Fight Colorectal Cancer

As of October 1, 2008 Amgen will no longer offer rebates to oncologists and oncology clinics who purchase Aranesp® (darbepoetin alfa) although they will provide larger discounts at the time of purchase.

They also will no longer base discounts for Neulasta® (pegfilgrastim) and Neupogen© (filgrastim) on purchases of Aranesp, a process known as bundling.  Neulasta and Neupogen help raise white cell counts lowered by chemotherapy and are designed to prevent infection resulting from treatment.

Nancy Roach, Chairperson of the C3: Colorectal Cancer Coalition, told the New York Times,

It’s a step in the right direction.

In addition, she told C3 Research News that

C3 supports fair pricing policies for drugs used in cancer treatment that don’t interfere with physicians making the best decision for their patients based on evidence of safety and effectiveness.

Although rebates and discounts are offered by others in the pharmaceutical industry, there was criticism of Amgen’s pricing policies as evidence emerged showing potential safety problems when the drug was used in ways other than indicated on its FDA-approved label.

An Amgen spokesperson told the New York Times that perceptions that physicians might be over-prescribing Aranesp were not true.

Nevertheless, we believe these contracting changes, along with other modifications, help to clear up those possible misperceptions.

For cancer patients, Aranesp is used to prevent blood transfusions in patients who are receiving chemotherapy. An erythropoetin stimulating agent (ESA), it boosts red cell counts.  Other ESAs include PROCRIT® and EPOGEN® (epoetin alfa).  PROCRIT is sold by Ortho Biotech, EPOGEN by Amgen.

Aranesp, Epogen, and Procrit are not appropriate for cancer patients who are not receiving chemotherapy, and their use should be restricted to the lowest dose possible to prevent blood transfusion.  Recent labeling changes also restrict use of ESAs to patients whose cancer treatment is not aimed at a cure.  The dosage and administration section of the revised labels state that “Therapy should not be initiated at hemoglobin levels ≥ 10 g/dL.

A revised Medication Guide for patients was also released in August, 2008 reflecting the new labeling and potential for faster tumor growth, shorter survival, and serious cardiovascular side effects.

A yellow bead for a week in the hospital.  A white bead for every day of chemotherapy.  Glow in the dark beads for radiation.  A child’s name spelled out in beads.  Necklaces that tell stories of cancer journeys and help sick children endure tough times.

Beads of Courage™ were originally developed by Jean Baruch, a children’s cancer nurse, at  Phoenix Children’s Hospital.  Baruch now heads the program which has expanded to a number of other children’s hospitals in the United States and internationally.

Special handmade beads mark important milestones including purple hearts when treatment ends.  Parents whose children die are comforted with a butterfly bead.  Artists and beadmakers throughout the country contribute beads for the project.

Baruch’s research shows that children use the beads to communicate better and deal with painful procedures more easily when they receive the beads.  Anticipation of a black bead for a needle stick calms frightened children and helps health staff.

Watch children receiving Beads of Courage at Arkansas Children’s Hospital.

Five randomized studies have shown that chewing gum after colon surgery reduces the time it takes for patients to pass gas and have a bowel movement.

Patients in the studies chewed sugarless gum from 5 to 45 minutes, three times a day after surgery.  Control groups had similar surgeries but didn’t chew gum.

There was a trend toward leaving the hospital sooner, but the studies were too small to definitely show fewer hospital days for the gum chewers.

Still, the study authors wrote,

The potential cost savings from the reduction of even one postoperative day compared with the cost of several sticks of chewing gum are huge.

During intestinal surgery, the bowels stop moving contents forward, a situation known as ileus.  After surgery doctors listen for sounds in the bowel and wait for gas to pass through the rectum as signs that bowel activity is resuming.

Overall in the five studies, patients who chewed gum passed gas about half a day sooner and had their first bowel movement a day sooner.

The team concluded,

Chewing gum may enhance intestinal recoveryfollowing colectomy and reduce the length of hospital stay. Owing to the potential for substantial cost savings, larger-scale,blinded, randomized controlled trials with placebo arms are warranted.

Previously, C3 News has reported post-surgical gum chewing studies in California and Dallas and Pittsburgh.

More information about the overview of gum studies is on Medpage Today.

SOURCE: Purkayastha et al., Archives of Surgery, Volume 143, Number 8, August, 2008.

Spanish researchers have found that patients treated every week with Camptosar® (irinotecan, CPT-11) plus a high dose of  continuous infusion 5-FU (fluorouracil) without leucovorin had similar outcomes to those treated with the more common biweekly FOLFIRI treatment that includes leucovorin.  FOLFIRI is Camptosar, 5-FU, and leucovorin.  The new treatment is called FUIRI. Read the rest of this entry »

The Food and Drug Administration has approved an oral formulation of Aloxi® (palonosetron) to prevent nausea and vomiting from chemotherapy.  A single 5 milligram capsule reduces the risk of nausea during the first 24 hours after chemotherapy and for up to five days afterwards.  The medicine is taken about an hour before chemotherapy starts. Read the rest of this entry »