Vitamin E supplements reduce peripheral neuropathy caused by cisplatin and paclitaxel based chemotherapy in a small, randomized trial

Researchers in Greece have found that giving patients 600 mg of vitamin E during cisplatin and paclitaxel chemotherapy and for 3 months after it ends reduces the incidence of peripheral neuropathy.

In a small trial, 16 patients received the vitamin E intervention and 15 got a placebo. Four of the sixteen (25%) showed signs of neurotoxicity while 11 of 15 on placebo did. In addition, objective testing of peripheral neuropathy was lower in those on vitamin E.

Results of the study by A.A. Argyriou MD and his colleagues at the University of Patros in Greece are published in the January 5, 2005 issue of Neurology.

The authors concluded that vitamin E may have a role in preventing chemotherapy-induced neuropathy, but they urged a larger, randomized trial of the intervention.

Read the study abstract in Neurology.

Read an article about the study on Medscape.

Connective Tissue Growth Factor (CTGF) expression increases survival and appears to reduce spread of colorectal cancer

Researchers in Taiwan studied tumors specimens from 119 patients with either stage II or III colorectal cancer. Those with the highest levels of CTGF had significantly greater survival at 5 years than those with low levels. For stage II, patients with high CTGF had an 87.5% chance of 5-year survival compared to 47.5% for those with low levels. For stage III patients, 76.7% of high level were alive at 5 years, while those with low levels had a 28.1% survival rate.

The research team also observed that in colon cancer cell lines, reducing the amount of CTGF increased the amount of invasion. Mice injected with a substance that reduced CTGF levels had increased rates of liver metastasis.

The scientists concluded that, "Our results implicate CTGF as a key regulator of CRC invasion and metastasis, and it appears to be a useful and better prognosis factor for patients with stage II and stage III CRC."

Read the study abstract in Gastroenterology, January 2005.

Read an article about the study on Medscape.

Amgen adds a warning not to exceed recommended dosage to its label for Aranesp

Based on excessive blood clots and fatalities seen with similar drugs to Aranesp (darabepoetin alfa), Amgen recommends that dosage of the drug be limited to what is in the current prescribing information. Target hemoglobin levels should not exceed 12 grams/deciliter.

Read the safety alert and download the label and "Dear Healthcare Professional" letter at FDA MedWatch.

Read an Reuters Health article on the warning.

Long term consumption of red meat and processed meat tied to colon and rectal cancer risk

Researchers following a large group of men and women for more than twenty years have found a link between reports of high red meat intake over time and colon and rectal cancer. Nearly 150,000 people answered questionnaires about their diet, exercise, and other lifestyle factors in both 1982 and 1992. Incidence of colon and rectal cancer have been recorded through 2001.

An new analysis of the group enrolled in the Cancer Prevention Study II Nutrition Cohort shows an increased risk in distal colon and rectal cancers in those who had the highest intake of red meat. Processed meat intake was also related to colon cancer. People who ate more poultry and fish than red meat had a decreased risk of colon cancer.

Results of the study are reported in The Journal of the American Medical Association in the January 12, 2005 issue.

Read a discussion of the report on Medscape.

Read the entire study report in The Journal of the American Medical Association.

Avastin label is updated with risks of heart attack, stroke, and other arterial blood clots

The FDA and Genentech have agreed on an addition to the warnings section of the Avastin (bevacizumab) label to reflect an increased risk of blood clots in arteries that can lead to strokes, heart attacks, angina, and TIA's.

In combined randomized studies involving nearly 1700 patients, 4.4% of people taking Avastin along with chemotherapy had an arterial thrombolytic event compared to 1.9% of those on chemotherapy only. People over 65 were at the highest risk.

In its letter to health professionals, Genentech points out that Avastin improves median survival of patients with metastatic colorectal cancer from 15.6 months for chemotherapy alone to 20.3 months for those taking Avastin along with chemotherapy.

Download a "Dear Health Professional" letter and the new label from Genetech's web site

Read the Genentech Press Release.

Read the FDA safety alert.

Fecal DNA testing is more sensitive than FOBT but still misses many adenomas and cancers

Members of the Colorectal Cancer Study Group screened 4,404 average risk people without cancer symptoms using all three methods -- fecal occult blood test (FOBT), DNA stool testing, and colonoscopy. Thirty-one invasive colorectal cancers were found by colonoscopy, but DNA testing revealed only 16 (51.6%) of them. FOBT found even fewer, four of the 31 (12.9%).

When adenomas with high grade dysplasia were added to cancers, DNA testing found 29 of 71 (40.8%) compared to 10 (14.1%) identified with FOBT. Using the broadest category of suspicious lesions, DNA testing found only 76 of 418 or 18.2%. FOBT found 45 (10.8%).

Thomas F. Imperiale, MD, from Indiana University in Indianapolis, and colleagues for the Colorectal Cancer Study Group published their results in the December 23, 2004 issue of The New England Journal of Medicine.

Read an article about the study on Medscape.

Read the study abstract in The New England Journal of Medicine.