The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. In some cases, such as elderly patients or those with many co-morbid illnesses, the regimen of choice might not be suitable. For many of the cancers listed, surgery and/or radiation therapy may be the treatment of choice or may also be part of the management. Anticancer...

Recently, full-page advertisements have appeared in the New York Times and other newspapers promoting the Viralizer (Viral Response Systems, Greenwich, CT), a heated nebulizer-sprayer device marketed for treatment of colds, sore throats, allergy and sinusitis symptoms. The device is available without a prescription for about $30 to $40.

Desflurane (Suprane - Anaquest), an inhalation anesthetic, has been approved by the US Food and Drug Administration for induction and maintenance of general anesthesia in adults and for maintenance of anesthesia in infants and children. Like isoflurane (Forane), the last volatile anesthetic to become available in the USA (Medical Letter, 23:112, 1981), the new agent is a halogenated methyl ethyl ether, differing from isoflurane in the substitution of a fluorine for a chlorine atom.

Ablation of the globus pallidus, an old treatment for Parkinsons disease, is being tried again, using more refined stereotactic techniques, improved brain imaging and new methods for recording neuronal activity (CW Olanow, Ann Neurol, 40:341, September 1996).

Dronedarone (Multaq – Sanofi), an analog of amiodarone, was approved by the FDA in 2009 for oral treatment of paroxysmal or persistent (non-permanent) atrial fibrillation or atrial flutter. Amiodarone (Cordarone, and others) is more effective for this indication, but its use is often limited by its adverse effects, including thyroid and pulmonary toxicity.

Prosthetic heart valves have been used effectively in patients with mitral and aortic valvular heart disease for more than 50 years, but no replacement valve developed to date is suitable for all types of patients.

Nogapendekin alfa inbakicept-pmln (Anktiva – ImmunityBio), a first-in-class interleukin-15 (IL15) receptor agonist, has been approved by the FDA for use with Bacillus Calmette-Guérin (BCG) for treatment of patients with BCG-unresponsive nonmuscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors. Such patients generally undergo bladder tumor resection, followed by intravesical BCG treatment, but treatment failure and cancer recurrence are common. The adenoviral vector-based intravesical gene therapy nadofaragene firadenovec-vncg (Adstiladrin)...

Vasodilators are widely used for treatment of congestive heart failure (CHF) that has not responded adequately to diuretics and digitalis. Vasodilator drugs redistribute blood volume in patients with heart failure, lowering pressure and reducing volume in the failing left ventricle, which leads to increased cardiac output, decreased pulmonary capillary wedge pressure, and improved exercise tolerance. Since the last Medical Letter review of this subject (Volume 26, page 115, 1984), some additional data have become available.

Pneumocystis carinii pneumonia (PCP) is a common cause of death in patients with acquired immune deficiency syndrome (AIDS). PCP is the first serious opportunistic infection in more than 60% of patients with AIDS, and about 80% of AIDS patients develop PCP at least once (AE Glatt et al, N Engl J Med, 318:1439, June 2, 1988). Many studies using drugs to prevent PCP in patients with AIDS have recently been reported.

Octreotide acetate (Sandostatin - Sandoz), a synthetic octapeptide that mimics the actions of somatostatin, was recently approved by the US Food and Drug Administration for symptomatic treatment of patients with metastatic carcinoid or VIPomas (vasoactive intestinal peptide-secreting tumors).