Similarity of molecular portraits in synchronous bilateral breast cancers could be influenced by common environmental factors

 A recent study conducted within the Translational Research Department, Institut Curie, Universite de Paris, found that in breast cancer patients, "immune infiltration was not determined purely by local tumour microenvironment properties, but was different according to the subtype of the contralateral tumour."  The study further unveiled that 5% of patients with bilateral breast cancers carry BRCA1 or BRCA2 mutations; from the 17575 patients listed in the Institut Curie clinical databases, only 2.3% (404) patients had synchronous bilateral breast cancers.  

To read more about this study, click here. 

Source mentioned: Hamy A-S, Abécassis J, Driouch K, et al. Evolution of synchronous female bilateral breast cancers and response to treatment. Nature Medicine; Published online 6 March 2023. DOI: https://doi.org/10.1038/s41591-023-02216-8

HRQoL data support benefit of adding pembrolizumab to chemotherapy in patients with persistent, recurrent, or metastatic cervical cancer

 Findings from the Keynote-826 study indicate favourable outcomes on the use of pembrolizumab and chemotherapy with or without bevacizumab as a standard treatment regimen for patients with persistent, recurrent, or metastatic cervical cancer.  Cervical cancer "is commonly associate with bleeding, fatigue, pain, bladder, and bowel dysfunction, leg swelling, and sexual dysfunction", symptoms which worsen in advanced or recurrent stages.  The goal of the standard treatment regimen mentioned above is to prolong, preserve, and improve health-related quality of life.  

To learn more about this study, click here. 

Source mentioned: 

Monk BJ, Tewari KS, Dubot C, et al. Health-related quality of life with pembrolizumab or placebo plus chemotherapy with or without bevacizumab for persistent, recurrent, or metastatic cervical cancer (KEYNOTE-826): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet Oncology; Published online 3 March 2023. DOI: https://doi.org/10.1016/S1470-2045(23)00052-9

Estimate of the global economic cost of the most prevalent cancers in 204 countries from 2020 To 2050

 A recent decision analytical modelling study, using a "health-augmented macroeconomic model...to estimate the global economic cost of 29 cancer types for 204 countries..." is the first of its kind to study productivity loss among individuals with different educational and experience levels.  Study authors have found the estimated global economic cost of cancers from 2020-2050 to be $25.2 trillion, with tracheal bronchus, and lung cancer (15.4%), colon and rectal cancer (10.9%), breast cancer (7.7%), liver cancer (6.5%), and leukaemia (6.3%) deemed to sustain the highest economic costs. 

To read more about this study, click here. 

Sources mentioned: 

• Chen S, Cao Z, Prettner K, et al. Estimates and Projections of the Global Economic Cost of 29 Cancers in 204 Countries and Territories From 2020 to 2050. JAMA Oncology; Published online 23 February 2023. doi:10.1001/jamaoncol.2022.7826
• Lopes G. The Global Economic Cost of Cancer—Estimating It Is Just the First Step! JAMA Oncology; Published online 23 February 2023. doi:10.1001/jamaoncol.2022.7133

Exposure to antibiotics before treatment with immune checkpoint inhibitor associated with worse overall survival among older adults with cancer

A large population-level study from the Princess Margaret Cancer Centre in Toronto indicated that "antibiotic exposure and specifically fluoroquinolones before treatment with immune checkpoint inhibitor were associated with worse overall survival, with fluoroquinolone exposure conferring up to a 65% increased risk of mortality among older adults with cancer."   Of the 2,737 cancer patients who were administered immune checkpoint inhibitors, 59% received antibiotics 1 year before ICU treatment, while 19% received antibiotics 60 days before ICI.  The authors of the study further state that more data is required to further explore the association between antibiotic exposure, ICI treatment and survival outcomes among cancer patients in diverse settings. 

To read more about this study, click here. 

Sources mentioned: 

• Eng L, Sutradhar R, Niu Y, et al. Impact of Antibiotic Exposure Before Immune Checkpoint Inhibitor Treatment on Overall Survival in Older Adults With Cancer: A Population-Based Study. JCO; Published online 24 February 2023. DOI: 10.1200/JCO.22.00074
• Pinato DJ, Cortellini A. Antibiotic Therapy: The Cornerstone of Iatrogenic Resistance to Immune Checkpoint Inhibitors. JCO; Published online 24 February 2023. DOI: 10.1200/JCO.23.00049

New study finds millions in U.S. missed cancer screening during second year of COVID-19 pandemic

 A new study released by the American Cancer Society has unveiled that 4.4 million fewer women were screened for cervical cancer in 2021, compared to 2019.  For breast cancer, the numbers are 1.1 million fewer breast cancer screening tests administered, along with 700,000 thousand fewer for prostate cancer. According to associate scientist Jessica Star, "the COVID-19 pandemic continues to have a detrimental effect on important cancer screenings...", highlighting the importance of creating greater advocacy and awareness among get screened campaigns. 

To read more about this study, click here. 

study of Hodgkin lymphoma survivors suggests a dose-response association of colorectal cancer risk with subdiaphragmatic radiotherapy

 Findings from a case-control study of Hodgkin lymphoma survivors after a 5-year period found a "dose-response association between radiotherapy and colorectal cancer risk, and modification of this association by procarbazine."  Study authors also indicated that Hodgkin lymphoma survivors have a 2.8 times higher rate of a colorectal cancer diagnosis, a rate that remains at this increased level for over 40 years.  While these results are specific to a 5-year period (patients treated more recently would experience lower radiotherapy and chemotherapy doses), "an understanding of the dose-response relationship is needed to quantify and estimate the risk of secondary cancers based on individual treatment exposures." 

To learn more about this study, click here. 

Source mentioned: Geurts YM; Shakir R, Ntentas G, et al. Association of Radiation and Procarbazine Dose With Risk of Colorectal Cancer Among Survivors of Hodgkin Lymphoma. JAMA Oncology. Published online 2 February 2023. doi: 10.1001/jamaoncol.2022.7153.

First-line serplulimab in combination with chemotherapy improves survival in patients with PD-L1-positive, locally advanced or metastatic oesophageal squamous cell carcinoma

 Findings from the ASTRUM-007 study, focusing on the the use of first-line Serplulimab and chemotherapy every 2 weeks for patients with locally advanced or metastatic PD-L1 positive oesophageal squamous cell carcinoma, were recently published in Nature Medicine. 

The respecified fine analysis of the study, assessed by a blinded Independent Radiological Review Committee (IRRC) determined that "Serplulimab plus chemotherapy significantly improved PFS compared with placebo plus chemotherapy with median PFS of 5.8 months and 5.3 months." 

To read more about this study, click here. 

Source mentioned: Song Y, Zhang B, Xin D, et al. First-line serplulimab or placebo plus chemotherapy in PD-L1-positive esophageal squamous cell carcinoma: a randomized, double-blind phase 3 trial. Nature Medicine; Published online 2 February 2023. DOI: https://doi.org/10.1038/s41591-022-02179-2 

Large genomic analysis identifies persistent tumour mutational burden associated with immunotherapy response

Findings from a recently completed genomic analysis published in Nature Medicine indicates that "a high persistent TMB [tumour mutational burden], a biologically relevant measure of tumour foreignness within the overall TMB, represents an 'uneditable' target set for adaptive immune responses and may function as an intrinsic driver of sustained immunologic tumour control that cannot be readily bypassed by neoantigen loss via chromosomal deletions during cancer evolution."  Following an extensive evaluation of mutations across 31 tumour types amongst 9,242 patients, along with 8 patient cohorts (total of 524 patients) diagnosed with non-small-cell lung cancer, melanoma, mesothelioma, and head and neck cancer patients, the study team discovered that "mutations in single-copy regions and those present in multiple copies per cell constitute a pTMB...linked with response to immune checkpoint blockade. 

To read more about this study, click here. 

Source mentioned: Niknafs N, Balan A, Cherry C, et al. Persistent mutation burden drives sustained anti-tumor immune responses. Nature Medicine; Published online 26 January 2023. DOI: https://doi.org/10.1038/s41591-022-02163-w

Prognostic role of ctDNA in patients with surgically resectable colorectal cancer

 Results from GALAXY, part of the CIRCULATE study from Japan, analyzing circulating tumour DNA (ctDNA) was recently published in Nature Medicine.  Investigators from GALAXY demonstrated that "postsurgical ctDNA status is a most significant prognostic biomarker than the currently used high-risk clinicopathological features in resectable colorectal cancer and can potentially be predictive of adjuvant chemotherapy benefit."  The study authors thus believe that incorporating postsurgical ctDNA into TNM staging criteria can be further developed as a result of findings from GALAXY. 

To read more about this study, click here. 

Source mentioned: Kotani D, Oki E, Nakamura Y, Yukami H, Mishima S, Bando H, Shirasu H, Yamazaki K, Watanabe J, Kotaka M, Hirata K, Akazawa N, Kataoka K, Sharma S, Aushev VN, Aleshin A, Misumi T, Taniguchi H, Takemasa I, Kato T, Mori M, Yoshino T. Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer. Nat Med. 2023 Jan;29(1):127-134. doi: 10.1038/s41591-022-02115-4. Epub 2023 Jan 16. PMID: 36646802; PMCID: PMC9873552.

Suicide risk higher among individuals with cancer

 A new study conducted by researchers at the American Cancer Society (ACS) indicates that "the risk for suicide of individuals diagnosed with cancer...is 26% higher compared with the general population."  While the study explains that additional characteristics, including geographic, racial/ethnic, and socioeconomic also play contributing roles to this statistic, Dr. Xuesong Han, senior study author explains that joint efforts by local and national governments are needed to ensure insurance coverage for psycho-oncological and psychosocial issues, as well as "development of appropriate clinical guidelines for suicide risk screening and inclusion of suicide prevention in survivorship care plans."  

To read more about this study, click here. 

Implementation of clinical trials regulation in the EU and EEA

 Effective January 31, 2023, the Clinical Trials Information System (CTIS) "will become the single-entry point for sponsors and regulators of clinical trials for the submission and assessment of clinical trial data which includes a public searchable database for healthcare professionals, patients, and the public."  Soft-launched nearly one year ago on January 31, 2022, CTIS was created to regulate how clinical trials are authorized and supervised across the European Union.  

To read more about CTIS, including access to training material and webinars, click here. 

Patient-reported symptom burden and supportive care needs of patients with stage II-III colorectal cancer during and after adjuvant systemic treatment

 A retrospective population-based cohort study conducted on newly diagnosed stage II-III colorectal cancer patients in Calgary, Alberta, Canada was recently published in JCO Oncology Practice.  The study, conducted on 303 patients over a period of 3 years (January 2016 - January 2019), indicated that while symptom severity was low and most systems either remained stable and/or or improved following adjuvant systemic treatment, "ongoing assessments and interventions to address physical and psychologic symptoms and supportive care needs in patients [with colorectal cancer] during and after treatment are needed." 

Study mentioned: Cuthbert CA, O'Sullivan DE, Boyne DJ, Brenner DR, Cheung WY. Patient-Reported Symptom Burden and Supportive Care Needs of Patients With Stage II-III Colorectal Cancer During and After Adjuvant Systemic Treatment: A Real-World Evidence Study. JCO Oncol Pract. 2023 Jan 6:OP2200462. doi: 10.1200/OP.22.00462. Epub ahead of print. PMID: 36608313.

Western region of U.S. has highest prostate cancer mortality among white men; black men face highest prostate cancer mortality overall

A recent study completed by researchers at the American Cancer Society indicates that the highest mortality rates for prostate cancer in white men occurred in the western part of the United States, particularly in California, while "black men...had an estimated 70%-110% higher incidence and mortality rate for prostate cancer than white men overall..."  The study also indicated socioeconomic disparities in four genitourinary cancers (bladder, kidney, prostate, testicular), among both men and women in the United States.   In addition to the aforementioned prostate cancer findings, the study also uncovered highest incidence of bladder cancer among white individuals in the U.S. Northeast, while kidney cancer incidence was most prevalent in the Appalachia and southern regions.  Among ethnic and racial groups, rates of bladder cancer were highest among American Indian and Alaska Natives, while mortality rates were highest in Hispanic men afflicted with testicular cancer. 

To read more about this study, click here. 

Grey Horizon blog posts will resume the week of January 3rd; Happy Holidays

To all Grey Horizon readers, 

Thank you for supporting the blog this past year.  Postings will resume the week of week of January 3, 2023.  

Merry Christmas and Happy Holidays!