Oral drugs may protect cancer patients from blood clots
London, May 13: Taking oral drugs daily can be an effective treatment for nearly 10 million cancer patients worldwide suffering from a deadly blood clot condition, results from a clinical trial have showed.
People with cancer have an increased risk of developing blood clots, with roughly one in five experiencing venous thromboembolism (VTE) -- either a blood clot in a deep vein or a condition in which one or more arteries in the lungs become blocked by a blood clot.
The results from the clinical trial called "select-d" suggested that prescribing the oral drug rivaroxaban significantly reduced VTE recurrence among patients with cancer.
"Clinicians were already adopting the oral drug into practice for non-cancer patients and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot," said lead author Annie Young, Professor at University of Warwick in the Britain.
Although there are many causes and risk factors for VTE, cancer patients are particularly at risk due to a combination of factors such as immobility, pancreatic and gastric tumours as well as chemotherapy, the researcher said.
For the "select-d" trial, researchers enrolled 406 patients who had cancer and VTE; most (69 per cent) were receiving cancer treatment (typically chemotherapy) at the time of their VTE.
Half were randomly assigned to receive low-molecular-weight heparin (dalteparin) and half were given the oral drug rivaroxaban. After six months of treatment, the VTE recurrence rate was four per cent among those taking the tablet and 11 per cent in those receiving dalteparin.
The results for secondary outcomes were mixed, the researcher said.
In patients receiving rivaroxaban, there were around the same percentage of major bleeding events (6 per cent) as those receiving dalteparin (4 per cent) but a marked and significant increase in clinically relevant non-major bleeds (13 per cent) with rivaroxaban compared to those having low molecular weight heparin (4 per cent).
The reason for increased bleeding is not known. It may be because rivaroxaban is more 'potent', the paper published in the Journal of Clinical Oncology said.
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England sticking with Key, McCullum and Stokes despite Ashes humbling
London (AP): England is not sacking anybody following the 4-1 Ashes loss in Australia.
A review of the tour by the England and Wales Cricket Board, announced within hours of the final match in January, was concluded on Monday. Firing people would “be the easy thing to do,” ECB chief executive Richard Gould said but he insisted, "This is not the time to throw everything out."
Managing director Rob Key, coach Brendon McCullum and captain Ben Stokes kept their jobs after the best England side to go to Australia in 14 years lost the Ashes in 11 days with two games to spare.
“Moving people on can sometimes be the easy thing to do. That's not the route that we're going to take,” Gould said. “I've seen the driving ambition and determination that we're lucky enough to have within our leadership group to take the lessons from the Ashes and move forward.”
Gould previously was the chief executive of Bristol City soccer club and said the ECB would not follow the same route as soccer's hire-and-fire culture.
“Cricket is a very unique sport in that it takes a team of leadership ... it's not like football where there's a single point of failure or success with a manager," he said. He added the ECB would not “select or deselect management based on a popularity campaign.”
The main criticisms of England's tour were poor preparation, player misbehavior, and selection mistakes.
At a press conference at Lord's, Gould and Key said McCullum and Stokes have not had a “bust up,” they did not want McCullum to “completely change” but “to evolve,” the behavior of some players was “unprofessional,” there will be more consequences for underperforming, and a commitment to “better long-term planning” ahead of major test series.
Some changes were already implemented for the Twenty20 World Cup, where England reached the semifinals. Gould implied that performance saved McCullum.
Key acknowledged that England supporters would be disappointed to see the management team go unpunished.
“I know people want punishment and that people then should be sacked for that,” Key said. “That doesn't mean we don't feel like we've gone through some serious pain: Brendon, myself, Ben. It's been as tough a time as I think I've had.”
