May 25 – June 1, 2013
In this section, we will highlight the some of the most high-impact studies, updates, and analyses published in medicine during the past week.
Crizotinib versus Chemotherapy in Advanced ALK-Positive Lung Cancer and
Acquired Resistance to Crizotinib from a Mutation in CD74–ROS1
This phase 3, open-label trial compared crizotinib with chemotherapy in 347 patients with locally advanced or metastatic ALK-positive lung cancer who had failed prior therapy. There was an improvement in progression free survival (7.7 months vs. 3.0 months, p < 0.001), however there has been no overall mortality benefit to be seen (HR 1.02). An acquired CD74–ROS1 rearrangement was identified in a patient that had an initial dramatic response to crizotinib and is shown to block drug binding.
In this phase 2 RCT of selumetinib and dacabazine vs. dacabizine alone for the treatment of BRAF+ melanoma, patients receiving zelumetinib had a statistically significant improvement in progression-free survival (5.6 months vs. 3.0 months, p = 0.021), however there was no statistically significant improvement in overall survival (13.9 months vs. 10.5 months, p = 0.39).
Outcomes of Medical Emergencies on Commercial Airline Flights
In this study, investigators retrospectively looked at the records of in-flight medical emergencies and found that the most common problems were syncope (37.4%), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). There was 1 medical emergency per 604 flights, with 25.8% resulting in transport to a hospital, 8.6% admitted to a hospital, and 0.3% dying. 7.3% of airborne medical emergencies required diversion of the flight.
In this multicenter RCT, 43 (25%) patients with cystic fibrosis and low bone mineral density were observed with 5% or more improved bone marrow density after receiving 12 months of calcium and calcifediol. Patients subsequently randomized to alendonate had 16.3% more bone mineral density increase vs. 3.1% in placebo.
By David Ouyang
