The Gander

Pat Kelly | 15 Nov 2018 | 0 Comment(s)

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The Medical Independent blog takes a look at the more unconventional niches in science and research

Stifling breast cancer

New research published recently in the New England Journal of Medicine has suggested that a combination of immunotherapy and chemotherapy can slow disease progression for patients with triple-negative metastatic breast cancer.

A team at the Sloan Kettering Cancer Centre in the US combined atezolizumab (Tecentriq) with chemotherapy and observed a marginal slowing of disease progression, particularly for patients whose tumours were positive for PD-L1.

The researchers wrote that the chemotherapy treatment “roughens-up” the surface of the tumour cells and removes part of the tumour cells’ “protective cloak”, allowing the body’s immune system greater access to it.

Patients treated with this combination therapy increased their delay in progression by 1.7 months compared to placebo. However, in patients with PD-L1 positive tumours, progression was delayed by approximately 2.5 months. While survival was increased by 3.7 months and the authors noted that this is not statistically significant, they hope their work can lead the way in more research focused on treating breast cancer with a combination of chemotherapy and immunotherapy.

Joint research project 

A team from the Beth Israel Deaconess Medical Centre in the US has found, via the largest analysis of its type to date, that almost all of the conventional treatments for tennis elbow provide little or no therapeutic benefit compared to placebo.

Eleven non-surgical treatment options were examined, including laser therapy, botulinum toxin injection therapy, oral anti-inflammatories, ultrasound, acupuncture and physical therapy. Not only did some of these treatments increase the risk of adverse events, they also showed no benefits 26 weeks after diagnosis.

Among the 2,746 participants across 36 randomised studies, effects on grip strength and pain were evaluated. The researchers found that 99 per cent of the participants on placebo reported little or no pain after 26 weeks. Only patients who received shock-wave therapy said they had a long-term benefit from their treatment compared to the other methods, while the patients who had corticosteroid injections actually reported worse pain levels than those given placebo.

Co-author Dr Amin Mohamadi, research fellow at the  Beth Israel Deaconess Medical Centre, said: “That implies that, for most patients, tennis elbow is a self-limiting condition.

“We evaluated almost all of the non-surgical treatments available for tennis elbow and showed that they provide only minimal effect over placebo. Because almost all patients reported only minimal pain after the first four weeks, clinicians treating patients with tennis elbow may consider opting for a pain relief regimen to manage symptoms on a patient-to-patient basis.”

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