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Supportive Care

The evidence backing the use of myeloid growth factors in patients at high risk for febrile neutropenia is solid, according to Jeffrey Crawford, MD, of Duke Cancer Institute, Durham, North Carolina.


In a multicenter, randomized, phase 2/3 trial, the 4-drug combination oxaliplatin/irinotecan/fluorouracil/leucovorin (FOLFIRINOX) prolonged median overall and progression-free survival and increased the overall response rate compared with gemcitabine, the reference standard, for patients with metastatic pancreatic adenocarcinoma and good performance status (0-1). However, the combination regimen was associated with more adverse events, especially febrile neutropenia, and a decrease in quality of life.


By assigning weight to health outcomes and calculating the benefits from raloxifene compared with placebo and from tamoxifen compared with placebo, researchers developed a benefit/risk index for the use of these agents as chemo preventives in postmenopausal women at high risk for breast cancer. As seen in the indices in the article, the researchers found raloxifene better than tamoxifen for women with a uterus; for women without a uterus, the profiles were similar.

Effective management of breakthrough cancer pain requires optimizing background therapy for chronic pain and accurately assessing the type of breakthrough pain, said presenters at the 45th American Society of Health-System Pharmacists Midyear Clinical Meeting & Exposition.

“Knowing the type of breakthrough cancer pain can help match the right drug with the right goal,” said Mary Lynn McPherson, PharmD, BCPS, CDE, who is professor and vice chair, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy in Baltimore.

Every physician has a preferred way of writing prescription instructions, and pharmacists differ in how they translate those instructions to the pill bottle. A study published in the Annals of Internal Medicine by Wolf and associates found that the lack of a universal medication schedule (UMS) to standardize how prescriptions are written and filled contributes to poor patient adherence and increases safety concerns.
ORLANDO—Patients often do not understand the terms clinicians use to describe their hematologic malignancies, such as myelodysplastic syndrome, which may lead to misunderstandings about their disease. 

Guidelines specific to cancer patients needed
More education about assessment and management of cardiotoxicity would strengthen the quality of nursing care of cancer patients, according to a study presented at the Oncology Nursing Society’s 2010 Advanced Practice Nursing /Institutes of Learning (APN/IOL)Conference in Orlando, Florida.

ORLANDO—Women who are on intravenous (IV) chemotherapy regimens for recurrent ovarian carcinoma are at risk for nonadherence or nonpersistence with their treatment. But telephone support by an advance practice nurse (APN) can lower this risk and even boost compliance, a new, nonrandomized study suggests.

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