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Removing anthracyclines from HER2-positive breast cancer treatment reduces cardiac toxicity
When an anthracycline is not used concomitantly with adjuvant trastuzumab to treat HER2-positive breast cancer, cardiac toxicity is reduced.
When an anthracycline is not used concomitantly with adjuvant trastuzumab to treat HER2-positive breast cancer, cardiac toxicity is reduced, according to a multinational randomized controlled trial published in the October 6, 2011, New England Journal of Medicine.
"Trastuzumab improves survival in the adjuvant treatment of HER-positive breast cancer, although combined therapy with anthracycline-based regimens has been associated with cardiac toxicity," the researchers emphasized. They continued, "We wanted to evaluate the efficacy and safety of a new nonanthracycline regimen with trastuzumab."
To achieve their objective, researchers from the Breast Cancer International Research Group randomly assigned 3,222 women with invasive, high-risk, node-negative or node-positive, HER2-positive adenocarcinoma, to receive a standard anthracycline (specifically doxorubicin)–taxane chemotherapy regimen (AC-T), the identical regimen plus adjuvant trastuzumab, or a new nonanthracycline, trastuzumab-based regimen (TCH). To evaluate the cardiac toxicity of the regimens, they put in place a safety evaluation protocol that included monitoring left ventricular ejection fraction (LVEF) a total of 7 times throughout the study.
No cases of cardiac death were observed in any of the treatment groups.
Also of importance, researchers did not find a significant difference in the rate of disease-free or overall survival between the 2 trastuzumab-containing regimens, and the rate of many acute toxic effects and leukemia were also lower in the TCH group. Consequently, the researchers concluded their report by remarking, "The risk-benefit ratio favored the nonanthracycline TCH regimen over AC-T plus trastuzumab, given its similar efficacy, fewer acute toxic effects, and lower risks of cardiotoxicity and leukemia."
SOURCE
Slamon D, Eiermann W, Robert N, et al. for the Breast Cancer International Research Group. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med. 2011;365:1273–1283.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
