© 2003 by Oxford University Press
Journal of the National Cancer Institute, Vol. 95, No. 11, 777,
June 4, 2003
© 2003 Oxford University Press
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In Brief
High-Dose Chemotherapy Shows Promise Against Multiple MyelomaHigh-dose chemotherapy combined with an autologous stem-cell transplant appears to be a more effective treatment for multiple myeloma than standard chemotherapy alone, according to a newly published randomized trial.
High-dose chemotherapy with stem-cell transplantation has increasingly been used as a first-line treatment for multiple myeloma despite the lack of data showing a survival benefit.
In a study in the May 8 issue of the New England Journal of Medicine, J. Anthony Child, M.D., of the General Infirmary in Leeds, United Kingdom, and his colleagues randomly assigned 401 patients with previously untreated multiple myeloma who were age 65 or younger to receive either standard chemotherapy or high-dose chemotherapy plus an autologous stem-cell transplantation.
After 7 years of follow-up, patients treated with the more aggressive therapy survived nearly 1 year longer (54.1 months versus 42.3 months) than patients treated with standard chemotherapy alone. Progression-free survival was also increased in the intensive-therapy group. Patients with poorer prognoses appeared to benefit the most from the more aggressive therapy.
Fiber, Colorectal Cancer Connection Examined
Two of the largest studies to date on the association between dietary fiber intake and colorectal polyps and colorectal cancer incidence, respectively, have swung the pendulum back in favor of fiber as a nutrient with the capacity to reduce cancer risk.
In one study published in the May 3 issue of The Lancet, Ulrike Peters, Ph.D., of the National Cancer Institute, and colleagues looked at dietary patterns of 3,591 people in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial with polyps and 33,971 trial participants without polyps. They found that people in the top 20% of dietary fiber intake (more than 30.6 g/day) had a 27% lower risk of developing polyps than people in the bottom 20% of fiber intake (less than 15.4g/day). The U.S. population consumes an average of 16 grams of fiber per day.
In the second study in the same issue of The Lancet, Elio Riboli, M.D., of the International Agency for Research on Cancer in Lyon, France, and colleagues examined dietary patterns and incidence of colorectal cancer among 519,978 people from 10 European countries who were participating in the European Prospective Investigation of Cancer and Nutrition (EPIC) study. They found that people in the top quintile of fiber intake, who consumed at least 35 grams of fiber per day, had a 25% lower risk of colorectal cancer than people in the lowest quintile, who consumed 15 grams or less of fiber per day.
Riboli and colleagues acknowledged that their study examined fiber in foods, and many foods contain other nutrients that may be associated with cancer protection.
FDA Approves Iressa for Advanced Lung Cancer
The U.S. Food and Drug Administration approved the drug Iressa (gefitinib) as a treatment for patients with advanced non-small cell lung cancer (NSCLC) who have exhausted all other treatment options. The Australian Therapeutic Goods Administration has also approved Iressa for the treatment of advanced NSCLC.
Iressa, marketed by AstraZeneca, is an epidermal growth factor receptor (EGFR) inhibitor that may block growth signals in cancer cells. There was some concern about the safety of the drug after reports emerged from Japan about patients who developed interstitial lung disease after being treated with Iressa. The findings caused the FDA to extend its review of Iressa by 3 months.
The FDA concluded that the toxicity of Iressa does not outweigh its demonstrated benefits. The agency pointed out that incidence of ILD was 2% in Japanese patients, and less than 0.3% in U.S. patients receiving Iressa.
See News, Vol. 95, No. 8, p. 577, "Apparent Adverse Drug Reactions Prompt Concern About Iressa", and Vol. 94, No. 21, p. 1596, "Despite Concerns, FDA Panel Backs EGFR Inhibitor".
—Linda Wang
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