The U.S. Food and Drug Administration (FDA) has expanded the approval of Prolia® (denosumab) to include treatment of bone loss among breast cancer patients treated with aromatase inhibitor therapy and prostate cancer patients treated with androgen deprivation therapy for non-metastatic cancer. Treatment is intended to increase bone mass among patients at high risk of fracture.
Osteoporosis affects an estimated 10 million Americans over the age of 50. Each year, roughly 1.5 million Americans will experience an osteoporosis-related bone fracture. These fractures commonly involve the wrist, hip, or spine, but can affect any part of the body.
Bone loss accelerates as we age (with particularly rapid loss in women after menopause), but can also be caused by certain types of cancer treatment. Hormonal therapies such as aromatase inhibitors for breast cancer and androgen-deprivation therapy for prostate cancer, for example, are known to cause bone loss. Bone loss from cancer treatment tends to be more rapid and severe than the bone loss that occurs naturally with aging.
Prolia targets a protein known as the RANK ligand. This protein regulates the activity of osteoclasts (cells that break down bone). Prolia has been shown to reduce the risk of fractures in high-risk postmenopausal women with osteoporosis, and was approved for this purpose in 2010.
Studies have also now shown that Prolia is effective against cancer treatment-induced bone loss. In a study of men undergoing androgen-deprivation therapy for non-metastatic prostate cancer, those who received Prolia were 62% less likely to develop a new vertebral fracture than those who received a placebo.Prolia has also been found to improve or maintain bone density among women undergoing aromatase inhibitor treatment for breast cancer.The most common side effects of Prolia were joint and back pain.
Prolia is the first drug approved for cancer treatment-induced bone loss.
References:
U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004. Body JJ. Prevention and treatment of side-effects of systemic treatment: bone loss. Annals of Oncology. 2010; 21(supplement 7):vii180-vii185.
Smith MR, Egerdie B, Hernandez Toriz N et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. New England Journal of Medicine. Early online publication August 11, 2009.
Ellis GK, Bone HG, Chlebowski R et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. Journal of Clinical Oncology. 2008;26:4875-4882.
2011년 10월 16일 일요일
African-American Men in Low-Sunlight Areas at Risk for Low Vitamin D
A study of men in Chicago found that low vitamin D levels were more common in African-American men than in European_American men. These results were presented at the Fourth AACR Conference on The Science of Cancer Health Disparities, held September 18-21 in Washington DC.
Vitamin D is important for bone health, and some research suggests that it may also reduce the risk of certain types of cancer. A role for vitamin D in cancer prevention has not yet been firmly established, however, and research on this topic continues. Vitamin D can be produced in the skin in response to ultraviolet B (UVB) radiation from the sun or obtained from dietary sources. Few foods naturally contain large amount of vitamin D, but vitamin D can be obtained from fatty fish such as salmon, fortified foods such as milk, and dietary supplements.
The level of vitamin D that is optimal for health is still a matter of debate, but it’s clear that some segments of the population are more likely than others to have levels that may be insufficient. People who are at increased risk of having low vitamin D levels include breastfed infants, older adults, people with limited sun exposure, people with dark skin, people who are obese or who have undergone gastric bypass surgery, and people with a reduced ability to absorb fat in the gut (such as those with Crohn’s disease).
To explore blood vitamin D levels among men in a low ultraviolet radiation part of the country (Chicago), researchers conducted a study among 492 men between the ages of 40 and 79. A low vitamin D level was defined as a level of 25-hydroxyvitamin D [25(OH)D] less than 30 ng/ml.
Low vitamin D levels were detected in 93% of the African American men and 70% of the European American men. People with darker skin tend to produce less vitamin D in their skin than people with lighter skin. The researchers note that recommendations regarding vitamin D intake may need to vary by factors such as skin color and sun exposure.
Because of the link between sun exposure and skin cancer, organizations such as the American Academy of Dermatology recommend getting vitamin D through dietary supplements rather than through sun exposure. Dietary supplements can provide an identical form of vitamin D without the skin cancer risk. It’s also important for people to realize that at high latitudes (regions farther from the equator, including the northern part of the United States), sun exposure does not produce any vitamin D during winter months.
Reference: American Association for Cancer Research (AACR) Press Release. African_American Men Living in Poor Sunlight Areas at Risk for Vitamin D Deficiency.
Vitamin D is important for bone health, and some research suggests that it may also reduce the risk of certain types of cancer. A role for vitamin D in cancer prevention has not yet been firmly established, however, and research on this topic continues. Vitamin D can be produced in the skin in response to ultraviolet B (UVB) radiation from the sun or obtained from dietary sources. Few foods naturally contain large amount of vitamin D, but vitamin D can be obtained from fatty fish such as salmon, fortified foods such as milk, and dietary supplements.
The level of vitamin D that is optimal for health is still a matter of debate, but it’s clear that some segments of the population are more likely than others to have levels that may be insufficient. People who are at increased risk of having low vitamin D levels include breastfed infants, older adults, people with limited sun exposure, people with dark skin, people who are obese or who have undergone gastric bypass surgery, and people with a reduced ability to absorb fat in the gut (such as those with Crohn’s disease).
To explore blood vitamin D levels among men in a low ultraviolet radiation part of the country (Chicago), researchers conducted a study among 492 men between the ages of 40 and 79. A low vitamin D level was defined as a level of 25-hydroxyvitamin D [25(OH)D] less than 30 ng/ml.
Low vitamin D levels were detected in 93% of the African American men and 70% of the European American men. People with darker skin tend to produce less vitamin D in their skin than people with lighter skin. The researchers note that recommendations regarding vitamin D intake may need to vary by factors such as skin color and sun exposure.
Because of the link between sun exposure and skin cancer, organizations such as the American Academy of Dermatology recommend getting vitamin D through dietary supplements rather than through sun exposure. Dietary supplements can provide an identical form of vitamin D without the skin cancer risk. It’s also important for people to realize that at high latitudes (regions farther from the equator, including the northern part of the United States), sun exposure does not produce any vitamin D during winter months.
Reference: American Association for Cancer Research (AACR) Press Release. African_American Men Living in Poor Sunlight Areas at Risk for Vitamin D Deficiency.
Regular Use of Nonaspirin NSAIDs May Increase Kidney Cancer Risk
Long_term users of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) may have an increased risk of developing renal cell (kidney) cancer. These findings were recently reported in the Archives of Internal Medicine.
Nonsteroidal anti-inflammatory drugs are used to reduce inflammation and pain; they include drugs such as aspirin and ibuprofen. Some studies have suggested that NSAIDs may reduce the risk of certain types of cancer, such as colorectal cancer, breast cancer, and prostate cancer. When it comes to kidney cancer, however, some data have shown that NSAIDs may increase rather than reduce risk.
To further investigate the link between NSAID use and kidney cancer, researchers tracked aspirin, nonaspirin NSAID, and acetaminophen (also a pain reliever) use among 77,525 women and 49,403 men participating in the Nurses’ Health Study and the Health Professionals Follow_Up Study. Data were collected beginning in1990 for the Nurses’ Health Study and in 1986 for the Health Professionals Follow_Up Study and again every two years through follow_up at 16 and 20 years, respectively.
Reference: Cho E, Curhan G, Hankinson SE, et al. Prospective evaluation of analgesic use and risk of renal cell cancer. Archives of Internal Medicine.
Nonsteroidal anti-inflammatory drugs are used to reduce inflammation and pain; they include drugs such as aspirin and ibuprofen. Some studies have suggested that NSAIDs may reduce the risk of certain types of cancer, such as colorectal cancer, breast cancer, and prostate cancer. When it comes to kidney cancer, however, some data have shown that NSAIDs may increase rather than reduce risk.
To further investigate the link between NSAID use and kidney cancer, researchers tracked aspirin, nonaspirin NSAID, and acetaminophen (also a pain reliever) use among 77,525 women and 49,403 men participating in the Nurses’ Health Study and the Health Professionals Follow_Up Study. Data were collected beginning in1990 for the Nurses’ Health Study and in 1986 for the Health Professionals Follow_Up Study and again every two years through follow_up at 16 and 20 years, respectively.
- 333 cases of kidney cancer were diagnosed among participants in both studies combined.
- Regular use of nonaspirin NSAIDs appeared to increase risk of kidney cancer, with an increase in relative risk of 51%.
- Regular use of aspirin and acetaminophen did not appear to increase risk of kidney cancer.
- Longer use of nonaspirin NSAIDs was associated with increasing risk of kidney cancer: Use for less than four years was associated with a 19% decreased relative risk of developing kidney cancer, whereas use from four to 10 years was associated with a 36% increased relative risk and use for 10 years or more with an almost threefold increase in relative risk.
Reference: Cho E, Curhan G, Hankinson SE, et al. Prospective evaluation of analgesic use and risk of renal cell cancer. Archives of Internal Medicine.
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