 |
|
Genetic Testing May Be Valuable in Treating Colorectal Cancer
July 28, 2009Weill Cornell Medical College Cost Effectiveness Study Looks at Potential Value of New Genetic Test for Guiding Chemotherapy Treatment
NEW YORK - For the 29,000 patients in the United States with metastatic colorectal cancer, chemotherapy with irinotecan is a standard treatment that has been shown to improve survival. But for more than one in 10 of these patients, a variation in their DNA means that this treatment could result in a severe reduction in their white blood cell count, leading to a high risk of bacterial infection and possible subsequent death. A new genetic test can identify those with the variation in order to lower the treatment dose - however, it has been unclear whether the testing is worthwhile.
A new cost-effectiveness study led by scientists at Weill Cornell Medical College has determined that so-called pretreatment pharmacogenetic testing is only beneficial if dose-reduced treatment is shown to be nearly as effective as the full dose. If the lower dose is as effective, the test could prevent many cases of severe neutropenia, an abnormally low count of an important type of white blood cells known as neutrophils. It would also mean better life expectancy and lower cost of care.
The study appears online in the journal Cancer and is expected in print in the Sept. 1 issue.
"Pharmacogenetic testing is a relatively new treatment innovation that may prove to be a valuable tool for clinicians as they develop personalized treatments for cancer patients to minimize side effects while maintaining outcomes," says lead author Dr. Heather Taffet Gold, assistant professor in the Division of Health Policy in the Department of Public Health at Weill Cornell Medical College. "Our study points to significant potential benefits for pretreatment pharmacogenetic testing for metastatic colorectal cancer, but remains to be verified by clinical research."
The study used a computer simulation model that follows hypothetical patients treated with the FOLFIRI (5-fluorouracil/leucovorin with irinotecan) chemotherapy regimen for metastatic colorectal cancer. The model assumed that under usual care, patients received a full dose of irinotecan. With genetic testing, irinotecan dosage was reduced 25 percent in individuals identified using the genetic test as having the UGT1A1*28 variant allele. The dose reduction is specified in the Food and Drug Administration-approved drug label to minimize cases of neutropenia.
Dr. Bruce Schackman, senior author of the study, says, "Cost-effectiveness evaluations of pharmacogenetic tests can provide important insights into both the clinical and economic value of these new treatment paradigms, but few of these types of studies have been conducted. Importantly, these studies also allow us to define in economic terms the value of additional comparative effectiveness research. In this case, we've determined that further research of up to $22 million should be conducted to study the risks and benefits of dose reductions based on the results of the genetic test."
Dr. Schackman is associate professor of public health and chief of the Division of Health Policy in the Department of Public Health at Weill Cornell Medical College.
"This study is an important example of how the combined use of cost-effectiveness analysis and pharmacogenetic testing can improve treatment outcomes," says Dr. Alvin I. Mushlin, Professor and Chairman of the Weill Cornell Department of Public Health. "Both methods are becoming increasingly integral to the advancement of evidence-based medicine."
Additional co-authors include Drs. Michael J. Hall of Fox Chase Cancer Center in Philadelphia and Victoria Blinder of Memorial Sloan-Kettering Cancer Center in New York.
The study received support from the American Cancer Society and the Agency for Healthcare Research and Quality (AHRQ) via Weill Cornell's Center for Education and Research on Therapeutics (CERT).
Weill Cornell Medical College
The study appears online in the journal Cancer and is expected in print in the Sept. 1 issue.
"Pharmacogenetic testing is a relatively new treatment innovation that may prove to be a valuable tool for clinicians as they develop personalized treatments for cancer patients to minimize side effects while maintaining outcomes," says lead author Dr. Heather Taffet Gold, assistant professor in the Division of Health Policy in the Department of Public Health at Weill Cornell Medical College. "Our study points to significant potential benefits for pretreatment pharmacogenetic testing for metastatic colorectal cancer, but remains to be verified by clinical research."
The study used a computer simulation model that follows hypothetical patients treated with the FOLFIRI (5-fluorouracil/leucovorin with irinotecan) chemotherapy regimen for metastatic colorectal cancer. The model assumed that under usual care, patients received a full dose of irinotecan. With genetic testing, irinotecan dosage was reduced 25 percent in individuals identified using the genetic test as having the UGT1A1*28 variant allele. The dose reduction is specified in the Food and Drug Administration-approved drug label to minimize cases of neutropenia.
Dr. Bruce Schackman, senior author of the study, says, "Cost-effectiveness evaluations of pharmacogenetic tests can provide important insights into both the clinical and economic value of these new treatment paradigms, but few of these types of studies have been conducted. Importantly, these studies also allow us to define in economic terms the value of additional comparative effectiveness research. In this case, we've determined that further research of up to $22 million should be conducted to study the risks and benefits of dose reductions based on the results of the genetic test."
Dr. Schackman is associate professor of public health and chief of the Division of Health Policy in the Department of Public Health at Weill Cornell Medical College.
"This study is an important example of how the combined use of cost-effectiveness analysis and pharmacogenetic testing can improve treatment outcomes," says Dr. Alvin I. Mushlin, Professor and Chairman of the Weill Cornell Department of Public Health. "Both methods are becoming increasingly integral to the advancement of evidence-based medicine."
Additional co-authors include Drs. Michael J. Hall of Fox Chase Cancer Center in Philadelphia and Victoria Blinder of Memorial Sloan-Kettering Cancer Center in New York.
The study received support from the American Cancer Society and the Agency for Healthcare Research and Quality (AHRQ) via Weill Cornell's Center for Education and Research on Therapeutics (CERT).
Weill Cornell Medical College
Colorectal Cancer Current Events and Colorectal Cancer News RSS'Cross-talk' mechanism contributes to colorectal cancer
Researchers at the University of Wisconsin-Madison School of Medicine and Public Health have identified a molecular mechanism that allows two powerful signaling pathways to interact and begin a process leading to colorectal tumors.
African-Americans with colorectal cancer have poorer outcomes, lower survival rates
New research published in the November issue of the Journal of the American College of Surgeons shows that African-American patients with colorectal cancer are more likely to be diagnosed with advanced disease and are less likely to undergo surgical procedures compared with Caucasians, suggesting that improvements in screening and rates of operation may reduce differences in colorectal cancer outcomes for African-Americans.
Colon cancer screening more effective earlier in day, UCLA study finds
The effectiveness of a screening colonoscopy may depend on the time of day it is performed. According to a new UCLA study, early-morning colonoscopies yielded more polyps per patient than later screenings, and fewer polyps were found hour by hour as the day progressed.
1 disease, not 1 demographic
The Asian continent has nearly four billion people living in 47 different countries, and each of these groups has their own unique set of health issues. But when they come to the United States, they're often lumped into one large demographic: "Asian/Pacific Islander."
Study shows unsedated colonoscopy for colorectal cancer screening well accepted by patients
Researchers from Taiwan report in a new study that unsedated colonoscopy for primary colorectal cancer screening is well accepted in a majority of patients.
M. D. Anderson redefines screening guidelines for breast, cervical and colorectal cancers
Drawing on years of experience in cancer research and patient care, The University of Texas M. D. Anderson Cancer Center released today the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.
The bowels of infection
Current research suggests that latent cytomegalovirus (CMV) infection may exacerbate inflammatory bowel disease (IBD). The related report by Onyeagocha et al, "Latent cytomegalovirus infection exacerbates experimental colitis," appears in the November 2009 issue of The American Journal of Pathology.
How to Lower Costs, Waiting Times for Colonoscopies
Colorectal cancer is a leading cause of cancer-related deaths in the United States, leading to over 50,000 fatalities every year.
Excess body weight causes over 124,000 new cancers a year in Europe
At least 124,000 new cancers in 2008 in Europe may have been caused by excess body weight, according to estimates from a new modelling study.
Adding cetuximab to chemotherapy reduces advanced lung cancer death risk by 13 percent
Patients with advanced non-small cell lung cancer who are given cetuximab (Erbitux) in addition to chemotherapy are 13% less likely to die than those who receive chemotherapy alone, regardless of which chemotherapy drug cocktail is used, new research finds. They also experience slower disease progression and an increased chance of tumour shrinkage.
More Colorectal Cancer Current Events and Colorectal Cancer News Articles
 |
American Cancer Society's Complete Guide to Colorectal Cancer by American Cancer Society (Author) Don't die of embarrassment--get informed about colorectal cancer Although colorectal cancer is the third most common cancer found in men and women, you may be unaware of your risk and don't know what you can do to prevent this serious disease. You may be too embarrassed to ask your doctor about changes in your bowel habits or get screened for colorectal cancer. American Cancer Society's Complete Guide to Colorectal Cancer provides sound information and support if you are concerned about or diagnosed with colorectal cancer. Written by experts in oncology, nursing, research, and colorectal cancer care, the up-to-date, evidence-based text explores every aspect of colorectal cancer, from physical to emotional aspects of the disease, including: What colorectal... |
 |
Be a Survivor: Colorectal Cancer Treatment Guide by Vladimir Lange (Author) Dr. Lange’s comprehensive overview of cancer and treatment options offers detailed information using simple, concise language and a wide variety of color photos and drawings. Colorectal cancer patients need to know more about their disease, yet there is an overload of information. Be a Survivor gives the patient the specific, reliable and necessary information to make good decisions about their cancer and treatment options. Annually, 150,000 Americans are told they have colorectal cancer, making it one of the top three most common cancers in the United States. Diagnosed early, colorectal cancer is treatable, often curable, and vey preventable. This resource covers all aspects of colorectal cancer—from diagnosis to recovery, including a chapter for the patient's spouse. |
|
Progress in Colorectal Cancer by Mediscript | |
 |
First Check Home ColoCheck Home Test, Colorectal Disease, 1 Test (Pack of 2) by First Check A First Check at 50 product. No specimen handling. No diet restrictions. FDA cleared. Fast. Accurate. Simple. A home test for the early warning signs of Colorectal Disease. Results in minutes. Early detection is key. First Check ColoCheck provides informa |
 |
New Tests, Treatments: Better Outcome for Colorectal Cancer Colorectal cancer is the third most common cancer and the second leading cause of cancer mortality in the U.S. Advances in imaging, genetics, molecular diagnostics, surgical techniques and chemotherapy are now making significant gains in our ability to prevent, diagnose, and treat this serious disease. Dr. Fisher reviews some of these recent successes and shares a vision of future care based on current research. |
|
Screening for Colorectal Cancer: An Easy Step to Save Your Life (Three Real Patient Stories) Also With: American Digestive Health Foundation (Producer), Chuck Peet (Host) | |
 |
Beating Colorectal Cancer Together Long Sleeve T-shirt Large White by Shop Zeus |
 |
Colorectal Cancer Awareness Ribbon Mouse Pad by MyHeritageWear.com The Colorectal Cancer Ribbon proudly displayed on a mouse pad. There is no better way to achieve awareness for the meaning of the Colorectal Cancer Ribbon than to display it on your mouse pad for everyone to see. The mouse pad measures at 9.25 x 7.75, it is machine washable, and the colors will not fade or run. Start gaining awareness today by presenting your Colorectal Cancer Ribbon mouse pad at work or at home. It is certain to keep your mouse rolling in style all while gaining support and awareness! |
 |
Understanding Colorectal Cancer Anatomical Chart (Laminated) by Anatomical Chart Company Understanding Colorectal Cancer Anatomical Chart defines colorectal cancer and shows colorectal anatomy with the following pathologies: * Adenocarcinoma of colon * Circumferential carcinoma of the transverse colon * Colonic polyps * Adenocarcinoma of jejunum * Adenocarcinoma of the rectosigmoid region The chart describes risk factors, signs and symptoms, screening and diagnostic tests, and treatment options, and illustrates and explains the stages of cancer. |
 |
Beating Colorectal Cancer Together Keychain by Design a Product LLC Text on keychain: Beating Colorectal Cancer Together * Durable acrylic key chain is crystal-clear and double-sided so the artwork or message is seen twice. * Sturdy metal ring holds your keys securely. * Full color printed images or messages are included. * If you have new ideas or need help selecting text for your custom keychains please contact us. * Size: 2 1/8" x 3 1/2" (Approx. business card) |
| © 2009 BrightSurf.com |