Carboplatin
12-Dec-2022: A commonly available and inexpensive drug, carboplatin, increases cure rate and survival in triple-negative breast cancer, an aggressive type of breast cancer
The results of the study by the Tata Memorial Centre show that a commonly available and inexpensive drug, carboplatin, increased the cure rate and survival of a very aggressive type of breast cancer, called triple-negative breast cancer, especially among young women who have this disease. Until the results of this study there was no conclusive evidence that this drug should be routinely used as part of the treatment of this disease.
Dr Sudeep Gupta, Professor of Medical Oncology at Tata Memorial Centre, presented, as a podium presentation, the results of the landmark ‘TMC Study - Platinum in TNBC’ at the ongoing San Antonio Breast Cancer Symposium, which is the largest and most important breast cancer conference in the world. Dr Rajendra A Badwe, Director TMC, is the Principal Investigator of this study, which was conducted by the Breast Cancer Working Group of Tata Memorial Centre, Mumbai.
The study was a randomized controlled trial which enrolled women with stage II-III triple negative breast cancer from 2010 to 2020 who were divided into two groups, both of whom received chemotherapy to downstage the disease prior to surgery. Women in the standard treatment group received standard chemotherapy comprised of once per week paclitaxel for 8 weeks followed by doxorubicin plus cyclophosphamide every 3 weeks for 4 cycles.
In the platinum group, women received the same chemotherapy with the addition of injection carboplatin once per week for 8 weeks, given with paclitaxel. Women in both groups underwent surgery after the last cycle of chemotherapy followed by radiotherapy. They were then followed up once every 6 months.
Dr Badwe explained the four main findings from this study. First, in the whole study population cure rate (5-year disease-free survival) increased by 6.6% from 64.1% in the standard arm to 70.7% in the platinum arm and the overall survival increased by 7.6% from 66.8% in the standard arm to 74.4 % in the platinum arm, which was statistically significant. Second, when the results were analyzed by age, the benefit of weekly carboplatin was almost exclusively confined to women younger than 50 years who had a large 12.5% increase in cure rate (5-year DFS 61.7% to 74.2%) and an 11.2% gain in overall survival (5-year overall survival 65.9% to 77.1%). Third, platinum-based chemotherapy wiped the tumor clean as assessed by pathologists in the operated breast specimen (pathological complete response) in 61% of younger (</=50 years) patients compared with 41% by standard chemotherapy. Fourth, carboplatin-based chemotherapy was well tolerated without high rate of toxicity.
The results were hailed by oncologists worldwide as immediately practice defining. A commonly available and inexpensive treatment like carboplatin will now be routinely offered as part of pre-operative chemotherapy regimen to women with TNBC which is the most aggressive type of breast cancer. Given that TNBC constitutes about 30% of breast cancer in India and about 45% of breast cancer in women younger than 50 years, the implications of this result are very important.
Yoga
12-Dec-2022: Inclusion of Yoga in the treatment of breast cancer patients is highly beneficial: Study by Tata Cancer Hospital
As per a study by the Tata Memorial Hospital, inclusion of Yoga in the treatment of breast cancer patients is highly beneficial. The inclusion of Yoga resulted in a 15% relative improvement in disease free survival (DFS) and 14% in overall survival (OS).
The yoga intervention was carefully designed with inputs from yoga consultants, clinicians as well as physiotherapists to suit the needs of breast cancer patients and survivors, keeping in focus, the different phases of their treatment and recovery. The yoga protocol included gentle and restorative yoga postures(asana) with regular periods of relaxation and pranayama. It was implemented through classes by qualified and experienced yoga instructors. Additionally, handouts and CD’s of the protocol were provided for maintaining compliance.
The largest clinical trial is an important milestone in use of YOGA in breast cancer since this is the first example of a very Indian traditional remedy being tested in a rigorous western design of randomized study with robust sample size. Breast cancer is the commonest cancer affecting women not only in India but globally. It raises huge amount of anxiety in women which is twofold, the first fear of cancer with threat to life and the second worry due to side effects of treatment and coping with it. It is heartening to see that YOGA practiced with rigour and perseverance has proved its superiority in maintaining excellent quality of life and has also numerically reduced the risk of recurrence and death by 15%.
Dr Nita Nair, presented in a SPOTLIGHT paper, the results of a landmark breast cancer study testing effect of YOGA, as a SPOTLIGHT presentation at the ongoing San Antonio Breast Cancer Symposium (SABCS), one of the most prestigious breast cancer conferences in the world held annually in USA. Out of thousands of research papers submitted to the conference few are chosen for spotlight discussion and our study deserved this due to the novelty of intervention and the first very Indian intervention impacting outcomes in breast cancer.
Fortified Ration
7-Dec-2022: Workshops organized in 9 districts having Tribal population for creating awareness towards benefits of Fortified Rice
The Union Minister of State for Consumer Affairs, Food and Public Distribution, Ms. Sadhvi Niranjan Jyoti in a written reply to a question in Lok Sabha today informed that various State Governments including Government of Rajasthan were requested to organize programmes to create awareness on benefits of fortified rice and its positive impact on nutritional security in the tribal areas of the country.
Accordingly, workshops/seminars in 9 districts having tribal population – in the States of Gujarat (Vapi), Maharashtra (Nashik and Nandurbar), Chhattisgarh (Kanker), Jharkhand (East Singhbhum), Madhya Pradesh (Shahdol, Mandla, Barwani) and Kerala (Wayanad) were conducted with the involvement of DFPD, FCI and other stakeholders such as Field Experts including Medical Professionals members of Media, prominent personalities, local leaders and Development Partners.
A provision of Administrative/Contingency Cost which inter-alia includes Information, Education, Communication (IEC) and Capacity Building to the tune of Rs. 5.00 lakh per district has been made, which is to be borne by the Government of India during the implementation of rice fortification initiative in Phase-II and Phase-III.
With the increased awareness and knowledge about the positive impacts of consumption of fortified rice, during 3rd quarter of FY 2022-23, out of 291 targeted Districts for the implementation in Phase-II, the coverage of implementation has increased to 250 Districts including districts having tribal population. Besides, some States have reported that awareness programme on rice fortification has had a positive impact on the mindset of public in general about the benefits of consumption of fortified rice.
27-Sep-2022: IEC Campaign on Fortified Rice in Tribal Areas in five States
In order to popularise and create awareness about the benefit of Fortified Rice specially in Tribal Areas of the country, the Department of Food and Public Distribution (DFPD) and States governments of Gujarat, Maharashtra, Chhattisgarh, Madhya Pradesh, Jharkhand, Telangana Rajasthan, Kerala organized workshops and seminars in the tribal belts and districts that have populations that are vulnerable to Thalassemia and Sickle Cell Anemia.
In Gujarat, the State Government organized a workshop in Meril Academy, Vapi on September 9, 2022. Following this, workshops were organized at Nanurbar (Maharashtra) on 13.09.2022, Nashik (Maharashtra) on 14.09.2022, Kanker (Chattisgarh) on 15.09.2022, Jamshedpur (Jharkhand) on 16.09.2022, Barwani (M.P.) on 20.09.2022, Mandla (M.P) on 22.09.2022 and Shahdol (M.P.) on 24.09.2022 in association with DFPD, Development Partners and FCI where Minister of State Governments, Collectors, DMs, Technical experts, Local experts, Doctors, Civil Surgeons, NGOs, Fair price Shop dealers, Sarpanch, Leaders of Tribal areas, Officials of Civil supply, Health, ICDS, Development partners and experts attended the programme.
The experts highlighted the benefits of fortified rice for the public and addressed their concerns and misgivings of the people and local media.
Fortification is the process of adding Fortified Rice Kernels (FRK), containing FSSAI prescribed micronutrients (Iron, Folic Acid, Vitamin B12) to normal Rice (Custom Milled Rice) in the ratio of 1:100 (Mixing 1 Kg of FRK with 100 Kg custom milled rice). Fortified rice is nearly identical to traditional rice in aroma, taste, and texture. This process is done in the rice mills at the time of milling of rice.
Rice fortification ecosystem has been enhanced significantly on boarding rice millers, FRK manufacturers, industries and other stakeholders for production and supply of fortified rice to meet the target requirement. There are more than 9000 rice mills in the country which have installed blending infrastructure for production of fortified rice and their cumulative monthly production capacity is around 60 LMT which is increased by more than 4 times since last year.
Fortification of rice is found to be a cost-effective and complementary strategy to increase vitamin and mineral content in diets with low turnaround time (TAT) and a step towards nutritional security and helps in fighting anemia and malnutrition in the country. This strategy is implemented in many parts of the world.
13-Sep-2022: Centre directs State Governments to organise awareness workshops about the benefits of Fortified Rice
In order to promote the benefits of Fortified Rice while elucidating the concerns about the impact of its consumption among some sections of the population those are vulnerable to Thalassemia and Sickle Cell Anaemia, the Department of Food and Public Distribution (DFPD) has requested various States like Gujarat, Maharashtra, Chhattisgarh, Madhya Pradesh, Jharkhand, Telangana Rajasthan, Kerala to organize workshop/seminar by the respective State Governments in the sensitive areas of tribal belts and districts that have populations that are vulnerable to Thalassemia and Sickle Cell Anaemia.
This initiative has been carried out by organizing workshops by the Govt. of Gujarat at Meril Academy, in Vapi on 09.09.2022 where Hon’ble Finance Minister, Government of Gujarat, Minister, Food & Public Distribution, Govt. of Gujarat, State Minister Food and Public Distribution, Government of Gujarat and other higher officers of Govt. of Gujarat and officer from Department of Food and Public Distribution, Government of India, technical experts and members from media attended the programme.
Ms. Neha Arora, State Programme Officer, Nutritional International, Gujarat made a presentation on fortified staples provided through social safety net programmes. Dr. Yazdi Italia former Honorary Director, Sickle Cell Anemia Control Programme, a Go-NGO Partnership Program of Govt. of Gujarat made a presentation on understanding Hemoglobinopathis-Sickle Cell Anemia, Thalassemia. Similarly, Prof. (Dr.) Sirimavo Nair, Nodal Officer, Gujarat (NFSA Concurrent Evaluation D/o Food & PD-Govt. of India) made a presentation on fortified staples and its positive impact on public health. Dr. Bhavesh Bariya, Asst. Professor, Department of Community Medicine, NAMO-MERI-Silvasa also made a presentation on fortified staples and its effect on Hemoglobinopathis.
The presentations were followed by a Panel discussion by technical experts and officials from FCI and D/o Food & PD. The programme was covered by several leading local newspapers in Gujarat.
At the end of the workshop, there was general consensus regarding the positive impact of rice fortification in Govt. schemes and its significant contribution to the country’s nutritional security strategy.
27-Jun-2019: Distribution of Fortified Ration
The Nutrient requirements and recommended dietary allowances (RDAs) for all age groups of the population including children are set and revised periodically by the National Institute of Nutrition - Indian Council of Medical Research.
The requirement of nutrients in children varies with the age, gender and nutritional status of the children. The RDAs for Indian population are finalized by National Institute of Nutrition – Indian Council of Medical Research (NIN-ICMR) based on the recommendations of the Expert Group, based on individual variability and nutrient bioavailability from the habitual diet.
As per the information received from Ministry of Consumer Affairs, Food and Public Distribution, Department of Food & Public Distribution has approved the "Centrally Sponsored Pilot Scheme on Fortification of Rice & its distribution through Public Distribution System". Financial Assistance up to 90% in case of North-Eastern, Hilly and Island States and up to 75% in case of rest of the States has been extended. Further, Government of India has also advised all States/UTs especially those States/UTs that are distributing wheat flour through Public Distribution System (PDS), to distribute fortified wheat flour through PDS.
The details of the States/UTs disbursing fortified ration through PDS is given below:
S. No |
States/UTs |
Status of disbursing fortified ration under PDS |
1 |
Andhra Pradesh |
DFS (4 Districts) |
2 |
Andaman & Nicobar Islands |
Fortified Wheat flour (All) |
3 |
Dadra & Nagar Haveli |
DFS(All) |
4 |
Gujarat |
Fortified Edible Oil (All) |
5 |
Himachal Pradesh |
Fortified Edible Oil (All) |
6 |
Karnataka |
Fortified Rice (1 District-Yadgir) |
7 |
Madhya Pradesh |
DFS(20 Districts-Alirajpur, Dindori, Anuppur, Betul, Dhar, Balaghat, Ratlam, Barwani, Mandla, Khargone, Chhindwara, Shahdol, Seoni, Jhabua, Sheopur, Hoshangabad, Burhanpur, Khandwa, Sidhi, Umaria) |
8 |
Maharashtra |
Fortified Rice (1 District-Gadchiroli) |
9 |
Rajasthan |
Fortified Edible Oil (All) |
10 |
Tamil Nadu |
DFS (All) |
11 |
Uttar Pradesh |
DFS (10 Districts-Meerut, Moradabad, Farrukhabad, Etawah, Hamirpur, Faizabad, Siddharthnagar, Sant Kabirnagar, Mau, Auraiya) |
12 |
West Bengal |
Fortified Wheat Flour (All). |