US Pharm.2006;31(9):98.

HPV Vaccine Doesn't Eliminate Need for Pap Tests
Vaccination against human papillomavirus (HPV) could delay the start and frequency of Pap test screening; however, regular Pap tests are still needed to screen for HPV strains not protected against by the vaccine, according to the September Harvard Health Letter. These strains account for about 30% of cervical cancers, and regular Pap tests remain the best way to prevent such cancers. In June 2006, the CDC Advisory Committee on Immunization Practices voted to recommend the HPV vaccine Gardasil for use in females ages 9 to 26.

Painkillers Associated with Birth Defects
Women taking NSAIDs during the first trimester of pregnancy have a twofold increased risk of having a child with a congenital anomaly, even after controlling for other possible causes of birth defects, according to a report in Birth Defects Research (Aug. 23, 2006; [Epub ahead of print]). Congenital anomalies were identified in 8.8% of births among 1,056 women who had filled a prescription for NSAIDs during the first trimester of pregnancy, compared with 7% of births among 35,331 women who did not fill such a prescription.

Long-Term Safety of Breast Cancer Drugs Shown
Results of the Arimidex, Tamoxifen, Alone or in Combination trial demonstrated that Arimidex (anastrozole) is better tolerated after surgery than tamoxifen for the treatment of postmenopausal women with early-stage breast cancer (Lancet Oncology. 2006;7:633-643). Adverse events did not differ among the treatment groups, but significantly fewer patients taking anastrozole experienced adverse events that were related to treatment or that caused them to withdraw from treatment. In addition, anastrozole had a significantly better risk-benefit profile, which takes into account both the chance of breast cancer recurrence and side effects caused by treatment.

Topotecan Not Recommended for Ovarian Cancer
Topotecan does not increase survival in patients with ovarian cancer when used with standard chemotherapy and is not recommended for future use, according to results of a phase III study (J Natl Cancer Inst. 2006;98:1036-1045). A total of 1,308 women with untreated ovarian cancer received paclitaxel and carboplatin followed by either topotecan or surveillance. Adding topotecan to the treatment regimen did not improve overall survival, progression-free survival, or quality of life. Furthermore, treatment with topotecan increased the frequency of blood-related toxicities and infections, which require extra medical attention.

New Natural Contraceptive Methods
New nonhormonal contraceptive methods have been developed by Georgetown University's Institute for Reproductive Health. One method, known as the Standard Days Method, uses CycleBeads, a string of 32 color-coded beads that helps a woman keep track of her cycle and the days during which she may become pregnant. The Standard Days Method has shown to be 95% effective in preventing pregnancy. Another method, known as the TwoDay Method, relies on the presence or absence of cervical secretions and is 96% effective in preventing pregnancy. The researchers encourage health care providers to present natural family planning methods to patients and to be aware of the pros and cons of each method.

HIV Drug May Be Used to Treat Cervical Cancer
Using the protease inhibitor lopinavir, researchers at the University of Manchester, United Kingdom, are developing a topical treatment for HPV. According to a report in the September Antiviral Therapy, lopinavir selectively kills cultured HPV-infected cervical cancer cells and could eventually be used to create a simple cream or pessary that could serve as an alternative to surgery in women with precancerous lesions.

"We are currently exploring the means of delivering this drug directly to the affected tissue. We would then move to a clinical trial…. If this proves successful we could see the treatment available fairly rapidly," said Dr. Ian Hampson.

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