HCN Essentials: Metformin for NSCLC, Pediatric ALL CNS Control, Diathesis in Breast CancerAugust 03, 2021 | Oncology Endocrinology, Diabetes, Metabolism Does Metformin Improve Outcomes in Nondiabetic, Unresectable Stage III NSCLC Treated with Chemoradiation? Publication: JAMA Oncology Objective: With NSCLC having relatively poor outcomes and the significant data supporting the use of metformin as an antineoplastic agent, the researchers wanted to compare overall or progression-free survival in chemoradiation alone vs. chemoradiation + metformin stage III NSCLC patients. Design: Randomized clinical trial, open-label, phase 2 study; 167 eligible patients Read full article Anesthesiology Controlling CNS Relapse in Children with ALL Treated Without Cranial Irradiation Publication: Blood Key Points: The authors identified the following four prognostic indicators that could help control CNS relapse in children with ALL. 1) Prephase dexamethasone treatment, 2) delayed intrathecal therapy, 3) use of total intravenous anesthesia during intrathecal therapy, and 4) flow cytometry examination of diagnostic CSF Design: 7,640 consecutive patients treated on Chinese Children’s Cancer Group ALL-2015 protocol Read full article Emergency Medicine A Bleeding Diathesis in a 65-Year-Old Woman with Newly Diagnosed Breast Cancer After diagnosis during a partial mastectomy, this patient’s estimated blood loss was 58 mL, causing anemia and requiring a red blood cell transfusion along with ventriculoperitoneal drain placement. With a substantive bleeding history before the diagnosis, what would you do next with this patient? Work her up for von Willebrand disease? Do a complete blood count test to look at platelet count, a peripheral smear to look at the morphology of the platelets, and a coagulation profile? Offer genetic testing for fibrinogen disorders? What would your next steps be? Read the full case presentation and expert opinion to see how your peers responded. Read full article
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