Radium-223 in Bone-Metastatic Prostate Cancer: Current Data and Future Prospects
July 15th 2015This article will describe the historic background of Ra-223; outline the clinical studies which led to phase III trials of this agent; highlight key results of these phase III studies; and explore possible future directions for use of Ra-223 and other alpha particles-both in prostate cancer and for management of other diseases.
Reassessments of ESAs for Cancer Treatment in the US and Europe
Anemia is a widely prevalent complication among cancer patients. At the time of diagnosis, 30% to 40% of patients with non-Hodgkin lymphoma or Hodgkin lymphoma and up to 70% of patients with multiple myeloma are anemic; rates are higher among persons with myelodysplastic syndromes. Among patients with solid cancers or lymphomas, up to half develop anemia following chemotherapy. For almost 2 decades, erythropoiesis-stimulating agents (ESAs) were the primary treatment for cancer-related anemia. However, reassessments of benefits and risks of ESAs for cancer-associated anemia have occurred internationally. We reviewed guidelines and notifications from regulatory agencies and manufacturers, reimbursement policies, and utilization for ESAs in the cancer and chronic kidney disease settings within the United States, Europe, and Canada. In 2008 the US Food and Drug Administration (FDA) restricted ESAs from cancer patients seeking cure. Reimbursement is limited to hemoglobin levels < 10 g/dL. In the United States, ESA usage increased 340% between 2001 and 2006, and decreased 60% since 2007. The European Medicines Agency (EMEA) recommended that ESA benefits do not outweigh risks. In Europe between 2001 and 2006, ESA use increased 51%; since 2006, use decreased by 10%. In 2009, Canadian manufacturers recommended usage based on patient preferences. In Canada in 2007, approximately 20% of anemic cancer patients received ESAs, a 20% increase since 2004. In contrast to Europe, where ESA use has increased over time, reassessments of ESA-associated safety concerns in the United States have resulted in marked decrements in ESA use among cancer patients.
Low Literacy Predicts Advanced Prostate Cancer Presentation
October 1st 1998Prostate cancer is the most common cancer in the United States, with an estimated 200,000 new cases diagnosed in 1998.[1] Compared with white men, African-American men have a 66% higher incidence of prostate cancer and mortality rates twice as high.[1]
Combinations of Hormones and Local Therapies in Locally Advanced Prostate Carcinoma
August 1st 1996Until recently, newly diagnosed patients with prostate cancer were faced with one of four basic management options: observation, radiation therapy, radical prostatectomy, or hormonal manipulation. The exact option chosen by an individual