2 Minute Medicine ® - Medical Oncology

1. In this cohort study, women were less likely to return for mammogram screening if their original result was a false-positive versus a true-negative. 2. Racial disparities in return mammogram screening were present, with Asian and Hispanic/Latinx women having the greatest reduction in likelihood of returning after a false-positive result. Evidence Rating Level: 2 (Good) Study Rundown: Breast cancer screening is an essential part of a secondary prevention strategy to reduce breast cancer mortality. Although the benefits are remarkable, mammography inevitably results in some number of false positive results leading to further imaging and biopsies, as well as higher financial burden...

1. Median PFS (5.6 months vs 5.6 months) and median OS (21.4 months vs 18.1 months) were similar in both arms. 2. Treatment-related adverse events grade 3-5 occurred in 38.7% of the belzutifan group and 39.4% of the everolimus group. Evidence Rating Level : 1 (Excellent) Study Rundown: Antiangiogenic and immune checkpoint therapies have improved outcomes for patients with advanced clear-cell renal-cell carcinoma, and after disease progression, options are limited and have limited improvements in overall survival...

1. In a retrospective analysis of 59,875 patients with metastatic prostate cancer, varying prognoses were found primarily depending on the site of metastasis 2. Asian patients had the best overall prognosis followed by African American and finally Caucasian patients Evidence Rating Level: 3 (Average) Prostate cancer is the fourth most diagnosed cancer in men and eight leading cause of cancer death worldwide. Localized prostate cancer has good survival outcomes, however, metastatic prostate cancer (mPC) confers a high risk of death...

1. The cumulative incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with breast cancer bone metastases was much higher compared to the available data reported in the literature thus far. Evidence Rating Level: 2 (Good) MRONJ is a common side effect of antiresorptive therapeutics such as bisphosphonates and denosumab which are used in the setting of metastatic breast cancer to manage bone metastases. While data has been reported on the risk of developing MRONJ, reports are highly variable and range between 1% and 17%...

1. Patel and colleagues conducted a secondary economic analysis of a trial that assigned high-risk cancer patients to serious illness conversations (SICs). 2. A machine learning algorithm effectively identified patients with high mortality risk. SICs for these patients were associated with reduced healthcare spending. Evidence Rating Level: 2 (Good) Study Rundown: Advanced cancer patients often receive treatment incompatible with their preferences at the end of their lives. However, serious illness conversations (SICs) are rarely initiated despite their ability to improve quality of life and mood and decrease healthcare use...

1. BrECADD resulted in significantly lower treatment-related morbidity than eBEACOPP. 2. Progression-free survival at 48 months was significantly greater in the BrECADD group compared to the eBEACOPP group. Evidence Rating Level: 1 (Excellent) Study Rundown : Intensified systemic chemotherapy provides high cure rates, albeit with severe and long-lasting toxicities, in patients with advanced-stage classical Hodgkin lymphoma. The BrECADD regimen (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone) aims to reduce these toxicities while maintaining treatment effectiveness compared to current treatment regimens...

1. The median progression-free survival in the metastasis-directed therapy arm was 10.3 months vs 2.5 months in the control arm with an HR of 0.43 (significant). 2. Baseline CA19-9 level were found to be prognostic, ≥90 U/mL compared to<90 U/mL had an HR 2.96 (significant). Evidence Rating Level : 1 (Excellent) Study Rundown: Patients with metastatic pancreatic ductal adenocarcinoma (PDAC) have poor outcomes after frontline chemotherapy however for patients with oligometastatic PDAC, some evidence exists for combining chemotherapy with metastasis-directed therapy (MDT) to improve outcomes...

1. In this modeling study, an alternative set of lung cancer screening criteria was more sensitive and specific overall in identifying high-benefit people as compared to the current United States Preventive Services Task Force criteria. 2. The alternative criteria were also more sensitive in identifying high-benefit people among racial and ethnic minorities. Evidence Rating Level: 2 (Good) Study Rundown: Lung cancer is the leading cause of cancer-related mortality in the United States, with the most significant risk factor being smoking...

1. In the United States, the estimated annual cost of cancer screening was $43 billion, with private insurance covering the majority of spending. 2. Colorectal cancer screening was the most frequently performed test and comprised nearly two-thirds of total spending. Evidence Rating Level: 2 (Good) Study Rundown : Cancer continues to be one of the greatest sources of morbidity and mortality worldwide, with over 600,000 deaths projected in the United States alone in 2024. Public interventions such as the U.S...

1. When comparing corticosteroid peak dose for immunosuppression for anti–PD-1 plus anti–CTLA-4–related adverse events, the HR for OS was 1.66 for 2.0mg/kg vs 0.5 mg/kg. 2. When comparing cumulative corticosteroid dose the HR for OS was 0.96 per 1,000-mg increase. Evidence Rating Level : 2 (Good) Study Rundown: Immune checkpoint inhibitors (ICIs) can often cause immune-related adverse events (irAEs), which if severe, require high-dose corticosteroids. While irAEs are linked to longer survival, recent studies suggest that aggressive immunosuppressive treatment might negate this benefit...

1. Approximately 88% of patients with GD2-positive diffuse midline glioma or other progressive CNS tumours receiving C7R-GD2.CARTs had a partial response to therapy or stable disease. 2. No dose-limiting toxicities were observed in any patient treated with GD2.CARTs or C7R-GD2.CARTs. Evidence Rating Level: 2 (Good) Study Rundown: Current treatment options remain limited for children with diffuse midline glioma (DMG), resulting in a poor prognosis for these patients. One promising novel approach is adoptive cell transfer involving T cells armed with chimeric antigen receptors (CART)...

1. Dose-dense adjuvant chemotherapy involving sequential epirubicin/cyclophosphamide and docetaxel showed improved breast cancer recurrence-free survival and event-free survival compared to standard adjuvant chemotherapy involving docetaxel.  Evidence Rating Level: 1 (Excellent) Study Rundown: A dose-dense sequential adjuvant chemotherapy regimen involving an anthracycline and a taxane has been shown to confer survival benefit in previous studies. However, such studies used paclitaxel once every 3 weeks as the control regimen which is inferior to other currently available regimens...

1. Median overall survival was 41 months in the TKI-only group vs 40 months in the TKI-SRS group, with HR 0.96 (non-significant). 2. Time to CNS progression was improved in the TKI-SRS group with HR 0.63 (significant), and this was especially seen in patients with BM ≥1 cm, HR 0.60 (significant). Evidence Rating Level : 2 (Good) Study Rundown: Stereotactic radiosurgery (SRS) is the preferred radiation treatment for limited brain metastases (BM) in EGFR/ALK-mutated non-small cell lung cancer (NSCLC) however newer-generation tyrosine kinase inhibitors (TKIs) have shown promising CNS response rates...

1. Patients in the sintilimab group reported a significantly greater event-free survival at 36 months compared to the standard therapy group. 2. Grade 3-4 adverse events were slightly more common in the sintilimab group. Evidence Rating Level: 1 (Excellent) Study Rundown: Anti-PD-1 therapy is used to treat metastatic and refractory nasopharyngeal carcinoma, yet its role in locoregionally advanced disease remains unclear. Sintilimab, a novel PD-1 inhibitor, has shown some promise when added to the standard chemoradiotherapy regimen, although further evidence is needed...

1. In a retrospective cohort study of women newly diagnosed with breast cancer, use of hormone therapy was associated with a decreased risk of developing alzheimer’s disease and related dementia (ADRD), especially in Black women and women younger than 75 years old.  Evidence Rating Level: 2 (Good)  Breast cancer is one of the most common cancer diagnoses in the United States and is the most common among women. One significant non-modifiable risk factor for developing cancer is age and the majority of breast cancer cases (83%) are found in women 50 years or older...

1. Tumor response rate at 25 weeks was significantly greater in vimseltinib than placebo. 2. Most adverse events were mild-to-moderate with no treatment-related fatalities. Evidence Rating Level: 1 (Excellent) Study Rundown: Tenosynovial giant cell tumour (TGCT) is an aggressive neoplasm of the tendon sheath with limited treatment options. Vimseltinib, an oral CSF1R inhibitor, has shown promise for symptomatic TGCT patients, although further research is needed. This randomized controlled trial aimed to assess the safety and efficacy of vimseltinib compared to placebo among patients with TGCT not amenable to surgery...

1. Co-occurrences could be clustered together into 7 clusters based on the predominant organ system affected; endocrine, cutaneous, respiratory, gastrointestinal, hepatic, musculoskeletal, and neurological. 2. Some clusters had overall survival benefits (endocrine, cutaneous), whereas others had worsened outcomes (respiratory, neurological). Evidence Rating Level : 2 (Good) Study Rundown: Immune checkpoint inhibitors can cause immune-related adverse events (irAEs) in up to 70% of patients and can affect multiple organ systems...

1. Median overall survival was 11.5 months in the tisotumab vedotin group and 9.5 months in the chemotherapy group, with an HR of 0.70 (significant). 2. Adverse events grade ≥3 occurred in 52.0% of the tisotumab vedotin group and 62.3% in the chemotherapy group. Evidence Rating Level : 1 (Excellent) Study Rundown: Immunotherapy alone or in combination with standard care has improved outcomes in recurrent cervical cancer however these outcomes remain suboptimal. Tisotumab vedotin, an antibody-drug conjugate that targets tissue factor and carries a microtubule-disturbing payload, has shown some promising results in phase II trials...

1. The complete response rates (pathological and clinical) were similar (~55%) in both groups. 2. Grade 3-4 adverse events rates were similar (~43%) in both groups with thrombocytopenia and neutropenia being the most common. Evidence Rating Level : 2 (Good) Study Rundown: Total neoadjuvant therapy (TNT) for locally advanced rectal cancer showed superiority compared to traditional approaches, however still have a low pathological complete response rate. Some recent studies have shown promise with a combination of TNT with immune checkpoint inhibitors (ICIs)...

1. Unhealthy sleep, as well elevations of liver enzymes and decreased levels of albumin and liver functional biomarkers, were significantly associated with increased risk of liver cancer. Evidence Rating Level: 2 (Good) Poor sleep quality has been positively associated with cancer risk; however, the association between sleep and liver cancer risk specifically remains unclear. Studies examining routine liver function biomarkers and the risk of incident liver cancer in the general population with large sample sizes are also limited...