Evaluación de la efectividad de abiraterona en el tratamiento del cáncer de próstata metastásico / Evaluation of the effectiveness of abiraterone in treatment of metastatic prostate cáncer

Objetivo: estudiar el perfil de efectividad y seguridad de abiraterona en la práctica clínica, en pacientes con cáncer de próstata metastásico hormonoresistente. Métodos: se diseñó un estudio descriptivo retrospectivo de los pacientes diagnosticados con cáncer de próstata metastásico que recibieron tratamiento con abiraterona durante los mese de febrero 2012 a abril 2013. Las variables estudiadas fueron sexo, edad, escala del Eastern Cooperative Oncology Group (ECOG), tratamiento previo con docetaxel, antígeno prostático especifico (PSA) y supervivencia libre de progresión. La información se obtuvo de las historias clínicas, el programa de prescripción Savac® y el programa de validación farmacéutica Farmis‒Oncofarm®. Resultados: los 24 pacientes incluidos contaban una mediana de edad de 70 años. El estado funcional fue ECOG<2 en el 58,3 por ciento y ECOG≥2 en el 41,7 por ciento de los pacientes. El PSA disminuyó un 50 por ciento o más de su valor basal en el 52 por ciento de los pacientes. En cuanto a la supervivencia libre de progresión la mediana fue de 166 días (5,5 meses). En los pacientes con un ECOG≤2 la mediana fue de 231 días (7,7 meses) mientras que para los pacientes con ECOG˃2 fue de 106 días (3,5 meses). Abiraterona presentó pocas reacciones adversas por lo que resulta un fármaco seguro, a pesar de presentar algunas reacciones de suma importancia. Conclusiones: los resultados obtenidos en nuestra práctica clínica difieren con los obtenidos en los estudios pivotales. Se observan mayor supervivencia libre de progresión en los pacientes con un ECOG≤1 y en los que nunca habían recibido quimioterapia previa(AU)

Objectives: to study the efficacy and safety profile of abiraterone in clinical practice to treat patients with hormone-resistant metastatic prostate cancer. Methods: retrospective and descriptive study of patients who were diagnosed with metastatic prostate cancer and were treated with abiraterone since February 2012 to April 2013. The studied variables were gender, age, level of Eastern Cooperative Oncology Group (ECOG) scale, prior treatment with docetaxel, prostate specific antigen (PSA), progression-free survival (PFS). Data sources included medical records, the Savac® prescription and the Farmis-Oncofarm® pharmaceutical validation programs. Results: twenty-four patients were included, with average age of 70 years. The ECOG performance status was less than 2 in 58,3 percent of patients whereas 41,7 percent of the patients showed ECOG equal to 2 or higher. The PSA decreased by 50 percent or more its basal value in 52 percent of the patients. As regards to PFS, the median was 166 days (5,5 months) in progression-free survival. In patients with ECOG≤2, the median PFS was 231 days (7,7 months), whereas for patients with ECOG˃2,it was 106 days (3,5 months). Abiraterone has fewer side effects, so it may be considered a safe drug, although some are significant. Conclusions: the results obtained in our clinical practice differ from the ones obtained in the pivotal trials . Increased progression-free survival was observed in patients with an ECOG≤1 or less, and in those who had never received prior chemotherapy(AU)

Is intravenous iron useful for reducing transfusions in surgically treated colorectal cancer patients?

BACKGROUND: The goal of the present study was to determine whether the intravenous administration of iron in the postoperative period of colon cancer surgical patients suffices to reduce the number of transfusions necessary. METHOD: The study was designed as a retrospective observational study conducted over a three-year period. A paired case-control design was used to analyze the effect of postoperative iron on patients' blood transfusion needs. Two groups were established (the case group, which received postoperative iron and the control group, which did not) and matched for age (± 3 years), gender, type of operation, tumor stage, and surgical approach. Of 342 patients who underwent operation, 104 paired patients were obtained for inclusion in this study (52 in each group). A second analysis was made to assess the effect of intravenous iron on the evolution of hemoglobin between the first postoperative day and hospital discharge in the subgroup of patients with reduction in hemoglobin, in subjects without preoperative or postoperative transfusions. Finally, a total of 71 patients were paired in two groups: 37 and 31 patients in case and control, respectively. RESULTS: The mean hemoglobin concentration at discharge for the case group was 10 ± 1.1 g/dl, vs. 10.6 ± 1.2 in the controls (P = 0.012). The number of transfusions in the case group was 3 ± 1.6, vs. 3.3 ± 3 in the control group (P = 0.682). Thus, 28.8 % of the patients in the case group received transfusions, versus 30.8 % of those in the control group (P = 0.830). In the second analysis, the decrease in hemoglobin concentration was 0.88 g/dl and 0.82 g/dl in case and control, respectively. CONCLUSIONS: Intravenous iron does not appear to reduce the blood transfusion requirements in the postoperative period of colorectal surgery patients with anemia. We consider that further studies are needed to more clearly define the usefulness of intravenous iron in reducing the transfusion needs in such patients.

Hepatitis aguda secundaria a bupropión / No disponible

No disponible