Cancer patient – Parentraide Cancer http://parentraide-cancer.org/ Sat, 18 Sep 2021 19:51:13 +0000 en-US hourly 1 https://wordpress.org/?v=5.8 https://parentraide-cancer.org/wp-content/uploads/2021/06/icon.png Cancer patient – Parentraide Cancer http://parentraide-cancer.org/ 32 32 In cervical cancer, the new first-line SOC may be pembrolizumab / chemo with or without bevacizumab https://parentraide-cancer.org/in-cervical-cancer-the-new-first-line-soc-may-be-pembrolizumab-chemo-with-or-without-bevacizumab/ https://parentraide-cancer.org/in-cervical-cancer-the-new-first-line-soc-may-be-pembrolizumab-chemo-with-or-without-bevacizumab/#respond Sat, 18 Sep 2021 19:25:37 +0000 https://parentraide-cancer.org/in-cervical-cancer-the-new-first-line-soc-may-be-pembrolizumab-chemo-with-or-without-bevacizumab/ In the population of all arrivals, the median PFS was 10.4 months (95% CI, 9.1-12.1) in the investigation arm vs. 8.2 months (95% CI, 6, 4-8.4) in the control arm (RR: 0.65; 95% CI, 0.53-0.79; P]]>

In the population of all arrivals, the median PFS was 10.4 months (95% CI, 9.1-12.1) in the investigation arm vs. 8.2 months (95% CI, 6, 4-8.4) in the control arm (RR: 0.65; 95% CI, 0.53-0.79; P <.001). The median OS in this population was 24.4 months (19.2 - NR) with pembrolizumab versus 16.5 months (95% CI: 14.5-19.4) with placebo (RR: 0.67 ; 95% CI: 0.54-0.84; P <.001).

In the group of patients with a PD-L1 CPS of 10 or greater, the median PFS with pembrolizumab plus chemotherapy with or without bevacizumab was 10.4 months (95% CI, 8.9-15.1) vs.8, 1 month (95% CI, 6.2-8.8) with chemotherapy with or without bevacizumab (RR: 0.58; 95% CI: 0.44-0.77; P <.001). The median OS was also NR (95% CI, 19.1-NR) in the investigation arm versus 16.4 months (95% CI, 14.0-25.0) in the control arm (RR: 0.61; 95% CI: 0.44-0.84; P = .001).

“Adding pembrolizumab to chemotherapy with or without bevacizumab offers statistically significant and clinically significant improvements in PFS and OS in patients with persistent, recurrent or metastatic cervical cancer. The significant benefit was observed in all populations of primary analysis and was generally consistent across all subgroups specified in the protocol ”, lead study author Nicoletta Colombo, MD, PhD, director of the oncology division gynecologist at the European Institute of Oncology and associate professor of obstetrics and gynecology at the University of Milan-Bicocca in Milan, Italy, said in a presentation of the results. “Overall, data from KEYNOTE-826 suggests that pembrolizumab plus platinum-based chemotherapy with or without bevacizumab may be a new standard of primary care for treatment. [of these patients]. “

Platinum-based chemotherapy has served as standard treatment for patients with persistent, recurrent, or metastatic cervical cancer, with the preferred regimen being platinum, paclitaxel, and bevacizumab. Although PD-1 inhibitors, such as pembrolizumab and cemiplimab (Libtayo), have already been shown to be effective in patients with previously treated cervical cancer, no data are available to indicate whether the addition from a PD-L1 inhibitor to chemotherapy with or without bevacizumab would improve outcomes.

To this end, the researchers initiated the KEYNOTE-826 double-blind trial, which recruited patients with persistent, recurrent, or metastatic cervical cancer that was not amenable to curative treatment.

Eligible patients had to have an ECOG performance index of 0 or 1 and could not have previously received systemic chemotherapy. However, prior radiotherapy and chemoradiotherapy were permitted.

A total of 617 participants were randomized 1: 1 to receive pembrolizumab 200 mg intravenously (IV) every 3 weeks for up to 35 cycles plus paclitaxel and cisplatin or carboplatin every 3 weeks for up to 6 cycles with or without bevacizumab IV at 15 mg / kg every 3 weeks (n = 308) or placebo plus chemotherapy with or without bevacizumab at the same dose and at the same schedule (n = 309).

Stratification factors included metastatic disease at diagnosis (yes vs. no), CPS PD-L1 (<1 vs. 1 to <10 vs. ≥10), and intended use of bevacizumab (yes vs. no).

The two primary endpoints of the study were OS and PFS assessed by the investigator according to the RECIST v1.1 criteria; the main secondary endpoints included overall response rate (ORR), duration of response (DOR), PFS at 12 months, and safety. Patient Reported Outcomes (PRO) were assessed using the EuroQoL EQ-5D-5L Visual Analog Scale (VAS) score and served as an exploratory endpoint.

The benefit of PFS and OS of adding pembrolizumab was evaluated sequentially in 3 patient populations: those with a PD-L1 CPS of 1 or greater, all newcomers, and those with a PD-L1 CPS of 10. or more. The overall alpha was controlled at 2.5% one-sided for the 6 main assumptions and all planned analyzes. The statistical analysis plan allows 2 intermediate analyzes before a final analysis.

The first interim analysis was to take place when approximately 370 events of disease progression or death have been reported in the patient population with a PD-L1 CPS of 1 or greater. At that time, all primary hypotheses had to be tested, Colombo noted.

As of the data cut-off date of May 3, 2021, 307 patients in the investigation arm and 309 patients in the control arm have received treatment.

“The median length of follow-up was almost 3 years, and approximately twice as many patients in the pembrolizumab arm continued or completed study treatment,” Colombo said.

The baseline characteristics in the all-rounder CPS and PD-L1 subassemblies were well balanced between the 2 treatment arms, Colombo added.

Among the all-comer population, the median age between the arms was 50.5 years (range, 22-82). In addition, 43.3% of patients had an ECOG performance index of 1, 72.3% had squamous cell disease, and 48.3% had previously received radiochemotherapy or radiotherapy.

At initial diagnosis, 30.8% of patients had stage IVB disease and 19.8% had metastatic disease at the time of entry into the study. Regarding PD-L1 status, 51.4% of patients had a CPS of 10 or more, 37.4% had a CPS between 1 and 10 and 11.2% had a CPS less than 1. Bevacizumab has been used in 63.1% of patients during the study. .

Additional data reported at the meeting showed that the 12-month PFS rates in the investigation and control arms in the subset of patients with a PD-L1 CPS of 1 or greater were 45.5 % (95% CI, 39.2% to 51.5%) and 34.1% (95% CI, 28.3% to 40.0%), respectively. In the population of all arrivals, these rates were 44.7% (95% CI, 38.8% to 50.4%) and 33.5% (95% CI, 28.0% to 39 , 1%), respectively. Finally, in the subset of patients with a PD-L1 CPS of 10 or greater, these rates were 44.6% (95% CI, 36.3% to 52.5%) and 33.5%, respectively. % (95% CI, 25.9% to 41.2%).

“The benefit of adding pembrolizumab was generally consistent across all subgroups specified in the protocol, with all HR favoring the pembrolizumab arm and all overlapping 95% CIs,” Colombo said.

SG benefit from adding pembrolizumab was generally consistent across all subgroups specified by the protocol. Notably, the HR favored the addition of pembrolizumab to the two bevacizumab subgroups, suggesting that adding immunotherapy to chemotherapy is beneficial whether or not patients can receive bevacizumab, Colombo said. .

“The relative OS benefit observed in the pembrolizumab arm appeared to increase with increasing PD-L1 expression and the HR for the PD-L1 negative population was 1.00,” Colombo added. “But, given the relatively small sample size of this subgroup and the overall study design, strong conclusions regarding the efficacy of pembrolizumab plus chemotherapy with or without bevacizumab in patients with PD tumors -L1 negative cannot be drawn. “

Addition of pembrolizumab to chemotherapy with or without bevacizumab also improved ORRs compared to placebo plus chemotherapy with or without bevacizumab in the 3 primary analysis populations.

In the subset of patients with a PD-L1 CPS of 1 or greater, the ORR in the investigative arm was 68.1% (95% CI, 62.2% to 73.6%) versus 50 , 2% (95% CI, 44.1 to 56.2%) in the control arm, with a median duration of response (DOR) of 18.0 months (range, 1.3+ to 24.2+) vs 10.4 months (range, 1.5+ to 22.0+), respectively.

In the population of all arrivals, the ORRs were 65.9% (95% CI, 60.3% -71.2%) versus 50.8% (95% CI, 45.1% to 56, 5%), respectively, with the same median DORs as reported in PD-L1 CPS of 1 or more subset. Finally, in the group of patients with a PD-L1 CPS of 10 or greater, the ORRs were 69.6% (95% CI, 61.8% to 76.7%) vs 49.1% (CI to 95%, 41.1% to 57.1%), respectively, with median RORs of 21.1 months (range, 1.3+ to 24.2+) versus 9.4 months (range, 2.1+ at 21.5+), respectively.

Investigators collected information about OWPs throughout the treatment of the trial. The time to deterioration of the EQ-5D-5L VAS score was improved in the pembrolizumab arm, with an HR of 0.75 (95% CI, 0.58-0.97). According to Colombo, the median time to deterioration was not reached in the investigation arm compared to 7.7 months in the control arm.

The safety profile of the pembrolizumab regimen was manageable. The incidence of all-cause, treatment-related or Grade 3 or more serious adverse reactions (AEs) were all numerically higher in the immunotherapy arm, but patients receiving pembrolizumab were generally on treatment longer than those receiving pembrolizumab. receiving the placebo, according to Colombo.

“About a third of patients in the pembrolizumab arm discontinued any component of treatment due to an AE,” Colombo said. “The incidence of AEs leading to death was similar in the treatment arms. As expected, the incidence of immune-related AEs was higher in the pembrolizumab arm.

The most frequently reported all-cause AEs in the investigation and control arms included anemia (61.2% vs. 53.4%, respectively), alopecia (56.4% vs. 57.9%) , nausea (39.7% vs. 43.7%), diarrhea (35.5% vs. 29.8%) and fatigue (28.7% vs. 27.2%), among others. The most common immune-mediated AEs were hypothyroidism (18.2% vs. 9.1%) and hyperthyroidism (7.5% vs. 2.9%).

Reference
Colombo N, Dubot C, Lorusso D, et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for persistent, recurrent or metastatic cervical cancer: randomized, double-blind phase 3 study, KEYNOTE-826. Presented at: ESMO 2021 Congress; September 16-21, 2021; virtual. Abstract LBA2_PR.


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Cancer patient speaks out after cyber attack delays treatment by months https://parentraide-cancer.org/cancer-patient-speaks-out-after-cyber-attack-delays-treatment-by-months/ https://parentraide-cancer.org/cancer-patient-speaks-out-after-cyber-attack-delays-treatment-by-months/#respond Sat, 18 Sep 2021 05:31:00 +0000 https://parentraide-cancer.org/cancer-patient-speaks-out-after-cyber-attack-delays-treatment-by-months/ A young woman who returned home to Ireland after Australian doctors gave her only five months to live suffered ‘disaster after disaster’ under her care due to the HSE cyberattack. Meabh Feerick, only 25, and mother of 3-year-old Noah, brought home cancer treatment scans on a USB drive, but doctors were unable to access the […]]]>

A young woman who returned home to Ireland after Australian doctors gave her only five months to live suffered ‘disaster after disaster’ under her care due to the HSE cyberattack.

Meabh Feerick, only 25, and mother of 3-year-old Noah, brought home cancer treatment scans on a USB drive, but doctors were unable to access the device due to the impact of the cyber attack that crippled HSE systems for months. This meant they couldn’t gauge how quickly the cancer was getting worse.

Then, after having re-tested at Mayo University Hospital (MUH), she was transferred to Galway University Hospital (GUH), but doctors were unable to access either series of analyzes.

“I have my son to think about …”

She called the delays “frightening” and said: “It is horrible to say that when I come home to my own country, this is happening.”

Ms Feerick said there is no cure for the aggressive genetic melanoma she suffers from, but she desperately wants to know how much time she spends with her son:

Everything has been affected. My scans are what tell us how far we are on the path. When they’re not over, then I’m in the dark. It’s hard for me, because I have my son to think about.

Ms. Feerick speaks out because she desperately wants to change the system.

“If I can make a difference somewhere, I can be reassured. I’m haunted that a child or an elderly person has to go through this same system, ”she said.

“My scans are what tell us how far we are on the path. When they haven’t finished I’m in the dark, ”says Meabh Feerick pictured with her son Noah in better times.

Rachel Morrogh, director of advocacy for the Irish Cancer Society (ICS), warned that many people could be affected by the disruption to health systems in the past 18 months:

Our biggest concern is that the issues highlighted by Maebh Feerick could become all too common since the start of the pandemic and the cyberattack that followed.

Ms Feerick was diagnosed in December following delays as community doctors didn’t realize how sick she was. After a series of surgeries and treatments in Sydney, doctors found that she did not have long to live and advised her to return home quickly.

However, when Ms Feerick arrived in mid-June, she entered an HSE under attack by cyber hackers, as well as the impact of Covid-19.

When she was seen at MUH in mid-July, she said: “They said they had no imagery, they said they would have to start this whole process over. I was told that whatever I brought home was more or less unnecessary. I was pushed back further.

Hospital could not access scans due to hack

She was told new scans could take up to two months, but she had them done earlier as a patient in Mayo when her condition worsened. When her care was transferred to Galway’s largest hospital, she was devastated to learn in mid-August that they could not access scans performed by their partner hospital.

“The hospitals would surely have a daily courier service. It’s been months now since the cyberattack, you’d think they’d have a system, ”she said.

New scans, some of which were only seen by her oncologist last week, show cancer continues to spread through her bones. Her spine is affected and there are fears for her brain, she said.

“I want to stress that there is a long wait for everything,” she said. “People are waiting for scans, waiting for results, waiting for appointments, everything is waiting.”

Priority systems “are back online”

Each nurse appears to do the work of five people, she said, praising the staff who treated her at both hospitals and at Mayo Hospice.

A spokeswoman for the Saolta hospital group said they could not comment on the individual care.

Meabh Feerick plays with his son Noah.
Meabh Feerick plays with his son Noah.

“The priority within the HSE is to ensure that patient services are fully functional,” she said.

“Most Priority Systems” are back online, including radiology and diagnostics.

The Irish Cancer Society fears that the health service is “losing hard-earned gains” as a result of improvements made to cancer services so far.

“We are sorry to hear of Maebh’s experience since returning to Ireland and our hearts go out to her and her son Noah,” Ms. Morrogh said.

“Clinicians tell us that they are seeing more advanced cancers because of delays in accessing services.


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Carboplatin Added to Paclitaxel Confers EFS Benefit in Triple Negative Breast Cancer https://parentraide-cancer.org/carboplatin-added-to-paclitaxel-confers-efs-benefit-in-triple-negative-breast-cancer/ https://parentraide-cancer.org/carboplatin-added-to-paclitaxel-confers-efs-benefit-in-triple-negative-breast-cancer/#respond Fri, 17 Sep 2021 19:38:11 +0000 https://parentraide-cancer.org/carboplatin-added-to-paclitaxel-confers-efs-benefit-in-triple-negative-breast-cancer/ September 17, 2021 3 minutes to read Source / Disclosures Published by: Source: Loibl S, et al. Abstract 119O. Presented at: Congress of the European Society of Medical Oncology (virtual meeting); September 17-21, 2021. Disclosures: AbbVie funded this study. Loibl reports relationships with AbbVie and several other pharmaceutical companies. Please see the summary for relevant […]]]>

September 17, 2021

3 minutes to read

Source / Disclosures

Source:

Loibl S, et al. Abstract 119O. Presented at: Congress of the European Society of Medical Oncology (virtual meeting); September 17-21, 2021.

Disclosures: AbbVie funded this study. Loibl reports relationships with AbbVie and several other pharmaceutical companies. Please see the summary for relevant financial information from all researchers. Healio could not confirm the financial information relevant to


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Addition of carboplatin to paclitaxel improved the complete pathological response and SES without an increase in secondary malignancies in patients with triple negative breast cancer, results from randomized phase 3 trials have shown.

Adding the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to the combination, however, did not increase benefit, according to long-term data from the BrighTNess trial presented at the congress of the ‘ESMO.

Addition of carboplatin to paclitaxel improved the complete pathological response and SES.
Data derived from Loibl S, et al. Abstract 119O. Presented at: Congress of the European Society of Medical Oncology (virtual meeting); September 17-21, 2021.

“These results generally support the inclusion of carboplatin in neoadjuvant chemotherapy for stage II and III tri-negatives. [patients with breast cancer], whatever the germline BRCA status,” Sibylle Loibl, MD, PhD, CEO and Chairman of the German Breast Group and Associate Professor at the University of Frankfurt, said during his presentation.

Sibylle Loibl, MD, PhD

Sibylle Loibl

Previous results from the BrighTNess trial have shown that the addition of carboplatin to neoadjuvant chemotherapy, with or without veliparib (ABT-888, AbbVie), conferred a higher rate of complete pathological response with acceptable safety in patients with the disease. operable triple negative breast cancer.

During ESMO, Loibl reported EFS and OS data – as well as second malignancies, such as acute myeloid leukemia or myelodysplastic syndrome – after at least 4 years of follow-up.

The trial included 634 patients with untreated stage II to III triple negative breast cancer. The researchers randomly assigned the 2: 1: 1 patients to 12 weekly doses of 80 mg / m2 paclitaxel plus carboplatin area under the curve 6 mg / mL every 3 weeks for four cycles and veliparib 50 mg orally twice daily (n = 316); paclitaxel plus carboplatin and placebo (n = 160); or paclitaxel plus placebo (n = 158). The patients then received doxorubicin and cyclophosphamide in four cycles every 2 to 3 weeks.

Pathologic complete response was used as the primary endpoint, with EFS and OS as secondary endpoints. A fixed test process evaluated the paclitaxel-carboplatin-veliparib combination first against paclitaxel, then against paclitaxel and carboplatin.

Researchers assessed efficacy in all patients and safety in those who received at least one dose.

The median follow-up was 4.5 years.

Results showed 4-year SES rates of 78.2% (95% CI, 73.5-83.2) with paclitaxel, carboplatin and veliparib, 79.3% (95% CI , 72.9-86.2) with paclitaxel and carboplatin and 68.5% (95% CI, 61.3-76.6) with paclitaxel alone. The RRs for SES were 0.63 (95% CI, 0.43-0.92) with the combination of three drugs versus paclitaxel and 1.12 (95% CI, 0.72-1, 72) with the combination of three drugs against paclitaxel and carboplatin. Post hoc analysis showed an RR for EFS of 0.57 (95% CI, 0.36-0.91) with paclitaxel and carboplatin compared to paclitaxel.

“Patients with a complete pathological response had significantly better SES, and this was similar regardless of the germline BRCA status, ”Loibl said during the presentation.

Researchers reported low mortality rates in all three treatment groups (12% with the combination of three drugs, 10% with paclitaxel and carboplatin, and 14% with paclitaxel alone). The RRs for OS were 0.82 (95% CI, 0.48-1.38) with the combination of three drugs versus paclitaxel, 1.25 (95% CI, 0.7-2, 24) with the combination of three drugs against paclitaxel and carboplatin, and 0.63 (95% CI, 0.33-1.21) with paclitaxel and carboplatin compared to paclitaxel.

One patient who received the combination of the three drugs and another who received paclitaxel developed only myelodysplastic syndrome, compared to no patient in the paclitaxel-carboplatin group. Six patients in each of the carboplatin groups developed a second malignant tumor compared to four patients in the paclitaxel group. The second most common malignancy was AML (0.6% in the three-drug group; 1.9% in the two-drug group; 0.6% in the paclitaxel alone group).

Monique Arnedos

Monique Arnedos

“For those [patients with triple-negative breast cancer] which require chemotherapy, carboplatin should be added to the treatment ”, invited the speaker. Monica Arnedos, MD, PhD, assistant professor in the department of medical oncology at the Gustave Roussy Institute in France, said immediately after the presentation. “Soon we should also add pembrolizumab [Keytruda, Merck], both based on the results of the BrightTness study we saw today and the KEYNOTE-522 trials. “


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Study highlights importance of deeply exploring immune responses to cancer https://parentraide-cancer.org/study-highlights-importance-of-deeply-exploring-immune-responses-to-cancer/ https://parentraide-cancer.org/study-highlights-importance-of-deeply-exploring-immune-responses-to-cancer/#respond Fri, 17 Sep 2021 00:28:00 +0000 https://parentraide-cancer.org/study-highlights-importance-of-deeply-exploring-immune-responses-to-cancer/ Over the past decade, scientists have explored vaccination as a way to fight cancer. These experimental cancer vaccines are designed to stimulate the body’s own immune system to destroy a tumor, by injecting fragments of cancer proteins found on the tumor. So far, none of these vaccines have been approved by the FDA, but some […]]]>

Over the past decade, scientists have explored vaccination as a way to fight cancer. These experimental cancer vaccines are designed to stimulate the body’s own immune system to destroy a tumor, by injecting fragments of cancer proteins found on the tumor.

So far, none of these vaccines have been approved by the FDA, but some have shown promise in clinical trials to treat melanoma and certain types of lung cancer. In a new finding that could help researchers decide which proteins to include in cancer vaccines, MIT researchers have found that vaccination against certain cancer proteins can stimulate the overall response of T cells and help shrink tumors in the patient. mouse.

The research team found that vaccination against the types of proteins they identified can help awaken populations of dormant T cells that target these proteins, thereby boosting the overall immune response.

This study highlights the importance of exploring in depth the details of immune responses to cancer. We can now see that not all anti-cancer immune responses are created equal and that vaccination can elicit a potent response against a target that would otherwise have been ignored. ”

Tyler Jacks, Professor of Biology David H. Koch, Fellow of the Koch Institute for Integrative Cancer Research and lead author of the study

MIT postdoctoral fellow Megan Burger is the lead author of the new study, which appears today in Cell.

Competition of T cells

When cells start to become cancerous, they begin to produce mutated proteins that are not seen in healthy cells. These cancerous proteins, also called neo-antigens, can alert the body’s immune system that something is wrong, and the T cells that recognize these neo-antigens start destroying the cancer cells.

Eventually, these T cells undergo a phenomenon known as “T cell depletion,” which occurs when the tumor creates an immunosuppressive environment that turns off the T cells, allowing the tumor to grow unchecked.

Scientists hope cancer vaccines could help rejuvenate these T cells and help them attack tumors. In recent years, they have worked on the development of methods for identifying neo-antigens in patients’ tumors for integration into personalized cancer vaccines. Some of these vaccines have shown promise in clinical trials to treat melanoma and non-small cell lung cancer.

“These therapies work surprisingly in a subset of patients, but the vast majority still don’t respond very well,” Burger said. “A lot of the research in our lab is trying to understand why and what we can do therapeutically to get more of these patients to respond. “

Previous studies have shown that of the hundreds of neo-antigens found in most tumors, only a small number generate a T-cell response.

The new study from MIT helps to understand why. In studies of mice with lung tumors, researchers found that as T cells targeting tumors appear, subsets of T cells that target different cancer proteins compete with each other, ultimately leading to the emergence a dominant population of T cells. Once these T cells are depleted, they still remain in the environment and suppress any competing T cell populations that target different proteins present on the tumor.

However, Burger found that if she vaccinated these mice with one of the neoantigens targeted by the suppressed T cells, she could rejuvenate these T cell populations.

“If you vaccinate against antigens that have suppressed responses, you can trigger those T cell responses,” she says. “Trying to identify these suppressed responses and target them specifically could improve patient responses to vaccine therapies.”

Shrinkage of tumors

In this study, the researchers found that they were most successful when immunizing with neoantigens that bind weakly to immune cells responsible for presenting the antigen to T cells. ‘one of these neo-antigens to vaccinate mice with lung tumors, they found that the tumors had shrunk by an average of 27%.

“T cells proliferate more, they target tumors better, and we are seeing an overall decrease in lung tumor burden in our mouse model following therapy,” says Burger.

After vaccination, the T cell population included a type of cells that have the potential to continuously fuel the response, which could allow long-term control of a tumor.

In future work, researchers hope to test therapeutic approaches that combine this vaccination strategy with anti-cancer drugs called checkpoint inhibitors, which can dampen depleted T cells, stimulating them to attack tumors. In support of this approach, the results released today also indicate that vaccination increases the number of a specific type of T cells that have been shown to respond well to checkpoint therapies.

Source:

Massachusetts Institute of Technology

Journal reference:

Burger, ML, et al. (2021) Antigen dominance hierarchies shape T cell phenotypes of the CD8 TCF1 + progenitor in tumors. Cell. doi.org/10.1016/j.cell.2021.08.020.


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Immunotherapy offers some small cell lung cancer patients ‘ray of hope’, expert says https://parentraide-cancer.org/immunotherapy-offers-some-small-cell-lung-cancer-patients-ray-of-hope-expert-says/ https://parentraide-cancer.org/immunotherapy-offers-some-small-cell-lung-cancer-patients-ray-of-hope-expert-says/#respond Wed, 15 Sep 2021 19:00:40 +0000 https://parentraide-cancer.org/immunotherapy-offers-some-small-cell-lung-cancer-patients-ray-of-hope-expert-says/ According to an expert from City of Hope, recent developments in immunotherapy treatment have given patients with advanced small cell lung cancer something to trust. “In practice for 30 years, we haven’t really seen this kind of progress in small cell lung cancer compared to non-small cell lung cancer”, Dr Ravi Salgia, medical oncologist and […]]]>

According to an expert from City of Hope, recent developments in immunotherapy treatment have given patients with advanced small cell lung cancer something to trust.

“In practice for 30 years, we haven’t really seen this kind of progress in small cell lung cancer compared to non-small cell lung cancer”, Dr Ravi Salgia, medical oncologist and Arthur Chair and Rosalie Kaplan in Medical Oncology in City of Hope, Calif., at the CURE® Educated Patient® Lung Cancer Summit. “But immunotherapy now gives us a silver lining, or a light at the end of the tunnel.”

However, as Salgia suggested, more research is still needed to further develop treatment options for patients with limited (confined) and extensive (metastatic) small cell lung cancer.

“I think we shouldn’t be happy with what we have for small cell lung cancer… we know we can do better,” he exclaimed. “How to do better? We have to go back to the lab; I cannot stress enough that lung cancer research needs to be supported.

During the summit, Salgia highlighted advances in the first and second line treatment of small cell lung cancer. He noted that small cell lung cancer, which accounts for about 15% of lung cancer diagnoses, can be fast growing, aggressive, and sometimes difficult to treat.

First-line treatment options

Salgia explained that while the disease can be difficult to treat, limited-stage and extended-stage disease should be treated differently.

For example, treatment of limited-stage small cell lung cancer may include the combination of chemotherapy drugs, such as etoposide and cisplatin. This combination would be administered in moderately intensive doses, according to Salgia, however no benefit is seen after four to six cycles of treatment.

Another treatment option is radiation therapy, which Salgia said “incredibly important”. It can improve local disease control and, he noted, can increase 2-3 year survival rates by 5%. It is most effective when given early and with chemotherapy, however, some studies show increased toxicity.

Salgia also mentioned prophylactic cranial radiation therapy, which has been effective in preventing cancer from spreading to the brain.

For late stage disease, some of the combination therapies include:

  • Tecentriq (Atezolizumab) plus carboplatin plus etoposide with maintenance Tecentriq
  • Imfinzi (Durvalumab) plus carboplatin / cisplatin plus etoposide with maintenance Imfinzi
  • Carboplatin / cisplatin plus etoposide
  • Carboplatin / cisplatin plus Onivyde (irinotecan)

Small cell lung cancer may respond to initial treatment with chemotherapy and radiation therapy, but recurrence is an important issue to highlight, Salgia noted. After the first-line treatment is finished, there are still some persistent cancer cells that can grow over time. Five-year survival rates for patients with limited-stage disease hover around about 20% to 30%, and are only about 2% to 6% for disease at an extended stage. Most patients in this population, Salgia noted, relapse with a poor prognosis.

Second-line treatment options

Before starting second-line treatment, it is necessary to identify where a patient’s disease has progressed since their last treatment and what options are available.

One of the most recent second-line treatment options approved for patients with metastatic disease, according to Salgia, was Zepzelca (lurbinectin). This was approved based on the results of a trial which demonstrated that the drug induced an overall response rate of 35.2% (a percentage of patients with a partial or complete response to treatment) in patients with platinum sensitive and resistant or relapsing small cell lung cancer. .

He noted that ongoing trials are currently testing whether Zepzelca is effective as a first-line therapy or in combination with other therapies.

Hope for the future

Salgia also stressed the importance of signing up for clinical trials as more information can be gathered and this creates hope for the future.

“A lot of people are doing great research to be able to help patients with small cell lung cancer,” he said. “And (the doctors) want to make sure that we can come up with great therapies like the ones we have for some of the non-small cell lung cancers, and we shouldn’t stand still until we find that. . “

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Osceola Student Founds ‘Chemo Strong’ to Help Cancer Patients | New https://parentraide-cancer.org/osceola-student-founds-chemo-strong-to-help-cancer-patients-new/ https://parentraide-cancer.org/osceola-student-founds-chemo-strong-to-help-cancer-patients-new/#respond Sat, 11 Sep 2021 14:40:00 +0000 https://parentraide-cancer.org/osceola-student-founds-chemo-strong-to-help-cancer-patients-new/ Kalley Smith’s mother, Amy, has undergone 16 cycles of chemotherapy and 28 cycles of radiation therapy since being diagnosed with breast cancer in September 2019. After watching her mother struggle for treatment and rehabilitation, Kalley has decided she needed to help other cancer patients. When she was a junior at OHS, she took a course […]]]>

Kalley Smith’s mother, Amy, has undergone 16 cycles of chemotherapy and 28 cycles of radiation therapy since being diagnosed with breast cancer in September 2019. After watching her mother struggle for treatment and rehabilitation, Kalley has decided she needed to help other cancer patients. When she was a junior at OHS, she took a course called “Why Wait” which helps motivate students to tackle a problem or issue they are passionate about. Kalley knew straight away that she would dedicate her time to helping people with cancer.

Over the past year, Kalley has raised funds to provide cancer care bags to patients at the Sainte-Croix Regional Medical Center (SCRMC). The bags contain things like hard candy, lotion, lip balm, puzzle books, and other items that make chemotherapy a bit easier.

Kalley decided to raise $ 1,200 and make 100 bags when she started. To date, she has raised over $ 3,000, purchased 120 bags and funded the purchase of a ceremonial bell that SCRMC cancer patients ring at the end of their last treatment.

The Sun sat down with Kalley and his mother Amy to discuss the project and all that Kalley has accomplished.

S: Tell me more about the ‘What Wait’ course. What did this involve and how did it influence your motivation to help others?

K: “Why wait? Is a course that offers the opportunity to study and tackle a subject that fascinates everyday students. Students then create a project that solves a problem related to their chosen topic by volunteering their time and contacting mentors. Without the “Why wait?” Platform, I would not have accomplished what I have today. Most of the help and advice I received was due to people in the community recognizing the name of the past years.

S: How did you decide what to put in the packaging, and was that also influenced by what you saw your mother go through?

K: One of my first project priorities was to speak with an expert who cares for cancer patients on a daily basis. My mom recommended one of her nurses at the St. Croix Falls infusion center. From there, I put together a list of questions; the most important being “which items do you think would be best to put in the packages?” The nurse gave me a great starting point on which to base my fundraising needs. Of course, I also asked my mom what she thought was worthy enough to be included in the packs, and she answered many of the same items. I also met community members along the way who recommended additional items that their loved ones appreciated during treatment. I added all the items that my funds allowed me for: blanket, water bottle, hard candy, hand warmers, journal, puzzle book, pen, mouthwash, brush soft toothbrush, hand sanitizer, lotion and balm stick.

S: How did you get the word out to help you raise money?

K: To start my fundraising journey, I created a GoFundMe page. From there, I shared it on social media so that my friends and family could contribute and share it even more. While it helped, a lot of the outreach was reaching out to small businesses and other authority figures who could help me sell fundraising items, like my Chemo Strong tumblers.

S: How long did it take to collect the money and how did it make you exceed your goal by so much?

K: The time between my first and last donation was around 8 months (October 2020 – May 2021). The fundraising process started slowly as I didn’t reach my initial goal of $ 1,200 until December. But, I swear he grew exponentially from there, thanks to a generous donation made by the Dresser Lions. By May, I had exceeded that number 2.5 times because I had raised over $ 3,000. To this day, I am more than speechless at the success I have had and I want to thank those who have contributed, because none of this would have been possible without you!

S: Where did the idea for the bell come from?

K: The idea for the bell only came from my mother. And it turns out I had a few hundred dollars that I hadn’t done anything with yet.

S: How did you feel about helping cancer patients after seeing your mom undergo chemotherapy, radiation therapy, and everything that goes with fighting cancer?

K: I am delighted to be able to help as many cancer patients as I have, because I have seen with my own eyes how frightening and even traumatic this journey can be.

S: If you don’t mind, briefly describe your own battle with cancer, when you were diagnosed, how long the treatment lasted and where you are today.

A: I was diagnosed with breast cancer in September 2019 and had a bilateral mastectomy in October. In November, I had a port placed for chemo, which started the day before Thanksgiving. I had 16 cycles of chemotherapy which lasted until April 2020. I started 28 cycles of radiation therapy in May and finished them at the end of June. In October 2020, I underwent reconstruction surgery. Today I’m fine. So far, I have no signs of the cancer coming back and I pray that it will stay that way. It has been a very long road.

Subject: After going through all of this, describe what it was like to see your daughter helping so many other people who were going through the same thing.

A: I am extremely proud of her !! She had a pretty high goal, and for her to exceed it by so much was incredible. She worked very hard on this project and was very passionate about it. It was fun to watch. She is an amazing young woman, with a heart of gold and she has proven it with what she has been able to accomplish. I hope she realizes how many lives she will touch and how she will make a difference for people at a very difficult time in their lives. After sitting in these chairs in the infusion center for hours on end while I received my chemotherapy treatments, I know firsthand how much others will appreciate her gift.


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Leading surgeon helps pancreatic cancer patients overcome obstacles https://parentraide-cancer.org/leading-surgeon-helps-pancreatic-cancer-patients-overcome-obstacles/ https://parentraide-cancer.org/leading-surgeon-helps-pancreatic-cancer-patients-overcome-obstacles/#respond Wed, 08 Sep 2021 17:01:57 +0000 https://parentraide-cancer.org/leading-surgeon-helps-pancreatic-cancer-patients-overcome-obstacles/ An internationally renowned pancreatic surgeon, surgical oncologist and cancer researcher Christopher Wolfgang, MD, PhD, joined NYU Langone Health in January. He is head of the new Hepatobiliary and Pancreatic Surgery Division in the Department of Surgery, after serving as Chief of Hepatobiliary and Pancreatic Surgery and Vice President of Surgical Oncology at Johns Hopkins Medicine. […]]]>

An internationally renowned pancreatic surgeon, surgical oncologist and cancer researcher Christopher Wolfgang, MD, PhD, joined NYU Langone Health in January. He is head of the new Hepatobiliary and Pancreatic Surgery Division in the Department of Surgery, after serving as Chief of Hepatobiliary and Pancreatic Surgery and Vice President of Surgical Oncology at Johns Hopkins Medicine.

Specializing in technically difficult cases, he has performed over 1,200 Whipple procedures, a complicated and high-risk surgical technique. This involves removing the head of the pancreas, part of the small intestine, gallbladder, and bile duct to preserve shared blood vessels, and then rebuilding a functioning digestive system. A luminary in the field of pancreatic cancer, his practice attracts patients from around the world whose tumors have previously been deemed inoperable.

You grew up on a farm in Pennsylvania. When you went to college, you started studying agriculture in the hopes of someday running the family business. What made you change course so drastically?

My father sent me to Penn State to study agricultural business. It was a big deal. I was the first Wolfgang in my immediate family to go to college. But I was not at all interested in the subject. I really wanted to study science and medicine. When I came home with a GPA of 1.86 in the first year, my parents gave me an ultimatum. They said, “Chris, you can study whatever you want, but you have to change your grades, or we’ll take you out of college.” I dove into science, and my grades skyrocketed after that. I loved the farm, and will always love it. It’s a part of our family. But my passion is medicine.

One quarter of pancreatic cancer patients die within one month of diagnosis and three quarters will die within one year. What drew you to a field with such overwhelming numbers?

When I started my training as a doctor-researcher, I knew I wanted to focus my efforts in an area where I could have the greatest impact. I am naturally drawn to and motivated by difficult challenges. Pancreatic cancer has dismal survival rates and receives far less attention than other cancers. It is also one of the most difficult cancers to treat surgically. So, of course, it was a natural fit.

You’ve performed over 1,200 Whipple procedures, a demanding, high-stakes surgery to excise pancreatic cancer. How did you develop a level of competence that attracts patients from all over the world?

There is a saying: “German for all trades, master of nothing. My philosophy is “Pick a thing or two and be the best at it.” I am like that with everything. Some people wonder how I can do the same operation over and over again. It’s because every time I complete an operation, I get a little better. Even after almost two decades in the operating room, I still feel like a better surgeon than a month ago.

“The majority of my patients have learned that surgery is not an option. It’s amazing when you can say, “I think we can get your tumor removed” or “We can give you a chance to be cured.” “

Because I deal with some of the more difficult, so-called “unresectable” cases, the majority of my patients have learned that surgery is not an option and that their tumors cannot be removed. I think about it as I finish an operation and send the tumor to the pathology lab. That sense of accomplishment and knowing that you’ve changed someone’s life never gets old. It’s amazing when you can say, “I think we can get your tumor removed” or “We can give you a chance to be cured.”

NYU Langone has one of the lowest death rates for the Whipple procedure. Why?

Studies show that pancreatic cancer patients have higher survival rates and fewer complications when they see a healthcare system that performs at least 10-20 Whipple procedures per year. This year alone, NYU Langone is expected to perform over 125 Whipple procedures.

It’s not just the surgeons’ experience and what we do in the operating room that matters, it’s the whole team, from anesthesia to nursing to the recovery room. We have the best and we all work together as one team to provide excellent patient care. We have assembled a multidisciplinary clinic that offers personalized medicine based on the very latest knowledge of the molecular biology of the patient’s tumor. We offer clinical trials and our innovative research translates into clinical advances. As Vince Lombardi once said, by pursuing perfection, we will catch excellence.

You spent 15 years with Johns Hopkins. Why join the NYU Langone Perlmutter Cancer Center?

Even though the standard of care for pancreatic cancer is excellent, the vast majority of patients still die. We will not turn the situation around unless we have a forward-looking approach to finding and treating the disease. At NYU Langone, pushing boundaries is part of the culture. I want to invent the future and set the global standard for pancreatic and hepatobiliary surgery, research and innovation.

My philosophy of taking calculated risks; seek pioneering and revolutionary solutions; and constantly questioning the status quo aligns with that of NYU Langone management. To paraphrase Wayne Gretzky, it’s not about where the puck is, but where it is heading. It means doing some things that at first may seem unconventional, but leadership understands that investing in innovation now will change the future.

How do you see the future of pancreatic cancer?

Two of the most important things that must happen to move the needle significantly are early detection and improved systemic control. My colleague Diane M. Simeone, MD, director of the Pancreatic Cancer Center at NYU Langone, focuses on early detection. Of the 60,000 cases of pancreatic cancer diagnosed each year, 80 percent are not eligible for surgery because the cancer is too advanced. Dr Simeone’s work will change this percentage.

However, we also need to break the biology of the disease. Even among the 20 percent of patients eligible for surgery, the tumor will rebound in 80 percent of these cases. Cancer is systemic, so it invariably spreads beyond the surgical site. The only way to cure this disease is to eradicate it systemically.

To that end, my research focuses on circulating tumor cells – what we call the seeds of metastases – and how cancer spreads. Even if we remove a tumor, we can still find these little seeds circulating throughout the body. If chemotherapy doesn’t kill them all, the disease rebounds. Understanding the biology of systemic disease is therefore one of the most important next steps in curing more people.

How long does it take for pancreatic cancer to metastasize?

Research shows that a tumor that develops in the pancreas can take 12 to 15 years to become invasive. If we can find and eliminate precancerous tumors within this window, we can potentially cure pancreatic cancer with surgery alone. The problem is that many early tumors are invisible. We cannot see them on the scans. We’re developing ways to find them in the blood, a diagnostic technique called a liquid biopsy. Tumors that can be detected on scans are called cystic neoplasms. Most of these lesions are benign, but 3-5% will undergo malignant transformation. The challenge with these types of tumors is figuring out which ones to watch for and which to remove surgically. So that’s another big area of ​​research.

Are there any particular risk factors for pancreatic cancer?

Most cases of pancreatic cancer are sporadic, which means they are caused by bad luck. Like all cancers, pancreatic cancer is induced by genes, but mutations occur in the adult cells of the pancreas, not in the sex cells which pass genes on from generation to generation. For example, as far as I know, I was not born with a mutation that predisposes me to pancreatic cancer, but I can get one.

“I am an optimist and optimist by nature. If I watch a game and my team loses 40 points, I always think to myself: “The game is not over yet. It’s the same attitude I have with my patients. We are always thinking about ways to beat cancer.

Germline mutations that create family reunification occur in less than 10 percent of cases. To better understand them, the Perlmutter Cancer Center is conducting a research project to sequence the DNA of patients with pancreatic cancer, then analyze these sequences for germline mutations. The other 90% of pancreatic cancer cases occur randomly or are due to hidden environmental exposures. For example, the incidence of pancreatic cancer is highest in the coal region of West Virginia, near where I grew up. It is therefore also essential to learn more about environmental factors.

You said the most important thing you can do for a patient, in addition to providing excellent clinical care, is to offer hope. What convinced you of this?

I develop a relationship with each of my patients. I am their doctor for life. I answer their emails. We are talking on the phone. Even patients who are now 15 years late will still see me once a year. These relationships are extremely important to me.

I am also an optimist and optimist by nature. If I watch a game and my team loses 40 points, I always think to myself: “The game is not over yet. I’m on the edge of my seat until the very end. It’s the same attitude I have with my patients. We never throw in the towel. We are always thinking about ways to beat cancer. We never give up.

At the same time, I am also a realist. When I see my patients for the first time, we chat for an hour. This is an opportunity for me to explain where we are and to prepare them for the hard road ahead. I tell them the odds are against us, but together we will fight anyway. I am with them. I master the technical aspects of my work. I have extensive knowledge of the disease and know when and how to operate.

But one of my most rewarding roles is as a cheerleader for my patients. If you take 100 people with localized pancreatic cancer, in 5 years 80 of those people won’t be here. But here’s the thing. We don’t know if you’re going to be in those 80s or 20s. I tell my patients, “Right now, I have no reason to believe that you won’t be in these 20. Go fight. and help you get through it every step of the way.


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HOPA Oncology Pharmacists Provide Chemotherapy Resources to Improve Patient Understanding and Outcomes | New https://parentraide-cancer.org/hopa-oncology-pharmacists-provide-chemotherapy-resources-to-improve-patient-understanding-and-outcomes-new/ https://parentraide-cancer.org/hopa-oncology-pharmacists-provide-chemotherapy-resources-to-improve-patient-understanding-and-outcomes-new/#respond Sat, 04 Sep 2021 10:00:00 +0000 https://parentraide-cancer.org/hopa-oncology-pharmacists-provide-chemotherapy-resources-to-improve-patient-understanding-and-outcomes-new/ MILWAUKEE, September 4, 2021 / PRNewswire-PRWeb / – The Hematology / Oncology Pharmacy Association (HOPA) has collaborated with the National Community Oncology Dispensing Association, Inc. (NCODA), the Oncology Nursing Society (ONS) and the Association of Community Cancer Centers ( ACCC) to launch a new intravenous cancer (IVE) treatment education website, ivcanceredsheets.com. Oncology pharmacists are encouraged […]]]>

MILWAUKEE, September 4, 2021 / PRNewswire-PRWeb / – The Hematology / Oncology Pharmacy Association (HOPA) has collaborated with the National Community Oncology Dispensing Association, Inc. (NCODA), the Oncology Nursing Society (ONS) and the Association of Community Cancer Centers ( ACCC) to launch a new intravenous cancer (IVE) treatment education website, ivcanceredsheets.com. Oncology pharmacists are encouraged to use the educational cards in discussions with people undergoing cancer treatment and their caregivers.

The website is a joint effort dedicated to being forward thinking and providing in-depth educational resources to improve treatment outcomes. The Intravenous Cancer Treatment Education website provides healthcare workers with the latest education material for intravenous cancer treatments, communicating vital information to help caregivers and people with cancer .

Sheets include common uses and treatment schedules, supportive medications, drug interactions, side effect management, and safe handling advice at home after treatment. Oncology professionals and caregivers can download several IVE files from the site library, which will continue to be updated by the collaborative. The sheets are also editable so that pharmacists can customize them according to an individual’s treatment plan.

The launch of the Online IV Cancer Treatment Education Sheets follows the success of the widely used online resource OCE (Oral Chemotherapy Education), which is also a collaborative initiative between NCODA, HOPA, ONS and ACCC. With a committee made up of representatives from each of the organizations, a development process is structured to produce reliable and reliable educational fact sheets that provide a solid amount of information on individual drugs and combined treatment regimens.

The Hematology / Oncology Pharmacies Association (HOPA) supports pharmacy professionals in hematology / oncology and promotes the role of the pharmacist in collaborative cancer management. Founded in 2004, HOPA provides crucial educational, networking and advancement opportunities frequently sought after by pharmacists, pharmacy interns, residents, fellows, students, technicians, researchers and administrators who specialize in in pharmacy in hematology / oncology. Her vision is to ensure that everyone affected by cancer has a hematology / oncology pharmacist as a full member of their care team.

Media contact

Michelle sieg, HOPA, 2625731085, msieg@hoparx.org

SOURCE HOPA


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High-intensity interval training helped men with localized prostate cancer improve cardiorespiratory fitness https://parentraide-cancer.org/high-intensity-interval-training-helped-men-with-localized-prostate-cancer-improve-cardiorespiratory-fitness/ https://parentraide-cancer.org/high-intensity-interval-training-helped-men-with-localized-prostate-cancer-improve-cardiorespiratory-fitness/#respond Wed, 01 Sep 2021 20:11:29 +0000 https://parentraide-cancer.org/high-intensity-interval-training-helped-men-with-localized-prostate-cancer-improve-cardiorespiratory-fitness/ High-intensity interval training resulted in decreased levels and rate of prostate specific antigen, as well as decreased growth of prostate cells in men with prostate cancer localized. Based on the results of the Phase 2 ERASE trial (NCT03203460) which was published in JAMA Oncology. Patients who adhered to the HIIT regimen had an increase in […]]]>

High-intensity interval training resulted in decreased levels and rate of prostate specific antigen, as well as decreased growth of prostate cells in men with prostate cancer localized.

Based on the results of the Phase 2 ERASE trial (NCT03203460) which was published in JAMA Oncology.

Patients who adhered to the HIIT regimen had an increase in peak oxygen uptake (VO2) of 0.9 ml / kg / min and the usual care group experienced a decrease of 0.5 ml / kg / min (adjusted mean difference between groups, 1.6 ml / kg / min (95% CI: 0.3-2.9; P = .01). Patients in the HIIT group experienced decreased PSA levels (-1.1 g / L; 95% CI, -2.1 to 0.0; P = 0.04), PSA rate (-1.3 g / L / year; 95% CI, -2.5 to -0.1; P = 0.04) and growth of LNCaP cells (-0.13 optical density unit; 95% CI, -0.25 to -0.02; P = .02). In addition, the researchers did not identify any statistically significant differences in the doubling time of PSA or testosterone. In addition to experiencing a significant increase in peak VO2 in liters per minute, patients in the HIIT cohort experienced upper body strength and lower body flexibility.

“To our knowledge, the ERASE trial was the first randomized clinical trial to examine the effectiveness of HIIT in men with localized prostate cancer under active surveillance. As we speculated, a 12-week supervised HIIT program significantly improved cardiorespiratory fitness and indicators of prostate cancer biochemical progression, ”the study investigators wrote.

The trial enrolled 52 eligible male patients, of whom 26 were randomized to the HIIT group and 26 to the usual care group. The mean age was 63.4 years and 89% (n = 46) of the patients identified as white. A total of 88% (n = 46) of patients completed the post-intervention peak VO2 assessment and 94% (n = 49) of patients completed the post-intervention blood test.

Baseline mean resistance exercise behavior was out of balance between groups, with the HIIT group using 18 (42) min / week and the usual care group using 44 (62) min / week, which was adjusted for the analyzes in because of the prognostic association with PSA and fitness outcomes.

This study was completed 2 weeks ahead of schedule at 10 weeks for the last 6 participants, 3 for each group, due to the impending closure of facilities during the COVID-19 outbreak.

Investigators reported a 100% adherence rate to intensity and duration, and patients attended 96% (n = 880) of the planned exercise sessions. A total of 15% (n = 8) of patients reported worsening of previous medical problems, including joint pain (n = 6), chest discomfort (n = 1), and dizziness (n = 1); the medical problems were related to HIIT. In addition, 1 patient reported gastric hemorrhage from a Dieulafoy lesion that was unrelated to HITT.

PSA doubling time was better in the HIIT group, although it did not reach statistical significance (adjusted mean difference between groups, 17.9 months; 95% CI, -3.8 to 39, 6; P = .10). The researchers did not identify an adjusted mean difference between the testosterone groups (1.0 nmol / L; 95% CI, -0.7 to 2.6; P = .24). Growth of LNCap cells was significantly inhibited in the HIIT group compared to the usual care group, the adjusted mean difference between groups being -0.13 optical density units (95% CI, -0.25 to – 0.02; P = .02; or -5.1%.

“These improvements appear to be significant and may translate into better outcomes for patients with prostate cancer who are managed by active surveillance,” the researchers concluded.

Reference

Kang DW, Fairey AS, Boulé NG, Field CJ, Wharton SA, Courneya KS. Effects of exercise on cardiorespiratory fitness and biochemical progression in men with localized prostate cancer under active surveillance: the ERASE randomized clinical trial. JAMA Oncol. Published online August 19, 2021. doi: 10.1001 / jamaoncol.2021.3067


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Investigation reveals disparities in practices and communication on brain metastases https://parentraide-cancer.org/investigation-reveals-disparities-in-practices-and-communication-on-brain-metastases/ https://parentraide-cancer.org/investigation-reveals-disparities-in-practices-and-communication-on-brain-metastases/#respond Sat, 28 Aug 2021 18:01:56 +0000 https://parentraide-cancer.org/investigation-reveals-disparities-in-practices-and-communication-on-brain-metastases/ “We conducted a large cross-sectional survey in which we compared the responses of physicians, caregivers and patients to identify areas for improvement in clinical care for brain metastases,” wrote the investigators led by Albert E. Kim, MD. “Our study is one of the first studies specifically designed for these patients, a unique population due to […]]]>

“We conducted a large cross-sectional survey in which we compared the responses of physicians, caregivers and patients to identify areas for improvement in clinical care for brain metastases,” wrote the investigators led by Albert E. Kim, MD. “Our study is one of the first studies specifically designed for these patients, a unique population due to their neurocognitive sequelae and limited prognosis.”

A total of 237 patients, 209 caregivers and 239 physicians responded to the survey. Most of the patients and caregivers were Caucasian, were young or middle-aged adults, and had a university education. Most of the physicians were male (89.9%) and Caucasian, with most (78.2%) reporting to be medical oncologists with 10 years or more of experience.

All patients had been diagnosed with brain metastases with histologically confirmed disease from any metastatic solid tumor. A caregiver was defined as “an adult individual (eg, family members, nurses), who was not a clinician, who provided support (eg, medical, financial, emotional, physical) to a patient with a confirmed diagnosis of brain metastases. “Physicians were classified as those who provided direct clinical care to patients with brain metastases.

A higher percentage of patients and caregivers reported a desire for increased discussion on these relevant issues related to the treatment of brain metastases compared to physicians. Patient / caregiver and physician respondents felt that a more in-depth discussion of the prognostic and therapeutic implications of brain metastases was preferred after a diagnosis of metastatic cancer. Common conversation points that patients and caregivers wanted more information about included brain metastasis survival rates, treatment options, and patient advocacy support.

Some of the most frequently asked questions by patients and their physicians’ caregivers after a diagnosis of brain metastases included worrisome symptoms, treatment options / successes, and impact on quality of life (QOL). Between 80% and 90% of patients felt that the information provided by physicians regarding social and financial support was useful. Doctors have often reported referring patients to support groups, published research, and online education tools.

When asked about their greatest concerns about a diagnosis of brain metastases, doctors said the subjects included neurological symptoms, treatment options / successes, and impact on patients’ quality of life as the most important. Compared to university physicians (30.9%), physicians affiliated with private practices (50.0%) were more concerned about a patient’s neurological symptoms (P = .019). On the other hand, academic physicians were more likely to be concerned about the state of published research and patient eligibility for clinical trials.

When it comes to treatment options, the clinical trial was one of the least recommended options among physicians and patients (23.0% vs. 17.9%, respectively). The most popular treatment options included stereotaxic radiosurgery, whole brain radiation therapy, and chemotherapy.

“It is essential that patients with brain metastases have more options for clinical trials,” said one of the study’s authors, Priscilla Brastianos, MD, associate professor of medicine and director of the CNS Metastasis Center at the Massachusetts General Cancer Center, in a press release.2 “Historically, patients with brain metastasis have been excluded from clinical trials. Broadening eligibility for all phases of clinical trials is critical to finding effective treatments for this population. “

Limitations of the study include a lack of diversity in the sample cohort, which may limit the generalizability of the results. The authors indicated that future research should include patients with both symptomatic and asymptomatic metastases as well as providers outside of medical oncology.

“Our hope is that these findings are a first step towards planning larger studies that identify survival issues for a specific subset within the brain metastasis population, assess the longitudinal impact of specific interventions on the quality of life of patients and obtain comments from other medical specialists. The results of these studies could inspire future quality improvement measures to improve specific aspects of the care of patients with brain metastases. These efforts will be instrumental in improving the outcome of severe disease, ”the researchers concluded.

The references

  • Kim AE, Wang GM, Waite KA, et al. Cross-sectional survey of patients, caregivers and doctors on the diagnosis and treatment of brain metastases. Neuro-Oncol practice.Published online July 13, 2021. doi: 10.1093 / nop / npab042
  • Investigation reveals disparities in care for patients with metastatic brain tumors. Press release. American Brain Tumor Association. August 24, 2021. Accessed August 27, 2021. https://prn.to/3sS6wMa


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