The addition of SBRT significantly delayed the onset of acquired resistance to EGFR-TKIs and prolonged the PFS and OS of patients. Radiotherapy of the primary lesion alone might be superior to metastatic sites.
https://www.thegreenjournal.com/article/S0167-8140(23)00219-0/fulltext
In men receiving radiation for intermediate risk prostate cancer, the addition of short term ADT reduces the risk of biochemical recurrence and distant metastasis at the cost of 6 months to a year of worse sexual and hormonal quality of life.
https://ascopubs.org/doi/full/10.1200/JCO.22.02389
In a huge public health shift, the USPSTF now agrees with the long-held stance of the American College of Radiology that screening mammography should begin every other year at age 40 (not 50) due to compounding evidence that it helps diminish breast cancer mortality, particularly with incidence on the rise for women in their 40s.
https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults
To our best knowledge, this study provided the largest salvage radiation therapy analysis in patients without ADT that were lymph node-negative on PSMA-PET. A multivariate analysis showed no significant difference in BPFS between locally PET-positive and PET-negative cases. These results supported the current EAU recommendation to initiate SRT in a timely manner after detecting BR in PET negative patients.
https://www.thegreenjournal.com/article/S0167-8140(23)00216-5/fulltext
https://www.redjournal.org/article/S0360-3016(23)00441-8/fulltext
In patients with early stage glottic cancer, retrospective data suggests local and regional control are similar for patients treated with IMRT and CRT. Additional prospective studies with uniform methods of volume delineation and image-guidance are needed to confirm the efficacy of IMRT.
BionTech, a leading producer of COVID mRNA vaccines, have turned their sights to pancreatic cancer. Using individual resected pancreatic tumors obtained at MSKCC, it created synthetic mRNA sequences to induce expression of up to 20 of an individual’s own tumor neoantigens. The phase 1 trial where 16 patients received these vaccines at 9 weeks post-op along with atezolizumab beginning 6 weeks post-op followed by standard adjuvant mFOLFIRINOX at 21 weeks post-op is now making headlines. That’s because half of patients (n=8) achieved a significant expansion of tumor-specific T cell populations with none of them seeing a recurrence within 18 months. That’s as opposed to a median time of recurrence of only 13 months among the other 8 non-responders. This is an exciting leap forward in the systemic management of a decidedly systemic disease despite the $100K price tag attached to each vaccine dose.
https://www.nature.com/articles/s41586-023-06063-y
Does hippocampal avoidance (HA) reduce long-term neurocognitive toxicity from whole brain radiation? This article highlights with longer follow-up data that HA-WBRT reduces the risk of neurocognitive failure compared to standard WBRT.
https://www.redjournal.org/article/S0360-3016(23)00438-8/fulltext
A look back at thymus and thoracic duct radiation dose in 116 cases of thoracic radiation for lung cancer revealed a significant correlation with decreases in absolute lymphocyte counts, an important note amidst the ever-increasing role of immune checkpoint inhibition at all stages of this disease. Find the article here (https://www.advancesradonc.org/article/S2452-1094(23)00089-1/fulltext).
This phase 3 randomized clinical trial found that hypofractionated IGRT (60 Gy in 15 fractions) was not superior to CFRT (60 Gy in 30 fractions) for patients with stage II/III NSCLC ineligible for concurrent chemoradiotherapy. Further studies are needed to verify equivalence between these radiotherapy regimens. Regardless, for well-selected patients with NSCLC (ie, peripheral primary tumors and limited mediastinal/hilar adenopathy), the convenience of hypofractionated radiotherapy regimens may offer an appropriate treatment option. Find the article here (https://jamanetwork.com/journals/jamaoncology/fullarticle/2783004).
This study is the first to use machine learning techniques to accurately predict the severity of morning fatigue from prior to through the week following the administration of CTX using total and individual item scores from the Lee Fatigue Scale (LFS). Our findings suggest that the language used to assess clinical fatigue in oncology patients is important and that two simple questions may be used to predict morning fatigue severity. Find the article here (https://link.springer.com/article/10.1007/s00520-023-07723-5).
This study performed meta-regression and meta-analysis to examine the dose–response association between occupational exposure duration to chemical agents and pancreatic cancer risk. Results demonstrated Pancreatic cancer risk increased as occupational exposure duration increased, with an exposure time window ranging from 1 to 30 years. Find the article here (https://academic.oup.com/occmed/advance-article/doi/10.1093/occmed/kqad050/7143670)
Psilocybin Therapy Reduced Major Depression Severity In Individuals With Cancer, Research Finds Oncology Nurse Advisor (4/26, Moore) reports, “A trial of psilocybin therapy for patients with cancer and major depression suggested preliminary efficacy on measures of depression and safety with this approach.” The research was published in JAMA Oncology. Find the article here (https://jamanetwork.com/journals/jamaoncology/article-abstract/2803623).
Yet more data demonstrates the significant advantage of adding 5 mg of olanzapine to triplet antiemetic regimens during highly emetogenic chemotherapy. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804394).
The addition of short term ADT to dose escalated radiation for intermediate risk prostate cancer doesn’t improve OS, but it reduces prostate cancer mortality, DM, and PSA failure. Find the article here (https://ascopubs.org/doi/full/10.1200/JCO.22.02390).
This retrospective look at 674 patients receiving immune checkpoint inhibition for eight different cancer primary sites revealed the third of patients with high tumor mutational burden achieved significantly longer survival confirming this is a robust predictor of response. Find the article here (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804390).
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