2 Minute Medicine ® - Surgery - Surgical Oncology

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. 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. 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. 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. 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...

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...

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...

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...

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...

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...

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...

1. 3-year invasive disease-free survival among the PET-based treatment group was 94.8%. 2. There were fewer treatment-related and serious adverse events among patients in the PET-based group compared to the non-PET-based group. Evidence Rating Level: 1 (Excellent) Study Rundown: Human epidermal growth factor receptor 2-positive (HER2-positive) breast cancers are associated with a high risk of recurrence and poor prognosis. Although developments in HER2-targeted therapies have improved survival among patients with HER2-positive breast cancer, many patients also receive chemotherapy which may increase the risk for adverse events...

1. Among patients on anticancer treatment with malignancy who were 75 years of age or older, the use of remote electronic patient-reported outcomes for monitoring had limited feasibility. 2. Feasibility was increased when considering only the subgroup of patients who agreed to test the web application, and not including the patients who declined. Evidence Rating Level: 2 (Good) In recent years, the use of telemedicine has expanded dramatically. Along with this has come many questions inquiring as to the efficacy of telemedicine and its feasibility...

1. The use of recombinant L-IFN adenovirus in patients with recurrent or refractory advanced solid tumours was well tolerated with few adverse events greater than Grade 3. 2. Recombinant L-IFN adenovirus injections showed preliminary efficacy against advanced solid tumours. Evidence Rating Level: 2 (Good) Oncolytic viruses are viruses that selectively induce cell lysis in tumour cells while preserving the health of normal cells. Prior studies have shown that the use of adenoviruses as a viral vector alone has limited efficacy in the management of tumours...

1. Overall response rate to afami-cel in both groups was 37%. 2. The majority of adverse-events were moderate in nature with no treatment-related deaths. Evidence Rating Level: 1 (Excellent) Study Rundown: Synovial sarcoma and myxoid round cell liposarcoma are rare, chemo-refractory malignancies with a poor prognosis once metastasized. Current treatment regimens are limited, and a more effective form of T-cell therapy is required. This randomized controlled trial aimed to evaluate the safety and efficacy of afamitresgene autocel (afami-cel), an autologous CD4+ and CD8+ T-cell therapy, in patients with HLA-A*02 and MAGE-A4-expressing synovial sarcoma and myxoid round cell liposarcoma...

1. The hazard ratio for recurrence or death comparing sentinel node biopsy only to completion axillary lymph node dissection was non-significant (0.89) and below the noninferiority margin. 2. The overall survival rates at 5 years were similar between both groups, 92.9% vs 92%. Evidence Rating Level : 1 (Excellent) Study Rundown : Previous studies have challenged the necessity of completion axillary lymph node dissection in breast cancer treatment in certain patients. This trial aimed to validate these findings while expanding eligibility criteria...

1. 18-month recurrence-free survival was significantly greater in the combination therapy group compared to pembrolizumab alone. 2. There were no treatment-related grade 4-5 adverse events or fatalities reported. Evidence Rating Level: 1 (Excellent) Study Rundown: Checkpoint inhibitors are now commonly used as adjuvant therapy for resected melanoma, yet recurrence remains a concern among many patients. mRNA-4157 (V940) is a novel individualized mRNA-based neoantigen therapy which may improve survival in high-risk melanoma patients, although further research is needed...