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Healthcare reform is a high-profile issue in the presidential election campaign, and drug access has become a central theme in the debate. Both Democratic and Republican candidates have rolled out healthcare reform plans that promise to cover the uninsured while also providing tax breaks and other incentives to help individuals obtain health insurance.

Ambulatory patients with cancer who are undergoing chemotherapy should not receive prophylactic anticoagulation to prevent venous thromboembolism, according to new guidelines developed by ASCO. "It's not cost effective and we also do not recommend screening these patients for thrombophilia," said Mark Levine, MD, McMaster University, Hamilton, Ontario, Canada.

Physicians treating cancer-related depression with paroxetine should not expect patients' insomnia to also improve, according to a study presented by Oxana G. Palesh, PhD, University of Rochester Cancer Center, NY. "We know that insomnia and depression often occur together frequently in the general population, suggesting that there may be a common mechanism," she said.

Metformin may represent a novel antitumor agent, say investigators from the University of Texas M.D. Anderson Cancer Center, Houston.

Several factors contribute to a disparity of cancer care and outcomes between minority and majority populations in the United States.

Advanced age should not be a barrier to initiating adjuvant chemotherapy in patients with stage III colon cancer. In an observational study, the oldest patients suffered no more adverse events when treated with adjuvant chemotherapy than did younger patients but were much less likely than their younger counterparts to actually receive adjuvant chemotherapy for their colon cancer, said Katherine L. Khan, MD, professor of medicine at the University of California, Los Angeles.

Cancer-related fatigue significantly interferes with patients' quality of life, and some areas often affected among these patients are not normally included on standard quality-of-life assessments, said Karen M. Mustian, PhD, University of Rochester School of Medicine, NY. More randomized, controlled trials are needed to identify these areas, she said.

Magnetic resonance imaging (MRI) is superior to mammography alone in diagnosing intraductal components of invasive breast cancer, allowing more accurate mapping before breast conservation surgery, said Simone Schrading, MD, Department of Radiology, University of Bonn, Germany.

An individualized exercise program may significantly reduce fatigue, increase strength, and improve psychosocial functioning during cancer treatment, according to results of a small study reported by Maike de Wit, University Clinic Hamburg, Germany.

A small study suggests that acupuncture has the potential to reduce pain and dysfunction in patients with head and neck cancer who have undergone neck dissection, said David G. Pfister, MD, chief, Head and Neck Medical Oncology, Memorial Sloan Kettering Cancer Center, New York.

High-dose vitamin D supplementation can provide relief of symptoms related to vitamin D deficiency from aromatase inhibitor therapy in postmenopausal women with breast cancer, said Q.J. Khan, MD, Cancer Center of Kansas, Wichita.

Most elderly patients do not receive combined modality treatment (CMT) with both chemotherapy and radiation for locally advanced, non-small cell lung cancer (NSCLC) despite trial data indicating that CMT enhances survival, decreases comorbidities, and is potentially curative. Data presented by Martin J. Edelman, MD, professor of medicine, University of Maryland Greenebaum Cancer Center, Baltimore, indicate that elderly patients receiving chemotherapy followed by concurrent chemotherapy and radiation derive the most significant survival benefit.

Strict evidence-based criteria should be used when prescribing erythropoiesis-stimulating agents (ESAs) for cancer, as ESAs appear to activate signaling pathways that are important in altering tumor behavior and treatment response, experts said.

The extent to which patients should have access to experimental therapies is a hotly contested issue, and courts and regulatory agencies have wrestled with the problems involved when an individual is willing to be treated with unapproved drugs at the potential expense of causing harm not only to the individual but to the clinical trial process itself.

Patients with metastatic colorectal cancer are more likely to respond to initial treatment that includes cetuximab if they have nonmutated, wild-type KRAS gene status, reported Eric Van Cutsem, MD, University Hospital Gasthuisberg, Leuven, Belgium. "For the first time in colorectal cancer, we are able to predict which patients are likely to be helped by the new biologics," he said. "KRAS is the first molecular marker for the selection of a targeted therapy in combination with a standard chemotherapy regimen in first-line metastatic colorectal cancer. KRAS testing should be routinely conducted in all colorectal cancer patients immediately after diagnosis to ensure the best treatment strategies for the individual patient."

In an effort to simplify therapy for patients with asthma or COPD, products have been designed that combine medications from 2 separate therapeutic classes.

In June 2007, FDA approved an Electronic Medication Management Assistant (EMMA) device and electronic medication administration record (eMAR) to help combat problems involving drug identification and dosing.

An investigational 500-mcg dose of interferon beta-1b demonstrated no advantage compared with the approved 250-mcg dose of interferon beta-1b or with glatiramer 20 mg in reducing relapse risk in patients with early relapsing-remitting multiple sclerosis (RRMS), said Paul O'Connor, MD, MS Program Director, St. Michael's Hospital, the University of Toronto, at the 60th Annual Meeting of the American Academy of Neurology, Chicago.

Lacosamide safely decreases pain scores in patients with painful diabetic neuropathy, according to a pooled efficacy and safety analysis presented at the 60th Annual Meeting of the American Academy of Neurology, Chicago.

Glatiramer represents a new option for delaying conversion of clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS), according to the results of a new study known as PRECISE, presented at the 60th Annual Meeting of the American Academy of Neurology, Chicago.

Iloperidone, a new-generation atypical antipsychotic, is currently under investigation for the treatment of schizophrenia. In 4 separate phase 3 trials, iloperidone has demonstrated efficacy in treating schizophrenia, with total Positive and Negative Symptom Scale (PANSS) scores decreasing by a range of 8 to 14 points depending on the iloperidone dose.

Generic drugs approved by FDA (through June 2008) including epoprostenol for injection, ropinirole, donepezil, and drospirenone/ethinyl estradiol.

Recent FDA action (through June 2008) related to lucinactant, loratadine/montelukast, niacin/laropiprant, fentanyl buccal, NPL-2008, carfilzomib, resveratrol, and rhitol.

New indication: Lubiprostone (Amitiza), a chloride channel activator, was approved on April 29, 2008, for the treatment of irritable bowel syndrome with constipation (IBS-C) in women aged at least 18 years.

New biologic: Certolizumab pegol (Cimzia), a tumor necrosis factor blocker, was approved on April 22, 2008, for the reduction of the signs and symptoms of Crohn's disease and the maintenance of clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.

An RNA signature present in blood that is highly accurate for detecting prevalent lung cancer can accurately predict the development of lung cancer within the next 2 years 80% of the time, said Thomas Zander, MD, Department of Internal Medicine and the Center for Integrated Oncology, University Clinic Cologne, Germany. "Early detection of lung cancer is a major need, as most patients present for diagnosis at a late stage when there is no chance for cure," Dr Zander said. Two-year survival after a lung cancer diagnosis is approximately 15%. Early detection may therefore be a promising strategy to improve survival rates.

A small study suggests that acupuncture has the potential to reduce pain and dysfunction in patients with head and neck cancer who have undergone neck dissection, said David G. Pfister, MD, chief, Head and Neck Medical Oncology, Memorial Sloan Kettering Cancer Center, New York.

High-dose vitamin D supplementation can provide relief of symptoms related to vitamin D deficiency from aromatase inhibitor therapy in postmenopausal women with breast cancer, said Q.J. Khan, MD, Cancer Center of Kansas, Wichita.