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This Week in the Medical Journals: Jul 13, 2012


In NEJM this week, researchers in the US and Europe report on the effects of MEK inhibitors on the survival of patients with BRAF-mutated melanoma. The team randomly assigned 322 patients with BRAF V600E or V600K metastatic melanoma to receive either the oral selective MEK inhibitor trametinib, or chemotherapy. They found that median progression-free survival was 4.8 months in the trametinib group, compared to 1.5 months in the chemotherapy group, and that the rate of overall survival at six months was 81 percent in the trametinib group and 67 percent in the chemotherapy group.

In JAMA this week, a team of European researchers reports on the effects of different combination therapies on survival in patients with resected periampullary adenocarcinoma. The team assigned 144 patients to the observation group, gave folinic acid followed by fluorouracil to another 143 patients, and gave gemcitabine to a third group of 141 patients. They found that 52 percent of the patients in the gemcitabine group died, compared to 58 percent of the patients given fluorouracil and 61 percent of the patients in the observation group. "Among patients with resected periampullary adenocarcinoma, adjuvant chemotherapy, compared with observation, was not associated with a significant survival benefit in the primary analysis," the team writes. "However, multivariable analysis adjusting for prognostic variables demonstrated a statistically significant survival benefit associated with adjuvant chemotherapy."

And in the British Medical Journal this week, researchers at the University of Dundee in the UK investigate the effects of spironolactone on the breast cancer risk of women older than 55. The team studied data from nearly 1.3 million patients, including women who had received at least two spironolactone prescriptions after age 55. They found no evidence of an increased risk of breast cancer in patients exposed to the drug, adding, "These data suggest that the long term management of cardiovascular conditions with spironolactone does not increase the risk of breast cancer in women older than 55 years with no history of the disease."

The Scan

Genetic Risk Factors for Hypertension Can Help Identify Those at Risk for Cardiovascular Disease

Genetically predicted high blood pressure risk is also associated with increased cardiovascular disease risk, a new JAMA Cardiology study says.

Circulating Tumor DNA Linked to Post-Treatment Relapse in Breast Cancer

Post-treatment detection of circulating tumor DNA may identify breast cancer patients who are more likely to relapse, a new JCO Precision Oncology study finds.

Genetics Influence Level of Depression Tied to Trauma Exposure, Study Finds

Researchers examine the interplay of trauma, genetics, and major depressive disorder in JAMA Psychiatry.

UCLA Team Reports Cost-Effective Liquid Biopsy Approach for Cancer Detection

The researchers report in Nature Communications that their liquid biopsy approach has high specificity in detecting all- and early-stage cancers.