State-of-the-Art Lecture: What Are The Most Important Ongoing Clinical Trials In Urologic Oncology Worldwide? Why Allopurinol? Healthcare professionals having tips for you..

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State-of-the-Art Lecture: What Are The Most Important Ongoing Clinical Trials In Urologic Oncology Worldwide?

ORLANDO, FL ( UroToday. com ) - Dr. Crawford presented information on challenges facing clinical trials from SWOG, ECOG and CALGB. Patient accrual for clinical trials is only 2-3%. Innumerable layers of rules and regulations have been created with numerous layers that increase costs and delays. He applauded prevention trials such as PCPT, SELECT, Toremifene for PIN and REDUCE. He gave poor marks for randomized treatment trials. Well designed randomized treatment trials have mostly closed secondary to poor accrual. The PUNCH study studying chemo/hormonal therapy may provide more information, but accrual is slow. The START study will randomize to treatment vs. active surveillance with delayed intervention as needed. Robotic surgery has also not been tested against existing open surgery and is sideways progress that may detract from a strong focus on clinical trials accrual, he said. He cited progress with sunitinib and sorafenib as progress of clinical trials in renal cell cancer. These drugs will be further tested in unfavorable renal cancers. In bladder cancer imaging and intravesical trials are ongoing.

Doctor Sandler presented trials from RTOG and EORTC. He focused on phase III clinical trials as central to new progress. Phase III studies must be equipoise with balance in the arms to resolve uncertainty in outcome. RTOG has completed many large randomized trials. RTOG 0126 assesses intermediate risk CaP and is accruing well. It takes about one year for a trial to ramp up to full accrual. He referred to ProtecT study that will address screening and treatment. They'll assess 5, 10 and 15 year survival. Up to 70% of localized CaP patients were randomized to active surveillance, radiotherapy or radical prostatectomy. With regard to post-operative radiotherapy, RADICALS trial from MRC evaluates the timing of radiotherapy. Patients are randomized to immediate or careful monitoring with salvage. The EORTC will randomize patients to post-operative radiotherapy alone or with androgen deprivation. He concluded that phase III clinical trials are critical and an international collaboration is ideal.

Presented by E. David Crawford, MD, and Howard M. Sandler, MD, at Annual Meeting of the American Urological Association ( AUA ) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday. com Contributing Editor Christopher P. Evans, MD, FACS

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Why Allopurinol?

uses of Allopurinol Allopurinol is an enzyme blocker that lowers high levels of uric acid in your body by decreasing the amount produced. It's used to treat gout and certain types of kidney stones. Allopurinol is also used to prevent high uric acid levels in patients who receive cancer chemotherapy. Cancer cells that are destroyed with therapy release large amounts of uric acid into the bloodstream.

how to use of Allopurinol Take Allopurinol by mouth usually once daily after a meal to reduce stomach upset, or as directed by your doctor. It is best to drink a full glass of water with each dose and at least another 8 glasses ( 8 oz. each ) a day while taking Allopurinol in order to prevent kidney stones from forming. If we are on restricted fluid intake, consult your doctor for further instructions. Your doctor may also instruct you on how to decrease acidity in your urine ( e. g. , avoid large amounts of ascorbic acid or Vitamin C ) .

Dosage is based on your medical condition and response to therapy. Use Allopurinol regularly to get most benefit from it. Remember to take it at same time each day.

For treatment of gout, it may take up to several weeks for this medicine to have an effect. We may experience an increase in the number of gouty attacks for several weeks to months after starting this medicine while the body rids itself of excess uric acid. Allopurinol isn't a pain reliever. To relieve pain, continue to take your prescribed medicines for gouty attacks ( e. g. , colchicine, ibuprofen, indomethacin ) as directed by your doctor.

side effects of Allopurinol Stomach upset, nausea, diarrhea, unusual taste, acute gouty attacks, or drowsiness may occur while use Allopurinol as your body adjusts to Allopurinol. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Allopurinol because he or she has judged that the benefit to you is greater than risk of side effects. Many people using Allopurinol don't have serious side effects.

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur:

Allopurinol may rarely cause very serious ( possibly fatal ) allergic reactions. Stop taking Allopurinol and seek immediate medical attention if any of these allergic reaction symptoms occur:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

precautions of Allopurinol Before taking Allopurinol, tell your doctor or pharmacist if we are allergic to it; or if you have any other allergies.

Before using Allopurinol, tell your doctor or pharmacist your medical history, especially of:

Allopurinol may make we drowsy; use caution engaging in activities requiring alertness such as driving or using machinery.

Alcohol may decrease effectiveness of Allopurinol. Limit alcoholic beverages.

Allopurinol should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

Allopurinol passes into breast milk. Consult your doctor before breast-feeding.

interactions of Allopurinol Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring we for it. Don't start, stop or change the dosage of any medicine before checking with them first.

Allopurinol shouldn't be used with following medication because very serious interactions may occur while use Allopurinol:

If you're currently using Allopurinol, tell your doctor or pharmacist before starting Allopurinol.

Before using Allopurinol, tell your doctor or pharmacist of all prescription and nonprescription/herbal products we may use, especially of:

This document doesn't contain all possible interactions. Therefore, before using Allopurinol, tell your doctor or pharmacist of all the products we use. Keep a list of all your medications with you, and share list with your doctor and pharmacist.