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Baking Soda: For Cooking, Cleaning, And Kidney Health?
A daily dose of sodium bicarbonate baking soda, already used for baking, cleaning, acid indigestion, sunburn, and more slows the decline of kidney function in some patients with advanced chronic kidney disease (CKD), reports an upcoming study in the Journal of the American Society of Nephrology (JASN). "This cheap and simple strategy also improves patients" nutritional status, and has the potential of translating into significant economic, quality of life, and clinical outcome benefits," comments Magdi Yaqoob, MD (Royal London Hospital).

Spend More, Get Less? The Health Care 'Conundrum'
On NPR"s Fresh Air, New Yorker staff writer Atul Gawande spoke about his article on the high cost of health care in McAllen, Texas. He found that costs in McAllen were higher than in the rest of the country because doctors ordered more tests and treatments for their patients, which did not result in a better quality of care. Gawande told NPR that "the difficulty comes in the conflict between when medicine is a business versus when it"s a profession. In a grey-zone case, whether a patient should get that endoscopy for heartburn, whether you send them to have a particular operation like a carpal-tunnel release for carpal tunnel syndrome, we make more money, and there is a temptation and a strong incentive to do more rather than less. At the same time, if we"ve crossed the border to the point where over-treatment is actually producing harm, we now have to think about how to rein in that part of what we do, even though it can sometimes mean losing money."
News of the day
Polls Show Americans Struggling To Pay For Health Care
A new study reports that about one-fourth of Americans say they"ve struggled in the last 12 months to pay for health care, Reuters reports.
Public Health

New Data From Satraplatin Phase 3 Trial In Second-Line Castrate-Refractory Prostate Cancer Presented At 2009 ASCO Annual Meeting

GPC Biotech AG (FRANKFURT: GPC) (XETRA: GPC) announced that data from the double- blind, randomized satraplatin Phase 3 trial, the SPARC trial (Satraplatin and Prednisone Against Refractory Cancer), were presented at the 2009 American Society for Clinical Oncology (ASCO) Annual Meeting in Orlando, Florida. The SPARC trial evaluated satraplatin plus prednisone versus placebo plus prednisone in 950 patients with castrate-refractory prostate cancer (CRPC) who had progressed after initial chemotherapy. The data presented are retrospective analyses of the SPARC trial evaluating correlations between overall survival (OS) and pain at baseline, pain progression, and progression-free survival (PFS) at three months. One presentation ("Use of pain at baseline and pain progression to predict overall survival in patients with docetaxel pretreated metastatic castration-refractory prostate cancer: results from the SPARC trial," Sartor et al, Abstract #5148), analyzed the docetaxel-pretreated population (n=488) in two separate ways: -- The first analysis compared OS in those patients who had no pain (Present Pain Intensity (PPI) score less than or equal to 1) vs. those with pain (PPI greater than or equal to 2) at time of entry to the trial. -- The second analysis compared OS in those patients who experienced pain progression versus progression by pre-specified measures other than pain (as judged by the blinded Independent Review Committee (IRC)). Shorter OS time was observed in docetaxel-pretreated patients who had pain at baseline compared to those who did not. The median survival of patients with baseline pain (n=178) was 44 weeks versus 72 weeks for patients without baseline pain (n=287) [stratified hazard ratio: 0.59 (95% CI: 0.48-0.74), stratified log-rank p less than 0.0001]. The IRC found that 414 docetaxel-pretreated patients (84.8%) progressed as of the data cutoff date for the SPARC study. Of these, the median survival of patients showing pain progression (n=196) was 47 weeks, compared to 71 weeks for non-pain progressors (n=292) [stratified hazard ratio: 0.71 (95% CI: 0.57-0.87), stratified log-rank p=0.0022]. Thus, pain at baseline, as well as pain progression, were prognostic indicators of OS in the docetaxel-pretreated patient population. A second presentation ("Correlation of progression-free survival and overall survival in men with metastatic castration-resistant prostate cancer who failed first-line chemotherapy: results from the SPARC trial," Halabi et al, Abstract #5150) evaluated whether PFS at three months was predictive of OS and explored the statistical dependencies between PFS and OS. Of the 853 men alive at three months post-randomization, 477 (56%) had already progressed. The median survival for this group was 34.5 weeks versus 78.7 weeks in men who had not progressed at the same three months timepoint. [hazard ratio: 2.16 (95% CI=1.84-2.55), p-value less than 0.001]. The dependence between PFS and OS was 0.29 (95% confidence limits=0.24-0.33, p-value less than 0.00001). Thus PFS at three months was predictive of OS. Additional studies will be needed to assess the clinical relevance of the individual components of progression as defined in the SPARC trial to OS. Data from other Phase I and Phase II clinical trials evaluating satraplatin in combination with other cancer therapeutic drugs were published in the 2009 ASCO Annual Meeting Proceedings: - Phase II trial of bevacizumab and oral satraplatin and prednisone in docetaxel pretreated metastatic castrate resistant prostate cancer - Vaishampayan et al (Abstract #e16028). - Dose finding study of the combination of satraplatin and gemcitabine in patients with advanced solid tumors - Di Paola et al (Abstract #e13534). - A phase I study investigating the combination of orally bioavailable platinum and nonparticle albumin-bound paclitaxel in advanced solid tumors - Deshpande et al (Abstract #e13501). About Satraplatin Satraplatin, an investigational drug, is a member of the platinum family of compounds. Platinum-based drugs are a critical part of modern chemotherapy treatments and are used to treat a wide variety of cancers. All platinum drugs currently on the market require intravenous administration. Satraplatin is an oral compound that clinical trial patients are able to take at home. GPC Biotech has a license agreement with Yakult Honsha Co. Ltd. under which Yakult has exclusive commercialization rights to satraplatin for Japan. GPC Biotech is currently in discussions with Yakult regarding further development and registrational efforts for satraplatin. GPC Biotech in-licensed satraplatin from Spectrum Pharmaceuticals, Inc. GPC Biotech


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