Nearly all patients who are treated with Vectibix™ (panitumumab) will develop an itchy skin rash that looks something like acne.  However, treating the rash preemptively  before it appears reduces its severity and lengthens the time before more serious rash appears.

During the STEPP (Skin Toxicity Evaluation Protocol with Panitumumab) trial, researchers randomized patients who were being treated with Vectibix to either preemptive skin rash management at the beginning of chemotherapy or reactive treatment once rash appeared.  After six weeks, 70 percent of patients treated preemptively had not developed grade 2 skin rash.  Sixty-two percent of the reactive group already had rash that was grade 2 or higher. Read the rest of this entry »

XELOX, as second-line therapy, was found to be as effective as the more commonly used FOLFOX treatment for patients whose cancer had already gotten worse on treatment with Camptosar® (irinotecan).

XELOX combines an oral drug Xeloda® (capecitabine) with Eloxatin® (oxaliplatin).  FOLFOX uses an infusional schedule of 5FU and leucovorin.

Researchers randomly compared XELOX to FOLFOX4 to treat 627 patients with metastatic colorectal cancer.  Patients had already received initial therapy with Camptosar and either had their cancer progress or were unable to tolerate the treatments.  Although outcomes were similar for the two regimens, side effects differed.

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US patients treated with 5FU or Xeloda® (capecitabine) were more likely to experience serious side effects than patients outside the United States.  They also required more dose reductions and had to stop treatment more often than their non-US counterparts.

Researchers reviewed the safety results of three randomized phase III clinical trials comparing bolus regimens of 5FU to Xeloda (capecitabine) to treat metastatic cancer, separating enrolled patients into those treated in the United States and those treated in other parts of the world.  They also analyzed an adjuvant trial that included US patients, patients in East Asia, and patients in the rest of the world.  Infusional 5FU was not part of any of these studies. Read the rest of this entry »

Chewing gum a few times a day reduces the time it takes for bowel function to return after laproscopic colectomy, allowing patients to leave the hospital sooner. Patients who chewed a stick of gum four times a day had bowel activity return sooner and went home on average almost a day earlier than patients who were restricted to sips of water after surgery.

During surgery to treat colon cancer by removing all or part of the colon, rhythmic bowel activity stops, a condition known as *postoperative ileus*. Eating or drinking during this time can lead to bloating, abdominal pain, and vomiting. Until normal bowel motility returns, patients have been limited to ice chips or very small sips of clear liquids. They cannot leave the hospital until they can eat and drink normally and have had at least one bowel movement.

Surgeons at the University of Texas Southwestern Medical Center, Dallas; Western Pennsylvania Hospital, Pittsburgh; and Presbyterian Hospital, Dallas randomized 102 patients undergoing both traditional open colectomy and laparoscopic colectomy to chew a stick of gum four times a day or be in a control group that was not given gum. Their research was discussed at the American College of Surgeons 2005 Clinical Congress in San Francisco.

For those who had laparoscopic surgery, bowel function returned for gum chewers an average of 2.9 days after surgery compared to 3.5 days for the control group. They left the hospital 4.4 days post-surgery compared to 5.2 days for the group that did not chew gum.

However, there was no similar difference for patients who had open colectomy. Both gum chewers and the control group had bowel function return at 3.6 days. Gum chewers went home at 5.9 days compared to 5.3 days for controls.

Harry Papaconstantinou, MD, who led the study explained that

There are multiple stimuli that can affect the gut motility after surgery, and some of these are manipulation of the bowel during surgery, the type of anesthetic used, any inflammation that might be caused by the surgery, as well as alterations in the autonomic [peripheral] nervous system, the release of neurotransmitters [chemical substances that influence the transfer of nerve impulses to muscle] and gut hormones. When patients undergo colectomy, all of these factors can be significant stimuli that results in postoperative ileus.

He estimated that each day in the hospital costs an average of $500 to $750 and that the small cost of several packs of gum could have a major impact on medical costs after laparoscopic surgery.