Potential of molecular profiling to refine surgical and radiotherapy decision-making in patients with meningioma

 Findings from the RTOG-0539 study, the largest meningioma cohort with multiplatform molecular ever conducted, was recently published in Nature Medicine.  Using retrospective data on 2,824 meningiomas, researchers found that "gross tumour resection was associated with longer progression-free survival across all molecular groups and longer overall survival in proliferative meningiomas." 

Click here to learn more about this study. 

Source mentioned: 

Wang JZ, Patil V, Landry AP, et al. Molecular classification to refine surgical and radiotherapeutic decision-making in meningioma. Nature Medicine; Published online 21 August 2024. DOI: https://doi.org/10.1038/s41591-024-03167-4

EMA recommends extension of therapeutic indications for encorafenib and binimetinib

 The European Medicine Agency (EMA) has recommended a change to marketing authorization for encorafenib and binimetinib for the treatment of adults with non-small cell lung cancer.  These drugs, when used in combination, as well as the drug cetuximab, may also be used to treat metastatic melanoma and metastatic colorectal cancer. 

To learn more about this recommendation, click here. 

Neoadjuvant chemotherapy with mFOLFIRINOX followed by chemoradiotherapy improves survival in patients with locally advanced rectal cancer

A recently unveiled long-term follow-up analysis of the UNICANCER-PRODIGE 23 study indicates that "neoadjuvant chemotherapy with mFOLFIRINOX followed by chemoradiotherapy improved overall survival and confirmed long-term disease-free survival and metastatic-free survival" in rectal adenocarcinoma patients. According to the UNICANCER-PRODIGE 23 study, patients receiving neoadjuvant mFOLFIRINOX had a 31% reduction in cancer recurrence. 

To learn more about the UNICANCER-PRODIGE 23 study, click here. 

Source mentioned:

Conroy T, Castan F, Etienne P-L, et al. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiotherapy in patients with locally advanced rectal cancer: long-term results of the UNICANCER-PRODIGE 23 trial. Annals of Oncology; Published online 7 July 2024. DOI: https://doi.org/10.1016/j.annonc.2024.06.019

Generation X and millennials have higher risk of developing 17 cancers compared to older generations

A new study conducted by researchers at the American Cancer Society indicates a continuous rise in cancer diagnosis in post-Baby Boomer generations, particularly in breast, pancreatic, and gastric cancers.  According to Dr. Ahmedin Jemal, senior author of the study, "the increase in cancer rates among this younger group of people indicate generational shifts in cancer risk and often serve as an early indicator of future cancer burden.." 

To learn more about this study, click here. 

Study mentioned: 

Sung H, Jiang C, Bandi P, Minihan A, Fidler-Benaoudia M, Islami F, Siegel RL, Jemal A. Differences in cancer rates among adults born between 1920 and 1990 in the USA: an analysis of population-based cancer registry data. Lancet Public Health. 2024 Aug;9(8):e583-e593. doi: 10.1016/S2468-2667(24)00156-7. PMID: 39095135.

AI-based score as a selection tool for supplemental MRI after negative mammography detects many missed breast cancers

 The impact of AISmartDensity, a new artificial intelligence tool aimed to uncover undetected breast cancer after negative mammography screening was found to be "four times more efficient in terms of cancer detection" compared to traditional density and risk models, following MRI imaging.  Despite these encouraging findings, authors of this study di caution that certain cancers identified by BI-RADS D could well be missed by AISmartDensity, necessitating additional research on outcomes of effects and prognosis on cancer characteristics. 

To learn more about AISnartDensity, click here. 

Source mentioned: 

Salim M, Liu Y, Sorkhei M, et al. AI-based selection of individuals for supplemental MRI in population-based breast cancer screening: the randomized ScreenTrustMRI trial. Nature Medicine; Published online 8 July 2024. DOI: https://doi.org/10.1038/s41591-024-03093-5

Adding olanzapine to standard triple antiemetic therapy for the prevention of carboplatin-induced nausea and vomiting

 A recently completed study from the Hamamatsu University School of Medicine in Japan has indicated that the addition of "olanzapine significantly improved nausea prevention in the overall and delayed phases in patients who received carboplatin."  Further, carboplatin, which has been classified as a moderate emetogenic chemotherapy agent, was not seen to cause serious adverse events in patients that were administered this drug. 

For further information, and to learn more about this study, click here. 

Source mentioned: 

Inui N, Suzuki T, Tanaka K, et al. Olanzapine Plus Triple Antiemetic Therapy for the Prevention of Carboplatin-Induced Nausea and Vomiting: A Randomized, Double-Blind, Placebo-Controlled Phase III Trial. JCO; Published online 4 June 2024. DOI: https://doi.org/10.1200/JCO.24.00278

40 % of cancer cases and almost half of all deaths in the U.S. linked to modifiable risk factors

 A new study conducted at the American Cancer Society attributes modifiable risk factors, namely smoking, obesity, alcohol consumption, physical inactivity, diet, and infections, as direct indictors of cancer death in nearly 50% of adult cancer deaths (30 years of age and older) in the United States. According to Dr. Farhad Islami, senior scientific director of cancer disparity research at the American Cancer Society, "despite considerable declines in smoking prevalence during the past few decades," 20% of cancer cases and 30% of all cancer deaths are a result of smoking.  Lisa Lacasse, president of the American Cancer Society Cancer Action Network, is adamant that "the cost to fully fund state tobacco control programs in tiny compared to the cost of tobacco-caused diseases and the potential tobacco-caused health care cost savings states stand to gain in the long term."  

To read more about this study, click here. 

Source mentioned: Islami F, Marlow EC, Thomson B, McCullough ML, Rumgay H, Gapstur SM, Patel AV, Soerjomataram I, Jemal A. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019. CA Cancer J Clin. 2024 Jul 11. doi: 10.3322/caac.21858. Epub ahead of print. PMID: 38990124.

Adjuvant dabrafenib plus trametinib associated with better RFS and DMFS than placebo among patients with resected stage III melanoma with BRAF V600 mutations

 Results of the COMBI-AD study, compiled after almost 10 years of follow-up analysis, has concluded that "12 months of adjuvant treatment with dabrafenib plus trametinib was associated with better relapse-free survival and distant metastasis than placebo among patients with resected stage III melanoma."  Further risk of death was 20% lower via the combined drug regimen compared to placebo. In addition, the COMBI-AD trial indicated overall survival after 3 years at 86% when patients were administered dabrafenib together with trametinib, compared to 77% when given a placebo. 

To learn more about the COMBI-AD study, click here. 

Source mentioned: Long GV, Hauschild A, Santinami M, et al. Final Results for Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma. NEJM; Published online 19 June 2024. DOI: 10.1056/NEJMoa2404139

Belantamab mafodotin–containing triplets a PFS benefit among previously treated patients with relapsed or refractory multiple myeloma

 Results of DREAMM-7, a randomized phase III study, were recently published in the New England Journal of Medicine.  According to DREAMM-7, "treatment with belantamab mafodotin, bortezomib and dexamethasone (BVd regimen) conferred a significant benefit...with respect to progression-free survival (PFS).." among melanoma patients. After a period of 18 months, overall survival for patients treated with the BVd regimen was 84% compared 73% in patients treated with daratumumab, bortezomib and dexamethasone (DVd). These findings indicate strong support for BVd as a preferred treatment option for patients with multiple myeloma. 

To read more about this study, click here. 

Sources mentioned: 

• Hungria V, Robak P, Hus M, et al. for the DREAMM-7 Investigators. Belantamab Mafodotin, Bortezomib, and Dexamethasone for Multiple Myeloma. NEJM; Published online 1 June 2024. DOI: 10.1056/NEJMoa2405090
• Dimopoulos MA, Beksac M, Pour L, et al. for the DREAMM-8 Investigators. Belantamab Mafodotin, Pomalidomide, and Dexamethasone in Multiple Myeloma. NEJM; Published 2 June 2024. DOI: 10.1056/NEJMoa240340

Grey Horizon postings will resume week of July 2, 2024

 To all Grey Horizon readers, 

Thank you for your continued support of this blog.  Postings will resume the week of week of July 2, 2024.  

Cost of care discussions rarely documented for patients with advanced cancer

 A recently completed population study by researchers at the American Cancer Society and the National Cancer Institute shows "cost discussions were infrequently documented in medical records" of patients with advanced non-small cell lung cancer and melanoma.  According to lead study author Dr. Robin Yabroff, scientific vice president of health services research at the American Cancer Society, cost discussions were noted in only 20.3% of non-small cell lung cancer and 24% of melanoma patients.  

To read more about this study, click here. 

Study mentioned: Yabroff KR, Mittu K, Halpern MT. Cost-of-care discussions for individuals with advanced non-small cell lung cancer and melanoma: Findings from a large, population-based pilot study. Cancer. 2024 Jun 13. doi: 10.1002/cncr.35380. Epub ahead of print. PMID: 38869706.

Neoadjuvant nivolumab and ipilimumab leads to a pathological response in a high proportion of patients with locally advanced dMMR colon cancer

 Results of NICHE-2, "a large phase II study involving patients with locally advanced mismatch repair-deficient (dMMR) colon cancers..." was recently published in the New England Journal of Medicine. As mentioned by the study authors, staging of dMMR colon cancer presents a number of challenges, due to microsatellite instability associated with "false positive enlarged lymph nodes owing to immune infiltration."  

To read more about the NICHE-2 study, click here. 

Source mentioned: 

• Chalabi M, Verschoor YL, Batista Tan P, et al. Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair–Deficient Colon Cancer. N Engl J Med 2024;390:1949-1958.
• Cercek A. Neoadjuvant Treatment of Mismatch Repair–Deficient Colon Cancer — Clinically Meaningful? N Engl J Med 2024;390:2024-2025.

NIH scientists develop AI tool to predict how cancer patients will respond to immunotherapy

 A proof-of-concept study developed by researchers at the National Cancer Institute utilizes artificial intelligence from a blood test "to predict whether someone's cancer will respond to immune checkpoint inhibitors." The study, conducted on 2881 patients treated with immune checkpoint inhibitors across 18 solid cancer types, provided accurate predictions on likely response to immune checkpoint inhibitor, as well as lifespan, overall survival, and cancer reoccurrence. 

To read more about the study, click here. 

Study mentioned: 

1. Chang T, Cao Y, Sfreddo HJ, et al. LORIS robustly predicts patient outcomes with immune checkpoint blockade therapy using common clinical, pathologic and genomic featuresExit Disclaimer. Nature Cancer. June 3, 2024. DOI: 10.1038/s43018-024-00772-7.

    

    

Adding 24 Months of ADT improves metastasis-free survival in patients with prostate cancer treated with postoperative radiotherapy

 A new study recently completed at the Institute of Clinical Trials and Methodology at University College London has unveiled that adding 24 months of ADT [androgen deprivation therapy] improved metastasis-free survival in prostate cancer patients undergoing postoperative radiotherapy.  

The study authors further explain that survival benefit "should be weighed against the extended duration of the well-known adverse events associated with ADT, such as sexual dysfunction, metabolic syndrome, and osteoporosis."   

To learn more about this study, click here. 

Sources mentioned: 

• Parker CC, Kynaston H, Cook AD, et al. on behalf of the RADICALS investigators. Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial. The Lancet; Published online 16 May 2024. DOI: https://doi.org/10.1016/S0140-6736(24)00549-X 
• 
  
• Parker CC, Clarke NW, Cook AD, et al. on behalf of the RADICALS investigators. Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial. The Lancet; Published online 16 May 2024. DOI: https://doi.org/10.1016/S0140-6736(24)00548-8 
• 
  
• Pollack A, Dal Pra A. Androgen deprivation therapy combined with postoperative radiotherapy for prostate cancer management. The Lancet; Published online 16 May 2024. DOI: https://doi.org/10.1016/S0140-6736(24)00802-X

Biomarker analyses in patients with HER2-positive or HER2-low gastric and gastro-oesophageal junction cancer treated with trastuzumab deruxtecan

 Findings of the DESTINY-Gastric01 randomized study, comparing trastuzumab deruxtecan vs. third line or later chemotherapy in HER2-positive gastric or gastro-esophageal cancer patients, was recently published in Nature Medicine. While the authors acknowledge that further investigations in larger studies is needed, "the biomarkers identified in this analysis are being investigated and validated in additional studies." 

To learn more about DESTINY-Gastric01, click here. 

Source mentioned: Shitara K, Bang Y-J, Iwasa S, et al. Trastuzumab deruxtecan in HER2-positive advanced gastric cancer: exploratory biomarker analysis of the randomized, phase 2 DESTINY-Gastric01 trial. Nature Medicine; Published online 14 May 2024. DOI: https://doi.org/10.1038/s41591-024-02992-x

Projected estimates of cancer in Canada 2024

 New research published in the Canadian Medical Association Journal summarizes the expected impact of cancer in Canada in 2024, including projections of new cancer cases and mortality, arranged according to gender and province/territory for 23 different types of cancer.  

Projected numbers for 2024 include 247,100 cancer diagnoses and 88,100 cancer deaths in Canada.  While rates of lung, colorectal, and prostate cancer are expected to decrease, other cancers, including liver, bile duct, kidney, melanoma, and non-Hodgkin lymphoma are expected to rise. 

To learn more about this research, click here. 

Source mentioned: 

Darren R. Brenner, Jennifer Gillis, Alain A. Demers, Larry F. Ellison, Jean-Michel Billette, Shary Xinyu Zhang, JiaQi Leon Liu, Ryan R. Woods, Christian Finley, Natalie Fitzgerald, Nathalie Saint-Jacques, Lorraine Shack, Donna Turner

CMAJ May 2024, 196 (18) E615-E623; DOI: 10.1503/cmaj.240095

Datopotamab deruxtecan shows promising activity in heavily pretreated advanced HR-positive/HER2-negative and triple-negative breast cancers

 TROPION-PanTumor01, a phase I study on the effects of datopotamab deruxtecan on heavily pretreated advanced HR-positive/HER2-negative breast cancer and triple-negative breast cancer (TNBC) indicated a "confirmed objective response rate of 26.8% in patients with HR-positive/HER2-negative breast cancer and 31.8% in patients with TNBC." While the study authors acknowledge that the number of patients in each cohort (41 HR-positive/HER2-negative and 44 in TNBC) use of datopotamab deruxtecan is being compared with single-agent chemotherapy as a possible second or third line treatment option.  

To read more about this study, click here. 

Source mentioned: Bardia A, Krop IE, Kogawa T, et al. Datopotamab Deruxtecan in Advanced or Metastatic HR+/HER2– and Triple-Negative Breast Cancer: Results From the Phase I TROPION-PanTumor01 Study. JCO; Published online 23 April 2024: DOI: https://doi.org/10.1200/JCO.23.01909

Analysis identifies 50 new genomic regions associated with kidney cancer risk

 A new genomic study conducted at the National Cancer Institute has identified "50 new areas across the genome that are associated with the risk of developing kidney cancer."  Study data from this data will be used to establish a polygenic risk score, looking at known kidney cancer risk factors, including high blood pressure, smoking, and high body-mass index. 

To read more about this study, click here. 

Source mentioned: Purdue MP, Dutta D, Machiela MJ, et al. Multi-ancestry genome-wide association study of kidney cancer identifies 63 susceptibility regions. Nature Genetics. April 26, 2024. DOI: 10.1038/s41588-024-01725-7.

AI tool developed with potential to more precisely match cancer drugs to patients

Researchers at the National Institutes of Health (NIH) have created an artificial intelligence (AI) tool which "uses data from individual cells inside tumors to predict whether a person's cancer will respond to a specific drug."  Single-cell RNA sequencing, providing higher resolution data at the single-cell level, is exploring transfer learning whereby AI models are being used to predict drug responses. 

To learn more about this proof-of-concept study, click here. 

Source mentioned: 

Sinha S, Vegesna R, Mukherjee S, et al. PERCEPTION predicts patient response and resistance to treatment using single-cell transcriptomics of their tumors. Nature. April 18, 2024. DOI: 10.1038/s43018-024-00756-7.

Colon cancer linked to mouth bacteria

 A new study, recently published in Nature indicates that Fusobacterium nucleatum, bacteria found in the mouth is linked to colon cancer.  Fusobacterium nucleatum, "associated with dental plaque and gingivitis."  While more evidence linking this bacterium to colon cancer is required (the Nature study was conducted on 100 colon cancer patients), the study authors "envision developing a vaccine against the Fusobacterium nucleatum", using an approach similar to the HPV vaccine. 

To read more about this study, click here. 

Neoadjuvant chemoimmunotherapy superior to neoadjuvant chemotherapy with event-free survival benefit in patients with resectable NSCLC and tumour PD-L1 less than 1%

 A recently published meta-analysis, conducted within the Department of Surgery at McGill University, concluded that "neoadjuvant chemoimmunotherapy as associated with improved overall survival, event-free survival, major pathological response and pathological complete response" compared to neoadjuvant chemotherapy alone in non-small cell lung cancer (NSCLC) patients.  In particular, improvements were noted in patients diagnosed with either stage II or stage III NSCLC.   

To learn more about this study, click here. 

Sources mentioned: 

• Sorin M, Prosty C, Ghaleb L, et al. Neoadjuvant Chemoimmunotherapy for NSCLC A Systematic Review and Meta-Analysis. JAMA Oncology; Published online 21 March 2024. doi:10.1001/jamaoncol.2024.0057
• Rolfo C, Russo A. The Chemoimmunotherapy Revolution in Resectable NSCLC—The Times They Are A-Changin’. JAMA Oncology; Published online 21 March 2024. doi:10.1001/jamaoncol.2024.0043

Oxaliplatin-based adjuvant chemotherapy shows good tolerance in fit older compared with younger patients with stage III colon cancer

 An ACCENT/IDEA pooled analysis conducted at the Bank of Cyprus Oncology Centre in Nicosia, Cyprus has shown that oxaliplatin-containing chemotherapy is both safe (in terms of toxicity management) and effective "in reducing recurrence rates in a large population [17,000] of older patients with stage III colon cancer."  According to the trial's authors, led by Dr. Demetris Papamichael, while the median age of colon cancer diagnosis is 70 in western countries, only 14-20% of patients more than 70 years old have participated in adjuvant trials. 

To read more about this trial, click here. 

Source mentioned: 

Gallois C, Shi Q, Pederson LD, et al. Oxaliplatin-Based Adjuvant Chemotherapy in Older Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 12 Trials. JCO; Published online 28 March 2024. DOI: https://doi.org/10.1200/JCO.23.0132

Webinar: compassion in oncology: a powerful antidote to a patient’s negative emotions

 The National Coalition for Cancer Survivorship (NCCS) has produced a new webinar discussing empathy and compassion in cancer care. In their presentation, Dr. Michael Crain and Claudio Pannunzio discuss three key aspects of compassionate care: "improving patient outcomes and satisfaction, decreasing health care costs, [and] reducing workplace burnout." 

To learn more and view the webinar, click here. 

 

Early studies show rapid antitumour CAR-mediated responses, short duration in patients with recurrent glioblastoma

 

Findings from the INCIPIENT study, an early phase I open-label study among participants with recurrent glioblastoma treated with intraventricularly delivered CARv3-TEAM-E T-cells, were recently published in the New England Journal of Medicine.  The CARv3-TEAM-E T-cells "provides proof of principle that multiple surface antigens can be targeted simultaneously with the use of CAR T-cells and confirms that EGFR is a suitable immunotherapeutic target in glioblastoma." 

To learn more about this study, click here. 

Sources mentioned: 

• Choi BD, Gerstner ER, Frigault MJ, et al. Intraventricular CARv3-TEAM-E T Cells in Recurrent Glioblastoma. NEJM; Published online 13 March 2024. DOI: 10.1056/NEJMoa2314390
• Bagley SJ, Logun M, Fraietta JA, et al. Intrathecal bivalent CAR T cells targeting EGFR and IL13Rα2 in recurrent glioblastoma: phase 1 trial interim results. Nature Medicine; Published online 13 March 2024. DOI: https://doi.org/10.1038/s41591-024-02893-z

Topical diclofenac gel reduces the incidence of hand-foot syndrome in patients treated with oral capecitabine

 D-TORCH, a phase III randomized trial recently published in the Journal of Clinical Oncology, application of topical diclofenac gel, used in osteoarthritis, resulted in lower "grade 2 or 3 hand-foot syndrome rates compared with placebo in patients with breast and gastrointestinal cancers treated with oral capecitabine."  Of the 131 patients who received topical diclofenac gel in the D-TORCH study, grade 2/grade 3 hand-foot syndrome occurred in only 3.8% of cases, compared to 15% in the placebo group. 

To learn more about the D-TORCH study, click here. 

Source mentioned: 

Santhosh A, Sharma A, Bakhshi S, et al., on behalf of the D-TORCH Trial Investigators. Topical Diclofenac for Prevention of Capecitabine-Associated Hand-Foot Syndrome: A Double-Blind Randomized Controlled Trial. JCO; Published online 27 February 2024. DOI: https://doi.org/10.1200/JCO.23.01730

High risk of breast cancer specific mortality at 20 years in men with hormone receptor positive stage I to III breast cancer

 Findings from the first population study assessing the risk of breast cancer specific mortality among male breast cancer patients, was recently published in JAMA Oncology.  As a diagnosis of breast cancer in males is rare, the disease trajectory, particularly with regards to inclusion of male breast cancer patients in clinical trials, has not been well studied.  However, "the median age at diagnosis is substantially higher in men than in women, and patients with male breast cancer are more likely to have regional nodal involvement."  

To learn more about this study, click here. 

Source mentioned: Leone J, Hassett MJ, Freedman RA, et al. Mortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor–Positive Breast Cancer. JAMA Oncology; Published online 29 February 2024. doi:10.1001/jamaoncol.2023.7194

National Institutes of Health launches research network to evaluate emerging cancer screening technologies

 The National Institutes of Health (NIH) has unveiled a clinical trials network focused on evaluating various cancer screening technologies.  This work is in support of Cancer Moonshot, "investigating how to identify cancers earlier, when they may be easier to treat."  

To read more about this research network, click here. 

Online tool predicts RFS and OS probabilities in patients with stage II melanoma

A new model created by Melanoma Institute Australia (MIA), further described and discussed in a recent issue of the Journal of Clinical Oncology, has been shown to "predict recurrence-free survival and overall survival in patients with a primary cutaneous melanoma considerably better" than what is described in cancer staging manuals.  Study authors further concluded that the MIA model can be used in daily practice without the need to conduct sentinel node biopsy, even for high-risk patients.  

To learn more about the MIA model, click here. 

Study mentioned: 

Varey AHR, Li I, El Sharouni M-A, et al. Predicting Recurrence-Free and Overall Survival for Patients With Stage II Melanoma: The MIA Calculator. JCO; Published online 5 February 2024. DOI: https://doi.org/10.1200/JCO.23.01020

Webinar: Making the mouth-body connection in cancer care

 The National Coalition for Cancer Survivorship (NCCS) has recently created a webinar, presented by Jill Meter-Lippert, dental hygienist and founder of Side Effect Support, discussing "current evidence or oral-systemic links with various types of cancer."  The presentation discusses a partnership between oncologists and dental practitioners, focusing on "oral hygiene modifications and product recommendations" to prevent, delay, or reduce complications from side effects following cancer treatments. 

Click here to view the complete webinar. 

Grey Horizon postings will resume week of February 5, 2024

To all Grey Horizon readers, 

Thank you for your continued support of this blog.   

Postings will resume the week of February 5, 2024.  

Take care and stay well.