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Collections 2 Minute Medicine ® - Radiati...

2 Minute Medicine ® - Radiation Oncology

https://read.qxmd.com/read/101001475/immunotherapy-plus-stereotactic-radiotherapy-improves-outcomes-in-early-stage-lung-cancer
#1
SUMMARY
Neel Mistry, Teddy Guo
1. 4-year event-free survival was significantly greater in I-SABR (77%) versus SABR alone (53%). 2. More patients in the I-SABR group experienced grade 3 immunological adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown : Standard treatment for early-stage inoperable non-small-cell lung cancer (NSCLC) includes stereotactic ablative radiotherapy (SABR). However, relapses remain common. Although immunotherapy may has shown efficacy in stage III NSCLC, its efficacy in earlier stages remains unknown...
September 28, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001470/cetuximab-maintenance-therapy-may-be-effective-for-ras-wild-type-metastatic-colorectal-cancer
#2
SUMMARY
Donika Yakoub, Alex Chan
1. This phase 2 randomized clinical trial found that patients with metastatic colorectal cancer who were treated with cetuximab maintenance therapy had improved progression-free survival and median overall survival compared to those undergoing observation alone in the maintenance phase. 2. There was no statistical difference in adverse events when comparing the control to patients taking Cetuximab. Evidence Rating Level: 1 (Excellent) Metastatic colorectal cancer (mCRC), particularly in patients with RAS wild-type tumours, presents a significant clinical challenge...
September 26, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001468/tumor-treating-fields-vs-standard-therapy-in-treatment-resistant-metastatic-nsclc
#3
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The median OS was 13.2 months with TTFields arm vs 9.9 months with standard arm, with an HR of 0.74. This effect was more pronounced in treatment with immune checkpoint inhibitors. 2. Most frequent TTFields therapy-related adverse events were grade 1 to 2 skin related events Evidence Rating Level : 1 (Excellent) Study Rundown: Metastatic non-small-cell lung cancer (NSCLC) remains difficult to treat once there is progression on platinum-based therapy. Tumor Treating Fields (TTFields) therapy, which disrupts mitosis using electric fields, has shown promise in other cancers (glioblastoma and pleural mesothelioma) with little adverse effects...
September 25, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001464/adjuvant-nivolumab-may-be-promising-for-treatment-of-completely-resected-merkel-cell-carcinoma
#4
SUMMARY
Neel Mistry, Teddy Guo
1. Disease-free survival at 24 months was 84% in the nivolumab group compared to 73% in the observation group. 2. Grade 3-4 adverse events were more common in the nivolumab group, however, there were no reported deaths. Evidence Rating Level: 1 (Excellent) Study Rundown : Merkel cell carcinoma (MCC), an aggressive skin cancer, poses a clinical challenge even after complete resection and radiation therapy. Immune checkpoint inhibitors targeting PD-1 and PD-L1 have shown promise in advanced MCC. This randomized controlled trial aimed to assess the safety and effectiveness of adjuvant immune checkpoint inhibition using nivolumab in completely resected MCC...
September 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001463/non-erosive-gastro-oesophageal-reflux-disease-not-associated-with-increased-incidence-of-oesophageal-adenocarcinoma
#5
SUMMARY
Davy Lau, Alex Chan
1. Patients with non-erosive gastro-esophageal reflux disease (GERD) do not have an increased incidence of developing esophageal adenocarcinoma compared to the general population. Evidence Rating Level: 2 (Good) For patients with gastro-esophageal reflux disease (GERD), endoscopic findings of mucosal erosion or metaplasia are associated with increased risk of esophageal adenocarcinoma. However, there has been no study to determine whether patients with non-erosive GERD, meaning normal endoscopic mucosal findings, are at increased risk for this type of malignancy...
September 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001454/atezolizumab-is-a-potentially-effective-treatment-option-for-patients-with-alveolar-soft-part-sarcoma
#6
SUMMARY
Kassandra McFarlane, Sze Wah Samuel Chan
1. 37% of study patients had an objective response to treatment with atezolizumab. 2. Median progression-free survival was 20.8 months. Evidence Rating Level : 2 (Good) Study Rundown: Alveolar soft part sarcoma (ASPS) has no standardized therapy and is one of the rarest sarcomas with a low 5-year overall survival. Traditional chemotherapies are generally ineffective; however, recent studies have shown promising outcomes with immune checkpoint inhibitors. This study examined the outcomes of atezolizumab, which binds to programmed cell death-ligand 1 (PD-L1), on objective response and progression-free survival in adult and pediatric patients with ASPS...
September 18, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001453/patritumab-deruxtecan-in-egfr-mutated-nsclc-post-egfr-tki-and-chemotherapy
#7
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The objective response rate was 29.8% (1% complete response, 66% partial response) with a PFS of 5.5 months and a median OS of 11.9 months. 2. 64.9% of treatment-emergent adverse events (TEAEs) of grade ≥3, in which thrombocytopenia and neutropenia were the most common. Evidence Rating Level : 2 (Good) Study Rundown: Salvage therapy is limited for patients with EGFR-mutated advanced NSCLC who have failed the typical initial treatment with EGFR TKIs and second-line platinum-based chemotherapy. However, it was found that HER3, a protein linked to resistance to EGFR TKIs, is prevalent in NSCLC tumours, and a recent experimental therapy targeting HER3, Patritumab deruxtecan (HER3-DXd), showed initial promise in a phase I study...
September 18, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001451/rectal-cancer-presentation-and-screening-rates-during-the-covid-19-pandemic
#8
SUMMARY
Davy Lau, Alex Chan
1. Despite the decrease in colonoscopies performed at the start of the COVID-19 pandemic, there was no difference in the percentage of colorectal cancer (CRC) presentations at a later stage or with higher acuity, when comparing patients diagnosed with rectal adenocarcinoma pre-pandemic and during the pandemic. Evidence Rating Level: 2 (Good) Colonoscopies as part of colorectal cancer (CRC) screening are instrumental in the early diagnosis of CRC, and have been associated with a 75% reduction in mortality for those diagnosed with left-sided colon cancer, likely due to earlier detection...
September 18, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001435/nivolumab-ipilimumab-vs-nivolumab-alone-in-advanced-cancers-other-than-melanoma
#9
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. Pooled overall survival and progression-free survival HR were found to be 0.95 and 0.88 for nivolumab/ipilimumab vs. nivolumab. 2. Pooled OR for grade 3-4 adverse events was found to be 1.84 for the combination compared to monotherapy Evidence Rating Level : 1 (Excellent) Study Rundown: Nivolumab/ipilimumab combination therapy has demonstrated improved progression-free survival (PFS) and overall survival (OS) vs. nivolumab alone in metastatic melanoma. However, this comparison has not been well established in other forms of advanced cancers, and limited direct comparisons exist...
September 11, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001419/breast-cancer-screening-discrepancies-in-different-countries-associated-with-different-outcomes
#10
SUMMARY
Rhianna Davis, Alex Chan
1. In Brasil, Russia, India, China, and South Africa, the availability of breast cancer screening programs was associated with a significant reduction in breast cancer mortality.  Evidence rating level: 3 (Average) Breast cancer is the greatest contributor to cancer-related morbidity and mortality for females across the world. Breast cancer screening (BCS) is an effective strategy for detecting asymptomatic people with breast cancer, allowing for early intervention. In Brazil, Russa, India, China, and South Africa (BRICS countries), which collectively account for approximately half of the global population, the association between BCS and breast cancer-related morbidity and mortality has not been well established...
September 5, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001411/vitamin-d3-supplementation-may-improve-relapse-free-survival-for-certain-digestive-tract-cancers
#11
SUMMARY
Donika Yakoub, Alex Chan
1. This post-hoc analysis of the AMATERASU randomized clinical trial found that, for digestive tract cancer patients with positive p53-immunoreactivity, 2000 IU/day vitamin D3 supplementation resulted in significantly improved relapse-free survival at 5 years.  Evidence Rating Level: 1 (Excellent) Recent meta-analyses of randomized clinical trials have found that daily vitamin D3 supplementation benefited cancer mortality. In this posthoc subgroup analysis of the AMATERASU randomized, double-blind, placebo-controlled clinical trial, patients with digestive cancers were followed up for a median of 3...
September 1, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001407/survivors-of-childhood-cancer-are-less-active-than-their-peers
#12
SUMMARY
Alex Gipsman
1. In a cross-sectional study, adolescent survivors of childhood cancers were more sedentary than age-matched controls. 2. Age, gender, BMI, cancer relapse, and central nervous system tumors were all associated with less physical activity and more sedentary time. Evidence rating: 2 (Good) Study Rundown: Childhood cancer survivors are at increased risk for chronic medical conditions such as cardiovascular disease and diabetes mellitus.  Higher levels of physical activity are associated with a variety of long-term health benefits and an improved quality of life in the general population...
August 30, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001406/lisocabtagene-maraleucel-may-induce-remission-in-relapsed-chronic-lymphocytic-leukemia-cll
#13
SUMMARY
Neel Mistry, Teddy Guo
1. Complete response or remission was reported in 18% of patients who received a single liso-cel infusion. 2. Nearly 10% of fatalities were thought to be due to liso-cel related complications. Evidence Rating Level: 1 (Excellent) Study Rundown: There exist limited options for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have failed treatment with both Bruton tyrosine kinase (BTK) inhibitor and venetoclax. This randomized controlled trial aimed to evaluate the use of lisocabtagene maraleucel (liso-cel), an autologous CD19-directed T-cell inhibitor, in patients with relapsed or refractory CLL or SLL...
August 30, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001398/cancer-mortality-after-low-dose-exposure-to-ionising-radiation-in-workers
#14
SUMMARY
Davy Lau, Alex Chan
1. The risk of mortality from solid cancer, lagged by 10 years, is estimated to be increased by 52% per Gy of radiation exposure, an association that is doubled when limiting to the low cumulative dose range of 0-100 mGy. 2. There is an approximate relationship between cumulative dose radiation exposure and mortality from solid cancer. 3. Excluding cancers commonly associated with smoking and asbestos exposure did not alter the association between radiation exposure and solid cancer mortality substantially...
August 24, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001392/endocrine-therapy-and-breast-conserving-surgical-management-without-follow-up-radiotherapy-is-safe-in-low-risk-luminal-a-subtype-breast-cancer
#15
SUMMARY
Kassandra McFarlane, Sze Wah Samuel Chan
1. 5-year recurrence incidence was 2.5% at follow-up. 2. Overall survival at 5 years without radiotherapy was 97.2%, with a disease-free survival rate of 89.9%. Evidence Rating Level : 1 (Excellent) Study Rundown: After breast-conserving surgical management of breast cancer, radiotherapy is often provided to help prevent recurrence, but not without inconvenience, increased risk of side effects, and considerable cost financially. Low-risk subtypes of breast cancer include the luminal A-subtype, described as having negative human epidermal growth factor receptor 2, estrogen receptor positivity of ≥1%, progesterone receptor positivity of >20%, and Ki67 index of 13...
August 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001391/vorasidenib-in-idh1-or-idh2-mutant-low-grade-glioma
#16
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. Median progression-free survival was shown to be 27.7 months in the vorasidenib group vs 11.1 months in the placebo group, with HR 0.39. 2. Adverse events (grade 3 and above) that were more common with vorasidenib than with placebo were an elevated alanine aminotransferase level, an elevated aspartate aminotransferase level, and an increased γ-glutamyltransferase level. Evidence Rating Level : 1 (Excellent) Study Rundown: Gliomas are common malignant brain tumours in adults, with mutations in IDH1 or IDH2 genes present in most grade 2 gliomas...
August 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001388/pyrotinib-plus-capecitabine-for-trastuzumab-resistant-her2-positive-advanced-breast-cancer-picture
#17
SUMMARY
Donika Yakoub, Alex Chan
1. This phase 2, single-arm, multicenter trial found that in HER2-positive breast cancer patients demonstrating resistance to trastuzumab, the combination of pyrotinib and capecitabine improved progression-free survival and objective response rates while maintaining an adequate safety profile.  2. Results also indicate that different underlying mechanisms of trastuzumab resistance may impact disease progression and the response to treatment. Evidence Rating Level: 1 (Excellent) Approximately one-fifth of patients diagnosed with breast cancer are HER2-positive...
August 18, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001380/atezolizumab-monotherapy-superior-to-chemotherapy-for-treatment-of-non-small-cell-lung-cancer
#18
SUMMARY
Neel Mistry, Teddy Guo
1. Median overall survival in the atezolizumab group was 10.3 months versus 9.2 months in the chemotherapy group. 2. Patients assigned to atezolizumab had fewer treatment-related adverse events and treatment-related deaths. Evidence Rating Level: 1 (Excellent) Study Rundown: Prior first-line trials in advanced non-small-cell lung cancer (NSCLC) lacked representation for older or patients with reduced fitness. Data surrounding treatment safety and efficacy for advanced NSCLC remains scarce. This randomized controlled trial aimed to compare the safety and efficacy of atezolizumab monotherapy with single-agent chemotherapy for patients with NSCLC who were ineligible for platinum-based chemotherapy...
August 15, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001378/perioperative-nivolumab-and-chemotherapy-in-stage-iii-nsclc
#19
SUMMARY
Daniel Goldshtein, Sze Wah Samuel Chan
1. The pathological complete response rate for the experimental group was improved compared to the control group. 2. Progression-free survival and overall survival at 24 months were also improved in the experimental group with HR 0.47 and 0.43 respectively. Evidence Rating Level: 1 (Excellent) Study Rundown: The optimal treatment for non-small-cell lung cancer (NSCLC) diagnosed at stage IIIA or IIIB remains uncertain. Recent trials (NADIM, CheckMate 816) demonstrated the benefits of combining chemotherapy and immunotherapy, prompting this study (NADIM II) to compare nivolumab-platinum chemotherapy neoadjuvant treatment followed by adjuvant nivolumab, against standard neoadjuvant chemotherapy in resectable stage IIIA/IIIB NSCLC patients...
August 14, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001377/the-addition-of-neoadjuvant-and-adjuvant-pembrolizumab-to-standard-chemotherapy-and-surgery-may-improve-outcomes-in-patients-with-early-stage-non-small-cell-lung-cancer
#20
SUMMARY
Kassandra McFarlane, Sze Wah Samuel Chan
1. At 24 months, more participants in the pembrolizumab group were alive without an event, compared with the placebo group. 2. 24-month survival in the pembrolizumab group was 80.9% as compared to 77.6% of placebo group patients. Evidence Rating Level : 1 (Excellent) Study Rundown: Standard treatments for advanced non-small-cell lung cancer (NSCLC) includes programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) immune checkpoint inhibitors. In recent studies, it has been shown that the addition of pembrolizumab, a monoclonal antibody that binds PD-1, improved outcomes...
August 14, 2023: 2 Minute Medicine
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