APF530 Could Improve Nausea Control in Cancer Patients

“A phase III study showed that APF530, a delayed release formulation of granisetron, could improve control of emesis in cancer patients receiving highly emetogenic chemotherapy (HEC). The results were presented at the 2015 American Society of Clinical Oncology (ASCO) Breast Cancer Symposium in San Francisco (abstract 68).

“Ian D. Schnadig, MD, of Compass Oncology in Portland, Oregon, presented the study, and said that with regards to supportive care, ‘we still have a ways to go to move the ball down the field in this important domain of cancer care.’ Specifically, managing delayed-phase chemotherapy-induced nausea and vomiting (CINV) is an unmet medical need, he said.

“The MAGIC trial was a phase III, prospective, randomized, placebo-controlled, double-dummy, double-blind trial including 942 patients receiving an HEC regimen. In one arm, patients received ondansetron and a placebo injection; in the other, they received an ondansetron placebo and a APF530 injection. Both groups received fosaprepitant and dexamethasone. The most common chemotherapy regimens were doxorubicin/cyclophosphamide-based and cisplatin-based.”


Rolapitant Reduced Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately Emetogenic Chemotherapy or Anthracycline/Cyclophosphamide

“In a phase III study reported in The Lancet Oncology, Schwartzberg et al found that the addition of rolapitant to serotonin (5-HT3) receptor antagonist and dexamethasone treatment significantly improved complete response rates in prevention of chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy or anthracycline and cyclophosphamide regimens.

“In this double-blind trial, patients from 170 sites in 23 countries were randomly assigned between March 2012 and September 2013 to receive oral rolapitant 180 mg or placebo 1 to 2 hours before the administration of moderately emetogenic chemotherapy. All patients received oral granisetron 2 mg and oral dexamethasone 20 mg on day 1 (except for those receiving taxanes, who received dexamethasone according to the package insert) and granisetron 2 mg on days 2 and 3. Treatment was given for up to six cycles, with a minimum of 14 days…

“The investigators concluded: ‘Rolapitant in combination with a 5-HT3 receptor antagonist and dexamethasone is well tolerated and shows superiority over active control for the prevention of chemotherapy-induced nausea and vomiting during the 5-day (0–120 h) at-risk period after administration of moderately emetogenic chemotherapy or regimens containing an anthracycline and cyclophosphamide.’ “


Postmastectomy Pain Effectively Treated With a Simple Injection

“For postmastectomy neuropathic pain, perineural infiltration with a combination of bupivacaine and dexamethasone is a ‘simple, effective, practice-changing treatment that any surgeon can do,’ according to Laura J. Esserman, MD, MBA, Professor of Surgery and Radiology at the University of California, San Francisco, School of Medicine and Director of the Carol Franc Buck Breast Care Center, senior author of the study.

“The intervention—2-mL injections of an equal ratio of 0.5% bupivacaine and 4 mg/mL of dexamethasone—was described at the 2013 San Antonio Breast Cancer Symposium. The study’s first author was Cathy J. Tang, MD, also a surgeon at the University of California, San Francisco.”

Editor’s note: Some patients experience chronic breast pain after undergoing a mastectomy. It may develop immediately after surgery, but may not develop until 6 months later. It can last for years. According to this article, a simple injection might solve the problem.


The Pitfalls of Androgen Deprivation Therapy


For men with advanced prostate cancer, androgen deprivation therapy (ADT) is usually the initial treatment of choice. ADT slows the growth of prostate tumors and can even make them shrink. But unfortunately, the results of ADT are short-lived; tumors can develop resistance to ADT and grow back, sometimes stronger than before. Scientists are hard at work to figure out the underlying mechanisms of ADT resistance and how to bypass it. Continue reading…


Steroid Treatment May Improve Cancer-Related Fatigue

Fatigue is a common and often debilitating symptom for people with advanced cancer. A recent clinical trial found that the steroid dexamethasone reduced fatigue in cancer patients who took it for 14 days. Other related symptoms, such as pain and loss of appetite, also improved, as did overall quality of life. However, in a recent survey, only one-quarter to one-third of cancer physicians said that they regularly use steroids to manage cancer-related fatigue. Because steroids can have serious side effects with long-term use, they may be most useful for patients with limited life expectancies or whose fatigue can be expected to resolve after short-term treatment.


Steroid Treatment May Improve Cancer-Related Fatigue

Fatigue is a common and often debilitating symptom for people with advanced cancer. A recent clinical trial found that the steroid dexamethasone reduced fatigue in cancer patients who took it for 14 days. Other related symptoms, such as pain and loss of appetite, also improved, as did overall quality of life. However, in a recent survey, only one-quarter to one-third of cancer physicians said that they regularly use steroids to manage cancer-related fatigue. Because steroids can have serious side effects with long-term use, they may be most useful for patients with limited life expectancies or whose fatigue can be expected to resolve after short-term treatment.


Steroid Treatment May Improve Cancer-Related Fatigue

Fatigue is a common and often debilitating symptom for people with advanced cancer. A recent clinical trial found that the steroid dexamethasone reduced fatigue in cancer patients who took it for 14 days. Other related symptoms, such as pain and loss of appetite, also improved, as did overall quality of life. However, in a recent survey, only one-quarter to one-third of cancer physicians said that they regularly use steroids to manage cancer-related fatigue. Because steroids can have serious side effects with long-term use, they may be most useful for patients with limited life expectancies or whose fatigue can be expected to resolve after short-term treatment.