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Collections 2 Minute Medicine ® - Radiati...

2 Minute Medicine ® - Radiation Oncology

Collection of high-impact paper summaries that have been hand-picked, written and peer-reviewed by practicing clinicians. Provides 2 minute summarization and application to bedside care. Updated weekly.

https://read.qxmd.com/read/101001996/tisotumab-vedotin-as-second-or-third-line-therapy-for-recurrent-cervical-cancer
#1
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
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...
July 15, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001989/immunotherapy-based-total-neoadjuvant-therapy-for-locally-advanced-rectal-cancer
#2
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
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)...
July 8, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001988/poor-sleep-and-elevation-of-liver-function-biomarkers-may-be-predictive-of-liver-cancer
#3
SUMMARY
Alex Chan
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...
July 6, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001986/metformin-may-reduce-all-cause-mortality-in-cancer-survivors
#4
SUMMARY
Alex Chan
1. Among US cancer survivors, metformin was associated with a lower risk of cardiometabolic diseases, all-cause mortality, and cardiometabolic mortality. Evidence Rating Level: 1 (Excellent) Cardiometabolic disease (CMD) is the leading cause of noncancer deaths in the cancer survivor (CS) population. Previous studies have found metformin to improve cardiometabolic status in populations with obesity, diabetes, or psychiatric disorders, potentially by inhibiting oxidative stress. However, the relationship between metformin use and cardiometabolic status in the CS population is limited...
July 5, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001983/subcutaneous-amivantamab-with-lazertinib-is-non-inferior-to-intravenous-administration-with-fewer-adverse-reactions
#5
SUMMARY
Vanessa Giuliano, Sze Wah Samuel Chan
1. Subcutaneous amivantamab combined with lazertinib was non-inferior to intravenous amivantamab with lazertinib in terms of efficacy in treating refractory EGFR-mutated NSCLC. 2. Subcutaneous amivantamab resulted in fewer infusion-related reactions, allowed for shorter administration times, and increased patient convenience compared to the intravenous formulation Evidence Rating Level: 1 (Excellent) Study Rundown: The present study is a randomized controlled trial that assessed the efficacy of subcutaneous amivantamab with lazertinib compared to intravenous amivantamab with lazertinib...
July 1, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001982/amivantamab-and-lazertinib-in-untreated-egfr-mutated-advanced-nsclc
#6
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The progression-free survival between the amivantamab–lazertinib group (23.7 months) and the osimertinib group (16.6 months) had an HR 0.70. 2. Grade 3 or higher adverse events occurred in 75% of the amivantamab–lazertinib group and 43% of the osimertinib group. Evidence Rating Level : 1 (Excellent) Study Rundown: Osimertinib is the current first-line therapy in EGFR-mutated advanced NSCLCs, although resistance eventually develops. This trial assessed the efficacy of combining amivantamab, an EGFR-MET bispecific antibody, with lazertinib, a third-generation EGFR-TKI, compared to osimertinib alone for treating EGFR-mutated advanced NSCLC...
July 1, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001974/daratumumab-linked-to-improved-progression-free-survival-and-mrd-negativity-in-transplant-eligible-myeloma-patients
#7
SUMMARY
Vanessa Giuliano, Sze Wah Samuel Chan
1. Daratumumab in combination with bortezomib, thalidomide, and dexamethasone (D-VTd) as induction and consolidation therapy led to superior progression-free survival and higher MRD-negativity rates compared to VTd alone. 2. Daratumumab maintenance therapy further improved progression-free survival and sustained MRD-negativity rates in patients who had received D-VTd or VTd induction and consolidation therapy. Evidence Rating Level: 1 (Excellent) Study Rundown : The present study is a phase 3 randomized controlled trial assessing the long-term impact of daratumumab induction, consolidation and maintenance therapy in patients with newly diagnosed multiple myeloma...
June 24, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001973/circulating-tumor-dna-guided-de-escalation-targeted-therapy-for-advanced-nsclc
#8
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. Patients with no biochemical or radiographic evidence of progressive disease had a median treatment break of 20.3 months. 2. 96% of patients with biochemical but not radiographic evidence of progressive disease had a further biochemical response to prior TKI retreatment. Evidence Rating Level : 2 (Good) Study Rundown: Treatment discontinuation for targeted therapies in NSCLC can improve quality of life but may cause rapid progression, requiring adaptive or intermittent strategies. This study looked at the use of plasma ctDNA as a biomarker to guide adaptive de-escalation of targeted TKI treatment in NSCLC...
June 24, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001965/osimertinib-significantly-improved-progression-free-survival-in-patients-with-unresectable-stage-iii-non-small-cell-lung-cancer
#9
SUMMARY
Melanie Adams, Sze Wah Samuel Chan
1. Treatment with osimertinib significantly improved progression-free survival, compared to placebo, in patients with unresectable stage III EGFR-mutated NSCLC 2. The safety profile of osimertinib was consistent with previous studies, with most adverse effects being grade 1 or 2, and manageable Evidence Rating Level : 1 (Excellent) Study Rundown: In this phase 3, double-blind, placebo-controlled trial, 216 patients with unresectable stage III EGFR-mutated non-small cell lung cancer (NSCLC) who had received chemoradiotherapy, were then randomly assigned to receive osimertinib (143 patients) or placebo (73 patients)...
June 17, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001964/neoadjuvant-immunotherapy-in-mismatch-repair%C3%A3-%C3%A2-%C3%A2-deficient-colon-cancer
#10
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. No disease recurrences were observed during the median follow-up time of 26.2 months. 2. Immune-related adverse events grade 3-4 occurred in 4% of patients. Evidence Rating Level : 2 (Good) Study Rundown: While adjuvant chemotherapy is standard for locally advanced DNA mismatch repair deficiency (dMMR) colon cancer, recent studies advocate for neoadjuvant immunotherapy. This study (NICHE-2) evaluated neoadjuvant nivolumab plus ipilimumab’s efficacy in this setting. The primary endpoints included 3-year disease-free survival and timely surgery (no more than 2 weeks beyond the prespecified 6 weeks after study enrollment) and secondary endpoints included pathological response and safety...
June 17, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001963/quantifying-the-reduction-of-primary-breast-cancer-associated-with-exercise
#11
SUMMARY
Simon Pan, Alex Chan
1. Across a follow-up period of approximately 5 years, there was a non-linear relationship between exercise at breast cancer diagnosis and distant recurrence-free interval (DRFI), with greater exercise exposure up to a certain threshold correlating with greater reductions in the risk of recurrence. 2. The relationship between the level of exercise at diagnosis and DRFI events was only observed in the premenopausal population and not the postmenopausal population. Evidence Rating Level: 2 (Good) While studies have shown that exercise both before and after breast cancer (BC) diagnosis is associated with reduced mortality, the association between exercise and disease recurrence after BC diagnosis has not been thoroughly investigated...
June 16, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001961/bpmri-associated-with-higher-false-positive-rate-than-psa-for-prostate-cancer-screening
#12
SUMMARY
Jayden Berdugo, Kiera Liblik
1 . In this decision model analysis, biparametric MRI (bpMRI) testing led to an increased rate of overdiagnosis and false positives compared to a first-line prostate-specific antigen (PSA) test for prostate cancer (PCa). 2. There were more life years saved when using bpMRI compared to other screening techniques. Evidence Rating Level: 2 (Good) Study Rundown: Many cancer screenings employ imaging-based techniques; however, PCa screening typically involves first-line biomarker testing and PSA. First-line bpMRI is a screening technique that has been proposed as an alternative to previously used tools...
June 14, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001955/long-term-survival-improved-with-use-of-tebentafusp-for-metastatic-uveal-melanoma
#13
SUMMARY
Simon Pan, Alex Chan
1. Across a median follow-up of 48.5 months, usage of tebentafusp for patients with metastatic uveal melanoma was associated with a median OS that was double those observed historically in similar patient populations. 2. Low circulating-tumour DNA (ctDNA) levels at baseline and greater reductions in ctDNA levels at week 9 of treatment were associated with improved OS. Evidence Rating Level: 1 (Excellent) Metastatic uveal melanoma (mUM) has historically been associated with a poor prognosis owing to a lack of treatment options and an agreed-upon standard of care...
June 13, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001942/asciminib-demonstrates-superior-efficacy-for-the-treatment-of-cml-in-comparison-to-imatinib-and-second-generation-tkis
#14
SUMMARY
Vanessa Giuliano, Sze Wah Samuel Chan
1. Asciminib demonstrated higher efficacy for the treatment of newly diagnosed CML than imatinib and second-generation TKI 2. Asciminib had a favorable safety profile compared to imatinib and second-generation TKIs. Evidence Rating Level : 1 (Excellent) Study Rundown: The present study is a phase three randomized controlled trial that set out to assess the efficacy of asciminib (a more specific TKI for the ABL myristoyl pocket) in comparison to an investigator-selected tyrosine kinase inhibitor (TKI) in the treatment of newly diagnosed CML...
June 10, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001940/neoadjuvant-nivolumab-and-ipilimumab-in-resectable-stage-iii-melanoma
#15
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The event-free survival at 12 months was 83.7% in the neoadjuvant group vs 57.2% in the adjuvant group. 2. Systemic treatment-related adverse events grade 3 or higher occurred in 29.7% in the neoadjuvant group vs 14.7% in the adjuvant group. Evidence Rating Level : 1 (Excellent) Study Rundown: Surgery remains the primary treatment for resectable stage III melanoma, often followed by adjuvant systemic therapy. Recent trials suggest that neoadjuvant immune checkpoint inhibitors (ICIs) may offer superior efficacy compared to adjuvant therapy...
June 10, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001927/short-term-androgen-deprivation-therapy-does-not-improve-survival-in-patients-receiving-postoperative-radiotherapy-for-prostate-cancer
#16
SUMMARY
Neel Mistry, Teddy Guo
1. There was no significant difference in metastasis-free survival between the ADT and non-ADT groups over 10 years. 2. Adverse events were comparable between both groups and no fatalities were reported. Evidence Rating Level: 1 (Excellent) Study Rundown: Short-term androgen deprivation therapy (ADT) with primary adjuvant radiotherapy is known to improve metastasis-free survival in patients with intermediate-risk and high-risk localized prostate cancer. However, the benefit of ADT with postoperative radiotherapy after radical prostatectomy remains unclear...
June 5, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001922/large-language-models-llms-demonstrated-higher-error-rates-compared-to-humans-in-a-clinical-oncology-question-bank
#17
SUMMARY
Cheng En Xi, Deepti Shroff Karhade
1. A comparative evaluation tested five publicly available LLMs on 2044 oncology questions, covering comprehensive topics in the field. The responses were compared to a human benchmark. 2. Only one of the five models tested performed above the 50 th percentile, with worse performance observed in clinical oncology subcategories and female-predominant malignancies. Evidence Rating Level: 2 (Good) Study Rundown: Many medical professionals have begun to use large language models (LLMs), such as ChatGPT, as augmented search engines for medical information...
May 27, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001906/perioperative-nivolumab-in-resectable-lung-cancer
#18
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The 18-month event-free survival in the perioperative nivolumab group was 70.2% vs 50.0% in the chemotherapy group with HR 0.58 (significant). 2. Grade 3-4 treatment-related adverse events occurred in 32.5% in the nivolumab group vs 25.2% in the chemotherapy group. Evidence Rating Level : 1 (Excellent) Study Rundown: Nivolumab, an anti-PD-1 antibody, combined with chemotherapy, has been used as neoadjuvant treatment for resectable non-small-cell lung cancer (NSCLC). Recently perioperative approaches, involving both neoadjuvant and adjuvant immunotherapy, have shown promising results in reducing disease relapse and improving overall survival...
May 20, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001904/genomic-data-optimizes-hematopoietic-stem-cell-transplantation-hsct-timing-for-myelodysplastic-syndromes-mds-and-improves-patient-outcomes
#19
SUMMARY
Vanessa Giuliano, Sze Wah Samuel Chan
1. A decision support system using the Molecular International Prognostic Scoring System (IPSS-M) can optimize the timing of HSCT for MDS patients. 2. Patients with low and moderate-low risk MDS benefit from delayed HSCT, while those with higher risks benefit from immediate HSCT under the IPSS-M model. Evidence Rating Level: 2 (Good) Study Rundown: The present study conducted a retrospective analysis to develop a decision support system (DSS) for predicting the optimal timing for hematopoietic stem cell transplantation (HSCT) in patients with myelodysplastic syndromes (MDS), using clinical and genomic data from the IPSS-M score...
May 20, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001900/novartis-arv-766-is-an-androgen-receptor-degrader-efficacious-in-treating-metastatic-prostate-cancer
#20
SUMMARY
Yidi Wang, Flaviu Trifoi
The Latest In 2021, ARVINAS started a phase-1/2 trial of 47 men with metastatic prostate cancer who have previously received at least one line of treatment with androgen receptor (AR) inhibitors. Preliminary data from the study showed that ARV-766 led to a greater than 50% reduction in Prostate-Specific antigen (PSA) in 42% of patients with AR resistance mutations. ARV-766 was well tolerated with no grade 4 treatment-related adverse events or dose-limiting toxicities. Physician’s Perspective Prostate cancer is the most prevalent urogenital malignancy in men...
May 15, 2024: 2 Minute Medicine
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