preparations (IVIPs) are well known. With newer preparations, HSRs have become rarer; however, severe reactions may still occur. We retrospectively reviewed records of patients evaluated for HSRs to IVIPs, to determine the safety of controlled re-administration (CRA). Allergological workup included a detailed history, skin prick tests (SPTs) with IVIP, and basophil activation tests (BATs) in some patients. CRA with an IVIP was done if indicated. 31 patients with mild to severe reactions were evaluated. SPTs and BATs were negative in all patients tested. 18 CRAs in 15 patients were performed. 12 patients tolerated the procedure, including three with a previous grade IV HSR. Two developed urticaria, one developed urticaria and dyspnea. The pathophysiology of HSRs to IVIPs remains currently unclear. SPTs and BATs provided no additional information. However, in appropriate situations, CRA under surveillance can be safely performed in most patients.

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http://ift.tt/2hAEal9

Carboplatin-Paclitaxel vs Cisplatin-Etoposide With Thoracic Radiation for NSCLC

This systematic review compares outcomes and toxic effects between thoracic radiation with either cisplatin-etoposide or carboplatin-paclitaxel for patients with stage III non–small-cell lung cancer.

http://ift.tt/2hTacrn

Lymphoma and Pregnancy—Reply

In Reply We read with interest the Letter by Avilés and colleagues regarding our recent submission reporting on fetal and maternal outcomes after treatment for Hodgkin and non-Hodgkin lymphoma during pregnancy. Specifically, Avilés et al were interested in the apparent omission of the CD20-targeted agent rituximab among the patients in our study with diffuse large B-cell lymphoma (DLBCL). Rituximab is a component of standard-of-care initial therapy for DLBCL (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone). Among the 24 patients who received antenatal therapy in our study, 4 patients did receive rituximab (1 in the first trimester and 3 in the second trimester (eTable 1 in the Supplement). Also, in our series the majority of patients had classic Hodgkin lymphoma, for which rituximab would not be a standard-of-care part of front-line therapy. Only 7 patients in our review had B-cell non-Hodgkin lymphoma (4 of whom had DLBCL). Avilés et al state that among 32 cases of DLBCL involving treatment during pregnancy at their institution, 9 patients received rituximab. While there were no reported acute toxic effects, severe late infections (mainly lung) occurring in 6 of 9 children necessitated acute critical care. Rituximab was the suspected etiology behind these infectious complications.

http://ift.tt/2hTey1A

Lymphoma and Pregnancy

To the Editor We read carefully the recent article by Pinnix et al about the treatment of patients with malignant lymphoma and Hodgkin lymphoma, which showed that standard treatment (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone [CHOP] or CHOP-like) administered to mothers with malignant lymphoma is well tolerated by the mother, without excessive toxicity, and with an excellent outcome (overall survival) compared with nonpregnant women who received the same treatment, as previously reported.

http://ift.tt/2gQ68L7

Prevalence and Spectrum of Gene Mutations and Colorectal Cancer

This cohort study examines the frequency and spectrum of cancer susceptibility gene mutations among patients with early-onset colorectal cancer.

http://ift.tt/2hTfQd7

Identifying Genetic Predisposition for Colorectal Cancer

Colorectal cancer (CRC) is the third most common cancer in the United States, diagnosed at a median age of 69 years for men and 72 years for women. Although CRC incidence and mortality have declined overall as a result of an increased uptake of screening, work remains to be done since 40% of eligible individuals are not compliant with CRC screening recommendations and CRC incidence is rising among adults younger than the screening age of 50 years. Hereditary cancer syndromes are implicated in approximately 5% of all CRC cases. Although the prevalence of genetic predisposition is likely higher among individuals who develop cancers at an early age, younger patients with CRC are significantly less likely than their counterparts with young-onset breast cancer to undergo genetic evaluation. Identification of hereditary cancer syndromes is important because morbidity can be averted through frequent endoscopic surveillance beginning at an early age.

http://ift.tt/2gQa6TT