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Cervical Cancer Vaccine Found Effective in Clinical TrialA vaccine designed to protect women from being infected with human papillomavirus (HPV) types 6, 11, 16, and 18 was effective in preventing high-grade cervical precancers and noninvasive cervical cancers in a large, randomized clinical trial, according to a statement from the vaccine's manufacturer Merck. Data from the trial were presented last month at the annual meeting of the Infectious Diseases Society of America.
The vaccine, Gardasil, was designed to protect women from infection with HPV types 16 and 18, which cause about 70% of cervical cancers worldwide, and HPV types 6 and 11, which cause about 90% of cases of genital warts.
In a phase III clinical trial of the vaccine (called Future II), more than 12,000 women aged 16–26 years from 13 countries were randomly assigned to receive either a three-dose regimen of Gardasil or placebo. In the 17 months following completion of the vaccine regimen, there were no cases of high-grade cervical precancers or noninvasive cervical cancers diagnosed among women who received the vaccine, but there were 21 cases in the placebo group.
Patients With Localized Prostate Cancer May Benefit From Short Course of Hormone Therapy
A course of 3 or 6 months of androgen deprivation given before and during radiation therapy may improve the outcomes for men with localized prostate cancer, according to a new study published online October 6 in The Lancet Oncology.
Androgen deprivation—which lowers levels of the hormone testosterone—is used to treat prostate cancer that has metastasized, but its role in the treatment of patients with localized cancer has not been determined. In a randomized trial, 818 men with localized prostate cancer were randomly assigned to radiation therapy alone, radiation plus 3 months of androgen therapy (starting 2 months before radiation therapy), or radiation plus 6 months of androgen therapy (starting 5 months before radiation therapy).
The researchers found that, after a median follow-up of 5.9 years, 3 months of androgen deprivation was associated with reduced biochemical failure, increased disease-free survival, and less need for salvage treatment compared with radiation therapy alone. The 6-month course of androgen deprivation was associated with even greater benefits in these three measures in addition to improved prostate cancer–specific survival. The authors note that further follow-up is needed to determine the effect of androgen deprivation on overall survival.
Other Health Problems Explain Some of the Racial Disparity in Breast Cancer Survival
Some of the difference in breast cancer survival between blacks and whites can be explained by the higher incidence of other health problems, such as diabetes and hypertension, in black women, according to a new study that appears in the October 12 issue of the Journal of the American Medical Association.
Although breast cancer survival has improved in the last 30 years, racial disparities still exist. In the United States from 1995 to 2000, 75% of black breast cancer patients survived at least 5 years, compared with 89% of white breast cancer patients. Several potential causes for this disparity have been identified, including advanced cancer stage, lack of access to medical care, inferior treatment, and lower socioeconomic status among black women, but the extent to which competing illnesses may be responsible has not been well studied.
In a study of 264 black and 642 white women from the Henry Ford Health System in Detroit who had been diagnosed with breast cancer between 1985 and 1990, 64 (24.9%) black women died of breast cancer and 95 (37.0%) died of competing causes, compared with 115 (18.3%) white women and 202 (32.1%), respectively, during the 10-year study follow-up. Black women had worse all-cause survival, breast cancer–specific survival, and competing-causes survival. At least one adverse health problem was present in 221 (86.0%) black women and 407 (65.7%) white women. These adverse health problems accounted for about half of the difference in all-cause survival and three-quarters of the difference in competing-causes survival.
FDA Approves Exemestane for Adjuvant Treatment of Breast Cancer
The U.S. Food and Drug Administration has approved exemestane (Aromasin) for the adjuvant treatment of postmenopausal women with estrogen receptor–positive early-stage breast cancer. The drug is used after 2–3 years of tamoxifen to complete a 5-year course of adjuvant therapy.
The approval is based on the Intergroup Exemestane Study—the results of which were published in the New England Journal of Medicine in March 2004—that found that women who switched to exemestane after 2–3 years of tamoxifen had better disease-free survival than women who stayed on tamoxifen for the full 5 years.
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