International Oncology News Reports from International Meetings and Researchers Possible Link Between Skin Cancer and Posttransplant Voriconazole Use
zole. That is, skin cancers developed at a mean of 910 days in voriconazoletreated patients versus 372 days in patients not receiving the drug. In addition, nine of 12 patients who developed skin cancers at multiple sites or with local recurrence had received voriconazole. Skin cancer is the most common malignancy following a lung transplant.
PARIS—New data suggest that voriconazole, which has been used as standard antifungal prophylaxis in lung transplant recipients, may increase the risk of skin cancer in lung transplant recipients. The findings were reported at the 29th Annual Meeting of the International Society for Heart and Lung Transplantation (ISHLT). A. A. Feist, MD, of the University Omega-3 Helps of California Medical Center, San Patient Recovery After Surgery Diego, and colleagues compared the incidence of skin cancer in a group of DUBLIN—Omega-3 fatty acids given as lung transplant recipients who re- part of an oral nutritional supplement ceived voriconazole for the prevention help preserve muscle mass in patients or treatment of aspergillus versus those undergoing surgery for esophageal canwho received other antifungal therapy cer, researchers reported in the March or no antifungal therapy. The cohort 2009 issue of The Annals of Surgery. included 149 patients who underwent A group from Trinity College Dublin a lung transplant procedure at their and St. James Hospital randomized a institution over a recent 6-year period. group of patients undergoing esophagecOverall, 12 of 28 patients, or 42.9%, tomy to receive a nutritional supplement who received voriconazole enriched with omega-3 developed squamous and/ starting 5 days before suror basal cell carcinoma vergery and continuing for 5 sus 12 of 21 patients, or weeks after surgery or to 9.9%, who did not receive standard enteral nutrition. prophylaxis. Results in 53 patients The data also showed showed that individuals that skin cancer was more who received omega-3 “clinically aggressive” in maintained all aspects of lung transplant patients their body composition ©iStockphoto.com/Johnathan Larsen treated with voriconapostoperatively, whereas
the control group lost a mean of 4 lb of muscle mass after surgery. The amount of weight loss in the control group was “clinically severe,” the authors wrote in their article. “Weight loss is extremely common before and particularly after surgery for esophageal cancer,” principal investigator ©iStockphoto.com/Hon Lau John V. Reynolds, MD, said in a news release. “Any approach that can preserve weight, in particular muscle weight and strength, may represent a real advance.” Omega-3 fats are essential fats that are found naturally in oily fish, with the highest concentrations in salmon, herring, mackerel, and sardines.
Denosumab Strengthens Bones in Prostate Cancer Patients STOCKHOLM—Denosumab, a genetically engineered antibody, significantly increases bone mineral density (BMD) in men with nonmetastatic prostate cancer who are being treated with androgen deprivation therapy, according to data presented at the 24th Annual European Association of Urology (EAU) Congress. Androgen deprivation therapy is associated with accelerated bone loss and increased risk of bone fractures. Matthew Smith, MD, with Mass-
©iStockphoto.com/Johan Möllerberg
achusetts General Hospital in Boston, and colleagues, reported findings in 1468 men who had been randomized to 3 years’ treatment with denosumab, 60 mg per day, or placebo. All men took calcium and vitamin D supplements throughout the trial. The primary end point was the change from baseline for lumbar spine BMD on dual x-ray absorptiometry obtained at 24 months. Results showed that the change in lumbar spine BMD from baseline was 6.7% more in denosumab-treated patients than placebo. The difference between the two groups was significant. Denosumab was also superior to placebo on several secondary end points including the incidence of new vertebral fractures and changes from baseline for total hip, femoral neck, and lumbar spine BMD at 36 months. —Jill Stein
Skin CanCerS Phone Consultation Cuts Delay to Skin Cancer Surgery SAN FRANCISCO—Researchers are reporting that skin cancer patients can decrease the time they have to wait between a biopsy and Mohs micrographic surgery by having a preoperative consultation by telephone instead of an office visit. Mohs surgery is used mainly to treat basal cell and squamous cell carcinomas but may be used to treat less common tumors, including early-stage melanoma. The new findings, released at the 67th Annual Meeting of the American Academy of Dermatology (AAD), show that the waiting time can be lowered by roughly 25% if the patient opts for a preoperative phone discussion with a Mohs surgical nurse in place of the standard preoperative visit to a surgeon. Researchers from St. Louis University School of Medicine compared waiting times and satisfaction levels in patients who had an office consultation per stanJune 2009
©iStockphoto.com/Tom De Bruyne
dard practice and patients who had a phone consultation before Mohs surgery for nonmelanoma skin cancer. For the study, 152 patients who had undergone Mohs surgery over a recent 6-month period were asked to participate in a 5minute telephone survey.
“While the increase in nonmelanoma skin cancer has fueled a demand for Mohs surgery, a shortage of Mohs surgeons has produced long delays for Mohs consultation and treatment,” Sharone Askari, MD, one of the researchers, said. Typically, patients have an office consultation with their surgeon before their day of surgery. Phone consultations were recently introduced at St. Louis University Hospitals to reduce lengthy delays between the biopsy and surgery. The phone consultation involves a discussion between the patient and a Mohs surgical nurse, who provides the same information as the surgeon provides with a standard office visit. Results from 136 patients who completed the survey revealed that the wait-
ing time from biopsy to surgery was 75 days for patients who had a phone consult compared with 104 days for those who had an office consult. Overall, 98% of phone consult patients said they were “very satisfied” with their overall surgical experience versus 87% of office consult patients. Ninety percent of phone consult patients said they preferred a phone consult, whereas 70% of office consultation patients reported a preference for an office consultation. Of a subset of patients who had both a recent phone consultation and a prior office consultation, 69% said they favored the phone consult. Askari said additional research is needed to confirm the findings and also to identify additional ways to better prepare patients for Mohs surgery. —Jill Stein
G REEN H ILL H EALTHCARE C OMMUNICATIONS
27
INTERNATIONAL ONCOLOGY NEWS
TON June09_FINAL:TON 6/8/09 10:56 AM Page 27