Both coumarin (1,2-benzopyrone) and warfarin (4-hydroxycoumarin) have been shown to prevent the recurrence of malignant melanoma. Their action is macrophage-dependent and the dosage is critical. In 1984 a multicentre, prospective, randomised, double-blind trial of coumarin, given as a daily 50-mg dose for 2 years after surgery in patients with high-risk melanoma, was started. the patients had lesions greater than 1.70 mm thick and TNM stage IB or stage II disease. To date there are 4 recurrences in the coumarin-treated group of 13 patients, and 10 recurrences in the placebo-treated group of 14 patients (P < 0.01). There were no toxic effects.

This study was conducted to assess the occurrence of fractures in solid-organ transplant recipients. Methods. Medical record review and surveys were performed. Patients received less than 6 months of glucocorticoids. Results. Of 351 transplant patients, 175 patients provided fracture information, with 48 (27.4%) having fractured since transplant (2–6 years). Transplants included 19 kidney/liver (50% male), 47 kidney/pancreas (53% male), 92 liver (65% male), and 17 pancreas transplants (41% male). Age at transplant was 50.8 ± 10.3 years. Fractures were equally seen across both genders and transplant types. Calcium supplementation (n = 94) and bisphosphonate therapy (n = 52) were observed, and an association with a lower risk of fractures was noted for bisphosphonate users (OR = 0.45 95% C.I. 0.24, 0.85). Fracture location included 8 (16.7%) foot, 12 (25.0%) vertebral, 3 (6.3%) hand, 2 (4.2%) humerus, 5 (10.4%) wrist, 10 (20.8%) fractures at other sites, and 7 (14.6%) multiple fractures. The estimated relative risk of fracture was nearly seventeen-times higher in male liver transplant recipients ages 45–64 years compared with the general male population, and comparable to fracture rates on conventional immunosuppressant regimens. Conclusion. We identify a high frequency of fractures in transplant recipients despite limited glucocorticoid use.

Objectives. There have been advances in the identification and understanding of molecular subsets of lung cancer, defined by specific oncogenic aberrations. A number of actionable genetic alterations have been identified, such as the epidermal growth factor receptor (EGFR) mutation. We aimed to establish the reasons why patients were not undergoing EGFR mutation testing at the time of histological diagnosis. Methods. The records of 70 patients with advanced adenocarcinoma of the lung managed through a single multidisciplinary team at a single institution were reviewed. Data were collected on method of tumour sample collection, whether this was sent for EGFR testing, and the result. Results. Seventy patients were identified. In 21/25 (84%) cases, cytological sampling was sufficient for EGFR mutation analysis, compared with 40/45 (89%) cases with histological sampling. EGFR mutation testing was not carried out in 22/70 (31.4%) patients. There was insufficient tumour sample for EGFR testing in 9/22 (40.9%) patients. Other reasons for not testing included poor patient fitness and problems in the diagnostic pathway. Conclusions. In this series, cytological tumour sampling was not the predominant reason why cancers failed to have EGFR mutation status established.

Background: Optimal therapy for radically treated SCLC is concurrent hyperfractionated chemoradiotherapy (CCRT-45 Gy/30fractions/3 weeks, 3-D conformal) and prophylactic cranial irradiation (after complete or a good partial response). CCRT is not always feasible; patients may then have sequential chemoradiotherapy (SCRT)-45 Gy/15 fractions/3 weeks, 2D or 3D planned. Methods: CCRT and 3D planning were introduced locally in 2010. We reviewed all SCLC cases treated with both chemotherapy (CT) and radiotherapy (RT) with potentially curative intent between 2010 and 2014 at Velindre Cancer Centre. Results: 87 patients were treated. 86 received both CT and RT (73 sequential and 13 concurrent). One deteriorated after cycle 1 chemotherapy (further CT/RT cancelled). The median age was 66 (range 36-85). 51 were female, 36 were male. WHO PS at presentation: 0-36%, 1-43%, 2-18%, 3-2%. 70% had stage III disease. 44 patients had 2D RT planning; 42 patients had 3D; 3D planning increased over time. Only 15% received CCRT.

Purpose: This study examined real-world data from patients who received eribulin for metastatic breast cancer (MBC) collected from 14 hospitals across the UK. Methods: Anonymized data were collected retrospectively from patients with MBC who had received eribulin. The data included hormone-receptor status, histological diagnosis, age, prior chemotherapy, response to eribulin, progression-free survival (PFS), and overall survival (OS). Results: Among 577 patients analyzed, the median age was 56 years and most patients (73%) were estrogen-receptor positive. The median OS was 288 days (95% confidence interval [CI]: 261–315) and the PFS was 117 days (95% CI: 105–129). Median OS was higher among older patients (≥ 65 vs < 65 years: 325 days [95% CI: 264–385] vs 285 days [95% CI: 252–317]; P = 0.028). Median OS was also higher in patients that received eribulin after fewer prior lines of chemotherapy (≤ 2 vs > 2 prior: 328 days [95% CI: 264–385] vs 264 days [95% CI: 229–298]; P = 0.042). Conclusions: These retrospective data suggest eribulin can be successfully used in older patients with MBC. Eribulin treatment was more effective in earlier-line settings which, while predictable, supports consideration of eribulin as a second-line treatment option.