Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs as well might be taken for a longer duration.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them would be in premenopausal women with ER-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing ten years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

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ICC lets ComEd delay smart meters until 2015

The Illinois Commerce Commission on Wednesday approved ComEd's request to delay the installation of smart meters until 2015 but said it will revisit the issue in April when the utility is scheduled to file a progress report on the program.

Under massive grid modernization legislation, ComEd was supposed to begin installing smart meters this year, but the ICC cut the funds ComEd was expecting to receive under the program and the utility said it could no longer afford to install the meters that quickly. The two sides are battling in court in a process that could take years.

An administrative law judge, as well as several consumer advocacy groups, had recommended the commission not accept the delay.

Jim Chilsen, spokesman for Citizens Utility Board, said a delay is not in the best interest of consumers. According to a ComEd commissioned analysis, the delay means consumers will miss out on approximately $187 million in savings that could come from the program over 20 years and will pay $5 million more for the smart meters. Chilsen said that CUB, which had urged the commission not to delay the program, will review the order once it becomes available and that it could seek to appeal the decision before the Illinois Appeals Court.

Other aspects of smart grid installation are under way, including "smart switches" used to automatically isolate outages and reroute power to customers. However, smart meters are the most consumer facing aspect smart grid and let the utility track on a computer what customers lack power and those who have had power restored.

Without the smart meters, customers must alert ComEd to an outage. Other parts of smart grid allow ComEd to see where the power is out in general.

The smart meters were a major component in ComEd's pitch to the state legislature for massive regulatory overhaul legislation that streamlines the rate-making processto give ComEd faster and more frequent rate hikes as it undertakes the multibillion-dollar grid modernization.

jwernau@tribune.com | Twitter @littlewern

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South Loop residents oppose DePaul arena near McCormick

The prospect of a DePaul University men's basketball arena being constructed on land just north of McCormick Place is drawing strong opposition from the Prairie District Neighborhood Alliance, a South Loop residents' organization, according to a letter released Tuesday.
 
A survey of 700 neighbors of the site, conducted by the community group, found more than 70 percent oppose construction of a Blue Demons arena there, Tina Feldstein, president of the organization, stated in the letter.
 
An arena would not fit within the residential and historic character of the area and could put two landmark structures, the Harriet F. Rees House and the American Book Co. building, at risk, the letter stated. It would also add to traffic congestion and potential rowdiness in an area already overburdened when conventions are in progress at McCormick Place or major events, including Chicago Bears games, are taking place at Soldier Field, Feldstein said in an interview.
 
"We're not against vibrant development, which hotel and retail would bring," Feldstein said. And the group would support an arena at an alternate site on the Near South Side, she said.
 
The letter was written in support of an alternate plan for the so-called "Olde Prairie" blocks, which is being put forward in bankruptcy court by developers Pam Gleichman, Karl Norberg and Gunnar Falk. Their plan calls for hotel and retail development on property directly north of the McCormick Place administrative offices and West Building on Cermak Road.
 
If they lose control of the property, it is expected to go up for auction, making it possible for the Metropolitan Pier and Exposition Authority, the state-city agency that owns McCormick Place, or other parties to make a run at it.
 
DePaul is weighing several sites, including property near McCormick Place and the United Center on the Near West Side. As well, the Allstate Arena in Rosemont is fighting to retain the team.
 
The neighborhood's opposition adds to resistance by Ald. Robert Fioretti, whose 2nd Ward includes McCormick Place.
 
"That is not a place to put an arena -- far away from the school," he said. "I think there are traffic issues related, and it would be a bad deal for taxpayers in these economic times."

Fioretti noted such a project likely would require public subsidy.
 
The Olde Prairie blocks have not been officially designated as a potential site for a DePaul arena, but Fioretti said it is his understanding that they are being seriously considered.
 
Jim Reilly, chief executive officer of the exposition authority, known as McPier, has publicly acknowledged that there have been talks with DePaul. A spokeswoman on Tuesday said it would be premature to comment further at this point.

A DePaul spokesperson could not be reached for immediate comment.
 
Chicago Mayor Rahm Emanuel has said he would like DePaul to bring men's basketball back to the city. A spokesman declined comment beyond that.
 
kbergen@tribune.com | Twitter @kathy_bergen

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32% of Young People Use Social Media in the Bathroom

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Disney loses appeal of “Who Wants to Be a Millionaire?” ruling

LOS ANGELES (Reuters) – The Walt Disney Co. was ordered to pay the British creator of the television game show “Who Wants to be a Millionaire?” $ 319 million after a Los Angeles court rejected the company’s request for a new trial.

Britain’s Celador International, which created the quiz show, sued Disney in 2004 alleging that the company hid some of the show’s U.S. profits from Celador.

A three-judge panel of the 9th U.S. Circuit Court of Appeals in Pasadena ruled on Monday that the lower court’s judgment was neither excessive nor based on speculation of profits owed.

A 2010 jury trial found that Disney and its domestic syndication company, Buena Vista Television, owed Celador $ 269.2 million and a federal judge added $ 50 million in interest.

“We are extremely disappointed with the decision, as ABC and Buena Vista Television continue to believe that they fully adhered to the ‘Millionaire’ agreement,” Walt Disney said in a statement on Tuesday.

Disney did not comment on further possible legal action.

“Who Wants to Be a Millionaire?” aired on Disney-owned broadcaster ABC from 1999 to 2002 and was credited with ushering in a new era of reality programming on U.S. television.

“I am pleased that justice has been done,” Celador Chairman Paul Smith said in a statement.

The game show, which started in Britain and later became an international hit, quizzes contestants on trivia for the top prize of $ 1 million. The show is now in U.S. syndication.

(Reporting by Eric Kelsey, editing by Jill Serjeant)

TV News Headlines – Yahoo! News

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United Dreamliner makes emergency landing in New Orleans

A brand-new United Airlines "Dreamliner" airplane bound for Newark was diverted Tuesday morning, making an emergency landing in New Orleans because of an undisclosed mechanical problem.

The highly acclaimed Boeing 787 Dreamliner recently began service in North America in a debut last month with United Airlines. United and Boeing are both based in Chicago.

On Tuesday, the 7:30 a.m. United flight 1146 from Houston to Newark was diverted to Louis Armstrong New Orleans International Airport and landed safely there at 9:25 a.m., the airline said. The plane, the third delivered to United recently, carried 174 customers and 10 crew members. Neither United nor Boeing would describe the problem except to say it was a "mechanical issue."

"We are reaccommodating the customers on a different aircraft to Newark," United said in a statement. "United will work with Boeing to review the diversion and determine the cause."

The Federal Aviation Administration "is looking into it," an FAA spokesman said.

Flights can be diverted for many reasons, from serious problems to a simple malfunction of a cockpit warning light. And flight diversions are not exceptionally uncommon. There were 816 diversions among large U.S. carriers in September alone and double that number in July, for example, according to federal statistics.

The 787 Dreamliner, a new-model aircraft that features greater passenger comforts and fuel efficiency compared with similar planes, is a big deal for both United and Boeing and has been highly touted by both the airline and the aircraft-maker.

However, any hint of a problem with a 787 is noticed. The plane has gotten mostly rave reviews, but is being delivered more than three years late because of design and production problems. The Dreamliner is different because instead of being made mostly of metal, half the plane, including the fuselage and wings, is made of strong, light composite materials.

gkarp@tribune.com

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Daley nephew indicted in '04 death of David Koschman

Chicago Tribune reporter Jason Meisner talks about how a Cook County grand jury indicted former Mayor Richard Daley's nephew on a charge of involuntary manslaughter in the death of David Koschman.

A special Cook County grand jury indicted former Mayor Richard Daley's nephew on a charge of involuntary manslaughter in the death of David Koschman in a drunken confrontation on the city’s Near North Side, the special prosecutor said today.

The grand jury found that Richard J. Vanecko "recklessly performed acts which were likely to cause death or great bodily harm to another" in Koschman’s death in 2004, according to the indictment.

Koschman, 21, had been drinking in the Rush Street nightlife district early on April 25 2004 when he and friends quarreled with a group that included Vanecko. During the altercation, Koschman was knocked to the street, hitting the back of his head. He died 11 days later.

Former U.S. Attorney Dan Webb, appointed special prosecutor in the case last spring, noted that at 6-foot-3 and 230 pounds, Vanecko towered over Koschman, who was 5-foot-5 and 125 pounds. There is no statute of limitations on a charge of involuntary manslaughter.

Koschman’s mother, Nanci Koschman, told a news conference that she planned to visit her son's grave and "I'm going to tell David tomorrow that he can finally have peace."

She said she refused to believe, over the years, that the fight was her son's fault, as detectives had told her. "You have to find the strength to go on," Koschman said. "I wanted his name cleared."

Koschman said she never sought vengeance, but accountability. "I want to thank the grand jury," she said. But she added, "It doesn't bring David back. And that's all I wanted."

Vanecko’s attorneys issued a statement saying they were disappointed by the indictment. According to the lawyers, Koschman’s blood-alcohol content was nearly three times the .08 legal limit for motorists – though he was on foot at the time of the confrontation.

Koschman “was clearly acting in an unprovoked, physically aggressive manner,” Vaneckos’ legal team said. “We are confident that when all the facts are aired in a court of law, the trier of fact will find Mr. Vanecko not guilty.”

Vanecko’s lawyers defended the work of police and prosecutors, saying “these agencies professionally investigate these types of incidents on a daily basis.”

“These decisions were not because of favoritism but because the facts did not warrant felony charges,” the lawyers said.

Vanecko, who currently lives in California, is expected to appear for arraignment at 9:30 a.m. Monday at the Leighton Criminal Court Building at 26th Street and California Avenue. Plans call for him to post $10,000 cash bond and be released pending trial. He faces 2 to 5 years in prison, or probation, if convicted of involuntary manslaughter.

Lawyers for Koschman’s mother sought a special prosecutor last year after an investigative series by the Chicago Sun-Times raised questions about whether police and prosecutors intentionally concealed evidence for political reasons.

In a statement released this afternoon, Webb said the grand jury continues “at a vigorous pace” to look into how authorities handled their investigation of Koschman’s death.

Locke Bowman, an attorney with Northwestern University's MacArthur Justice Center who represents Nanci Koschman, said he was encouraged that the investigation was continuing.

"Why has this taken so long?" he asked, wondering if the the clout of the powerful Daley family was at work. "Clearly, we need to have answers."

Webb said thousands of documents have been reviewed and more than 50 witnesses interviewed so far in the seven-month investigation.

Among the  issues Webb was tasked to sort out were whether clout tainted the original investigation in addition to whether Vanecko, now 38, should be charged criminally in connection with the death.

Judge Michael Toomin took the rare step of appointing Webb as a special prosecutor in April after concluding that Chicago police and county prosecutors mishandled the investigation.

The charges mark a dramatic twist in a case that seemed to fizzle out in 2004 as the investigation went nowhere.

Police initially said that witnesses gave conflicting accounts of what occurred and some claimed Koschman was the aggressor in the confrontation.

Almost two weeks after Koschman died of his injuries, a top prosecutor in the Cook County state’s attorney’s office was called to the Belmont Area headquarters on the day detectives put Vanecko in several lineups, all of which police said ended with witnesses failing to identify him as the assailant.

Vanecko had come to the station with his attorney, Terence Gillespie, who told police his client would not answer questions.

Dan Kirk, chief of staff for current State’s Attorney Anita Alvarez told the Tribune in an interview earlier this year that there was no admissible evidence that could have been used to file charges at the time.

Kirk said police had no positive identification from any of the lineups they conducted, no statements from the main suspect, no statement from the victim and no physical evidence.

jmeisner@tribune.com

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Four Things Google’s Nexus 4 Has in Common with the iPhone 4

Besides being each company’s flagship smartphone (and having the number 4 in their names), Google‘s new Nexus 4 and the 2010 iPhone 4 have a fair bit in common with each other.

This could be a good thing, if you remember just how popular the iPhone 4 was. Unfortunately, in this case it’s more of a bad thing, and hearkens back to “Antennagate” and the iPhone 4′s other problems. Do any of these features remind you of anything?

​A glass back

With the iPhone 5, Apple finally moved from a crack- and scratch-prone glass backplate to a solid, aluminum unibody construction. Google doesn’t seem to have gotten the memo that the former may have been a bad idea, however, and the Nexus 4 has a sparkly glass back surface.

While sparkly things obviously have their fans, the Nexus 4′s chassis also seems to lean towards the brittle side. Joshua Topolsky, who reviewed the Nexus 4 for The Verge, managed to crack the glass when he accidentally knocked his phone off the table. Meanwhile, Droid-Life’s Kellex found that setting the phone on a stone countertop caused its glass back to fracture in two.

​No 4G

Even Topolsky’s glowing review of the Nexus 4 said “It feels slow,” and “There’s simply no way to ignore this deficit.” That’s because, like the iPhone 4, the Nexus 4 lacks a 4G radio (even though it has the chip to support one if it had it).

The iPhone 4, however, was released in 2010, when 4G was still a new thing and the Android “superphones” which supported it had enormous screens and horrible battery life. Today, even the iPhone has 4G. Possibly because of bad blood between Google and the wireless carriers, which appear to resent Google’s selling phones unsubsidized and sans “customizations,” the Nexus 4 does not.

​Selling out fast

Every one of Apple’s iPhone models has sold out faster, and more dramatically, than the one before. Google’s Android devices, in contrast, haven’t tended to do so … although the new Nexus smartphones and tablets are starting to have this problem.

How bad is it? After Google finally got a new wave of Nexus 4s up for sale, they sold out in about a half-hour. Google claims that it hasn’t actually sold out, but even if you spotted the Nexus 4 on Google Play, chances are you ran into technical glitches which kept it out of your shopping cart. Tipster “Syko Pompos” told the Android Police blog how to get around this and place your order, but expect to wait months to receive it.

​Public relations nightmares

It hasn’t quite reached Antennagate levels yet, perhaps partly because the Nexus brand isn’t as well-known as the iPhone (the iPhone 4′s antenna problems were actually shared by many smartphones). But most of the press coverage of the Nexus 4 lately has been about how you can’t get one. Or else, how if you want one you’ll have to either buy it on contract or pay a lot more to get it unsubsidized from T-Mobile.

On the plus side (for the Nexus), this problem is only partly caused by the Google Play store’s technical errors. The biggest reason it’s taking so long to get out to people is, like with the iPhone 4, simply how popular it is.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.

Linux/Open Source News Headlines – Yahoo! News

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UK’s Prince William and wife Kate expecting a baby

LONDON (Reuters) – Britain‘s Prince William and his wife Catherine are expecting a baby, destined to be the country’s future monarch, although the mother-to-be is in hospital with a type of very acute morning sickness that sometimes indicates twins.

“Their Royal Highnesses The Duke and Duchess of Cambridge are very pleased to announce that The Duchess of Cambridge is expecting a baby,” the prince’s office said in a statement on Monday, adding that Queen Elizabeth and the royal family were delighted.

The couple, officially known as the Duke and Duchess of Cambridge, married in April last year, amid a global media frenzy and there has been much speculation, particularly in U.S. gossip magazines, about a possible pregnancy.

“It’s only been a matter of time. Everyone has been waiting for Kate to announce that she was pregnant,” Claudia Joseph, who has written a biography of the duchess, told Reuters.

A spokeswoman for the couple said 30-year-old Catherine, widely known as Kate, was in the King Edward VII Hospital in central London suffering from Hyperemesis Gravidarum, an acute morning sickness which causes severe nausea and vomiting and requires supplementary hydration and nutrients.

Professor Tim Draycott, a consultant obstetrician at the University of Bristol, said the condition was common in the early weeks of pregnancy but did not put the baby at any increased risk, although in extreme cases it can lead to the baby being born with a slightly low birth weight.

Draycott told Reuters it may also indicate more than one royal baby may be in the offing.

“Hyperemesis is slightly more common with twins,” said Draycott, explaining that the condition affected around one in 100 to 200 pregnant women.

William, a Royal Air Force helicopter pilot, was at her side and she is likely to remain in hospital for several days. There was no detail about when the baby was due, although the prince’s spokesman said she was less than 12 weeks pregnant.

“I’m delighted by the news that the Duke and Duchess of Cambridge are expecting a baby,” Prime Minister David Cameron said on his Twitter website. “They will make wonderful parents.”

BABY WILL BE KING, OR QUEEN

William, Queen Elizabeth’s 30-year-old grandson, is second in line to the British throne, and their first child will become the third in succession when he or she is born.

Last year Britain and other Commonwealth countries which have the queen as their monarch agreed to change the rules of royal succession so that males would no longer have precedence as heir, regardless of age.

The agreement also means an end to a ban on a future monarch marrying a Catholic, a stipulation dating back some 300 years.

Britain’s royal family are currently riding the crest of popularity on the back of William and Kate‘s wedding and the queen’s diamond jubilee this year which has witnessed nationwide celebrations.

“It’s something everyone can look forward to, just like their wedding brought the whole nation together,” said Johanna Castle, 25, a sales assistant in an east London homewear and fashion store.

The young royal couple have become global stars after some two billion people tuned in to watch their glittering marriage ceremony and the sumptuous display of pageantry that accompanied it, and barely a day goes by without a picture of Catherine appearing in the pages of Britain‘s royalty-obsessed newspapers.

The duchess, the first “commoner” to marry a prince in close proximity to the throne in more than 350 years, is now a fashion icon, with her attire scrutinized every time she steps out in public and followed by legions of women around the world.

U.S. President Barack Obama and his wife Michelle were one of the first to send congratulations, an indication of the young royals’ popularity across the Atlantic.

“I know they both feel that having a child is one of the most wonderful parts of their lives. So I’m sure that will be the same for the Duke and Duchess of Cambridge,” said White House spokesman Jay Carney.

With their fame has come unwanted attention, and there was anger in Britain when topless photos of Kate relaxing on holiday were published in a French magazine in September.

The pictures rekindled memories of the media pursuit of William’s mother, Princess Diana, who was killed in a car crash in Paris in 1997 while being chased by paparazzi.

“I will be very surprised if this isn’t handled with the utmost tact and sensitivity,” said media commentator Steve Hewlett. “Newspapers realize there’s a huge amount of goodwill towards Will and Kate, and they take their cue from their readers.”

“DADDY’S LITTLE CO-PILOT”

Kate made her last public appearance on Friday when she returned to her old school – a minor event that nonetheless generated live television coverage on news channels – when she looked healthy and joined in a game of hockey with pupils.

Earlier in the week William had hinted at a pregnancy during a visit to Cambridge in central England when they were given a home-made baby suit emblazoned with the words “Daddy’s little co-pilot”, a reference to William’s job.

“When I gave it to him he said ‘I’ll keep that’, and handed it to his aide,” said Samantha Hill.

Joseph, author of “Kate: The Making of a Princess”, said she believed the couple, who currently live in north Wales where the prince is based as a search and rescue pilot, had been waiting for the right moment to have a baby.

“My feeling has always been that they were not going to take the spotlight away from the queen in her Jubilee. But now 2013 is going to be William and Kate’s year,” she said, adding the couple would make wonderful parents.

“We have seen her with children and she is lovely with them, she’s got the natural touch, and her parents run a party business and she has spent a lot of time with children,” Joseph said. “(William) he has always talked about wanting children, so I am sure he is delighted.”

(Additional reporting by Tim Castle, Peter Schwartzstein and Natalie Huet in London and Steve Holland in Washington; editing by Paul Casciato)

Celebrity News Headlines – Yahoo! News

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Global Update: GlaxoSmithKline Tops Access to Medicines Index

Sang Tan/Associated Press

GlaxoSmithKline hung on to its perennial top spot in the new Access to Medicines Index released last week, but its competitors are closing in.

Every two years, the index ranks the world’s top 20 pharmaceutical companies based on how readily they get medicines they hold patents on to the world’s poor, how much research they do on tropical diseases, how ethically they conduct clinical trials in poor countries, and similar issues.

Johnson & Johnson shot up to second place, while AstraZeneca fell to 16th from 7th. AstraZeneca has had major management shake-ups. It did not do less, but the industry is improving so rapidly that others outscored it, the report said.

The index was greeted with skepticism by some drugmakers when it was introduced in 2008. But now 19 of the 20 companies have a board member or subcommittee tracking how well they do at what the index measures, said David Sampson, the chief author.

The one exception was a Japanese company. As before, Japanese drugmakers ranked at or near the index’s bottom, and European companies clustered near the top. Generic companies — most of them Indian — that export to poor countries are ranked separately.

Johnson & Johnson moved up because it created an access team, disclosed more and bought Crucell, a vaccine company.

The foundation that creates the index now has enough money to continue for five more years, said its founder, Wim Leereveld, a former pharmaceutical executive.

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