PC-SPES is a mixture of 8 herbs that was sold as a dietary supplement to keep the prostate healthy (see Question 1).
Some batches of PC-SPES were found to contain prescription medicines. It was taken off the market and is no longer being made (see Question 1).
Herbs in PC-SPES have been used in traditional Chinese medicine for many health problems, including prostate problems, for hundreds of years (see Question 2).
The herbs used in PC-SPES have been reported to help keep cancer cells...
The goal of the first phase of therapy (remission induction) is to induce a complete remission (CR). This phase typically lasts 4 weeks. Overall, approximately 98% of patients with newly diagnosed B-precursor ALL achieve CR by the end of this phase, with somewhat lower rates in patients with T-cell ALL or high presenting leukocyte counts.[1,2,3,4,5]
Induction chemotherapy consists of the following drugs, with or without an anthracycline:
Corticosteroid (prednisone or dexamethasone).
The Children's Oncology Group (COG) protocols do not administer anthracycline during induction to patients with National Cancer Institute standard-risk precursor B-cell ALL.
Patients treated by the following study groups receive an induction regimen with four or more drugs regardless of presenting features:
The most common four-drug induction regimen is vincristine, corticosteroid (either dexamethasone or prednisone), L-asparaginase, and either doxorubicin or daunorubicin. Some studies have suggested that this more intensive induction regimen may result in improved event-free survival (EFS) in patients presenting with high-risk features, but it may not be necessary for favorable outcome provided that adequate postremission intensification therapy is administered.[7,8] The COG reserves the use of a four-drug induction for patients with high-risk B-precursor ALL and T-cell ALL.
Many current regimens utilize dexamethasone instead of prednisone during remission induction and later phases of therapy.
The Children's Cancer Group conducted a randomized trial that compared dexamethasone and prednisone in standard-risk ALL patients.
The trial reported that dexamethasone was associated with a superior EFS.
Another randomized trial was conducted by the United Kingdom Medical Research Council.
The trial demonstrated that dexamethasone was associated with a more favorable outcome than prednisolone in all patient subgroups.
Patients who received dexamethasone had a significantly lower incidence of both central nervous system (CNS) and non-CNS relapses than patients who received prednisolone.
Other randomized trials did not confirm an EFS advantage with dexamethasone.[11,12]