This study shows that when given early after adjuvant chemotherapy for HER-2 positive breast cancer, trastuzumab provides significant mortality benefit in as little as two years. But the Herceptin debate is certainly not over – the benefit is small, the cardiac dangers great, the long-term effects unknown, the dosage uncertain and the costs enormous – as pointed out in the accompanying editorial.
Ever heard of medium-chain acyl-CoA dehydrogenase deficiency? As you’ll have guessed, it’s a rare metabolic disorder – potentially lethal but treatable. Over a ten-year period, 81 cases were picked up in Australia, and this paper makes an argument for neonatal screening using tandem-mass spectrometry.
If we could really help our patients lose weight and keep it lost, it would be a major breakthrough. We have three drugs to help our fat patients – orlistat, sibutramine and rimonabant. As this review makes clear, none is ideal and we don’t have any real evidence about their effects on hard end-points like cardiovascular disease or osteoarthritis.