This cross-sectional study reports that screening colonoscopies performed at 75 years or older are very unlikely to detect cancers (0.2%) and even more unlikely to detect one that is acted upon (0.07%). Find the article here (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2803491).
Daily radiation treatments present unique logistical challenges for underprivileged and / or rural patients, particularly for those who are both. This analysis demonstrates that hot spots for cancer incidence and mortality rates are found primarily in rural counties and even more pronounced in rural counties with a high proportion of Black residents. What’s more, lower rad onc provider density was associated with higher cancer mortality rates on the county-level. Find the article here (https://www.redjournal.org/article/S0360-3016(23)00090-1/fulltext).
Sarcoma (soft tissue sarcoma, STS) is a very difficulty cancer to ultimately cure. This article demonstrates that in two RTOG clinical trials of neoadjuvant radiation and chemo-radiotherapy for STS, patients who had a pathologic complete response had better overall survival and lower risk of recurrence than patients with residual tumor. (https://www.esmo.org/oncology-news/pcr-associated-with-improved-survival-outcomes-in-patients-with-soft-tissue-sarcoma-who-received-neoadjuvant-chemoradiotherapy-or-radiotherapy)
ASCO just released the new guideline update for how to manage metastatic prostate cancer and there are intriguing new changes. Please find the updates and changes here (https://ascopubs.org/doi/pdf/10.1200/JCO.23.00155).
This article provides a nice and concise summary surrounding the merit of MRI guided Radiation Therapy planning. This includes its benefits to offer superior soft tissue contrast compared to CT guidance, intrafraction imaging, and online adaptive replanning amongst other things. (https://www.sciencedirect.com/science/article/abs/pii/S1055320723000212)
This article is very intriguing and people should consider its merit for other malignancies. In this multicenter, randomized phase 3 trial from India, patients with operable, cN0-N1 breast cancer who were undergoing primary surgical resection were randomized to have a peritumoral lidocaine anesthetic injection roughly 10 minutes prior to surgery. Obviously, lidocaine injection may reduce postoperative pain, but the authors hypothesized that the anesthetic may suppress pro-metastatic cellular pathways activated during the cellular stress of surgery. In conclusion they found that peritumoral injection of lidocaine prior to breast cancer surgery was associated with a higher rate of DFS and OS at 5 years. (https://ascopubs.org/doi/full/10.1200/JCO.22.01966).
This very interesting SEER Analysis demonstrates that rates of active surveillance or watchful waiting for men ages 40+ soared from 16% in 2010 to 60% in 2018 for low risk prostate cancer and from 8% to 22% for favorable intermediate risk disease. (https://ascopubs.org/doi/pdf/10.1200/JCO.23.00155)
This interesting paper demonstrates for early-stage NSCLC, combination SBRT and durvalumab resulted in excellent disease specific outcomes. Safety appeared acceptable per protocol, but 5/18 patients experienced Grade ≥3 pulmonary toxicity including one Grade 5 event in a patient with ILD. Results support ongoing phase III trials determining the benefit of SBRT and immune check point inhibitors in this population. (https://www.redjournal.org/article/S0360-3016(23)00325-5/fulltext).
This is a riveting article highlighting how several hundred community health workers offer telehealth services that put women in underserved communities in touch with doctors. Find the article here (https://www.nature.com/articles/s41591-023-02204-y).
Dr. Don Dizon has been selected as a new editor for the journal. See the video and announcement here (https://acsjournals.onlinelibrary.wiley.com/hub/journal/15424863/homepage/editorialboard.html).
Last week the FDA approved Narcan nasal spray for over-the-counter use, a first for overdose reversal agents, with some cities even planning to install Narcan vending machines, though concerns remain over potential price-gouging when a single naloxone producer has approval. Find the announcement here (https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray).
Whether prostate SBRT is delivered every other day versus weekly doesn’t appear to impact efficacy or toxicity at 5 years. This is important and very meaningful because it demonstrates that shortened and more hypofractionated regimens of SBRT are equally effective and safe. Find the article here (https://www.redjournal.org/article/S0360-3016(23)00301-2/fulltext).
This exposé delves into what it frames as a major failure of the US to protect its military from its biggest threat while deployed during the “war on terror,” exposure to carcinogens, as veterans are reportedly 100 times more likely to receive a cancer diagnosis than to die in action. Find the article here (https://newrepublic.com/article/170975/veterans-cancer-crisis-war-terror).
The recently published Lung Adjuvant Radiotherapy Trial (Lung ART) reported increased rates of cardiac and pulmonary toxic effects in the postoperative radiation therapy (PORT) arm. It remains unknown whether the dosimetric parameters reported in Lung ART are representative of contemporary real-world practice, which remains relevant for patients undergoing PORT for positive surgical margins. From 2012 to 2022, demographic and dosimetric data were prospectively collected for 377 patients at 27 academic and community centers within the Michigan Radiation Oncology Quality Consortium undergoing PORT for nonmetastatic non-small cell lung cancer. With increased rates of IMRT use, cardiac and lung dosimetric parameters in this statewide consortium were slightly lower than those reported in Lung ART. These data provide useful benchmarks for treatment planning in patients undergoing PORT for positive surgical margins. Find the article here (https://www.practicalradonc.org/article/S1879-8500(23)00037-1/fulltext).
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