Herceptin after chemotherapy appears to keep tumors at bay.
* THE QUESTION Aggressive breast cancer occurs more often in women with an overabundance of a certain gene or protein. Might women with this type of cancer, known as HER2-positive breast cancer, benefit from early treatment with a drug that has shown success in fighting this cancer once it has spread to other parts of the body?
* THIS STUDY randomly assigned 3,387 women with HER2-positive breast cancer who had completed surgery and chemotherapy to receive trastuzumab (Herceptin) intravenously every three weeks or to continue normal postoperative care. Treatment began an average of eight months after diagnosis. One year later, breast cancer had recurred or developed in the other breast, another type of cancer had been diagnosed, or death from something other than cancer had occurred in 127 women who were taking Herceptin, compared with 220 women who were not -- a 46 percent difference.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Women with HER2-positive breast cancer. About one of every eight women will develop breast cancer, and an estimated 20 percent of them will have this more aggressive version, which tends to recur more often and carries a higher risk of death.
* CAVEATS Symptoms of congestive heart failure occurred in about 2 percent of the Herceptin group (vs. 0.06 percent of the others). The study did not assess long-term risks of the drug, nor did it determine whether Herceptin affects women differently depending on various characteristics, including heart disease risks. Whether the results would differ if the drug were given along with (rather than after) chemotherapy also remains unclear. The study was funded by F. Hoffman-La Roche, which markets Herceptin internationally and has financial ties to many of the primary authors.
* FIND THIS STUDY Oct. 20 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.
* LEARN MORE ABOUT breast cancer at www.cancer.org and www.cancer.gov/cancerinfo.
An intravenous arthritis drug seems to help inflamed skin.
* THE QUESTION The raised reddish patches of skin covered by a silvery scale that characterize plaque psoriasis, the most common type of psoriasis, can be tough to treat. Might a drug approved to treat diseases with similar biological makeup -- including rheumatoid arthritis and Crohn's disease -- be effective against psoriasis?
* THIS STUDY involved 378 adults with moderate to severe plaque psoriasis. They were given infliximab (Remicade) or a placebo intravenously every few weeks. After 10 weeks, symptoms had improved by 75 percent in 80 percent of those given Remicade, compared with 3 percent of the placebo group. The skin had cleared completely in about a fourth of those given the drug and none of those given the placebo.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with plaque psoriasis, which can occur at any age but generally first appears when people are 15 to 35 years old.
* CAVEATS Infliximab can increase a user's risk of contracting serious infections. The authors speculated that some people may benefit from taking the drug more frequently, but the study did not investigate alternate dosing regimens. Infliximab has not been approved as a psoriasis treatment. The study was funded and partially designed, conducted and analyzed by researchers with financial ties to Centocor and Schering-Plough, the drug's co-developers.
* FIND THIS STUDY Oct. 15 issue of The Lancet; abstract available online at www.thelancet.com.
* LEARN MORE ABOUT psoriasis at www.skincarephysicians.com and www.niams.nih.gov (click "Health Information").
Men in their seventies may also be good risks for surgery.
* THE QUESTION Prostate cancer knows no upper age limit, yet men older than 70 often are not considered good candidates for surgery to remove the gland. Do the risks of surgery outweigh the benefits for men in this age bracket?
* THIS STUDY analyzed records for all residents of a Canadian province who had a radical prostatectomy during the 1990s: 11,010 men. Within 30 days of the surgery, 53 men (0.5 percent) had died and 2,246 (20.4 percent) had experienced at least one complication. Older men had a slightly greater risk of dying, but even for those aged 70 to 79, the chances of death were a low 0.66 percent. The presence of other diseases and medical problems -- including heart and respiratory ailments -- had a stronger effect on increasing complications, regardless of a man's age.
* WHO MAY BE AFFECTED BY THESE FINDINGS? Men over 70 who have prostate cancer. More than 230,000 American men will be diagnosed this year with this disease, most of them older than 65.
* CAVEATS The study may underestimate the overall risk of prostatectomy because men with serious diseases or complications may not have had the surgery. The findings do not reflect possible long-term complications, including erectile dysfunction and incontinence.
* FIND THIS STUDY Oct. 19 issue of the Journal of the National Cancer Institute; abstract available online at www.jncicancerspectrum.oxfordjournals.org.
* LEARN MORE ABOUT prostate cancer at http://familydoctor.org and www.urologyhealth.org/adult.
-- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.