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With a plethora of new oncology research at your disposal, it can be difficult to keep track of the latest innovations and findings. Oncology Times is offering our readers summaries of the newest studies to keep you abreast of advancements across the spectrum of oncology care.



Tumour-infiltrating lymphocytes in advanced HER2-positive breast cancer treated with pertuzumab or placebo in addition to trastuzumab and docetaxel: a retrospective analysis of the CLEOPATRA study

In the randomized, phase III CLEOPATRA study, 808 patients with previously untreated HER2-positive advanced breast cancer received docetaxel and trastuzumab with pertuzumab (n = 402) or without (n = 406). The median progression-free survival and overall survival (OS) improved by 6.3 months and 15.7 months, respectively, with the addition of pertuzumab. Researchers found, in a retrospective analysis, that higher tumour-infiltrating lymphocytes are associated with improved OS in patients treated with docetaxel, trastuzumab, and pertuzumab or placebo (Lancet Oncol 2017;18(1):52-62). Data showed that longer OS was associated with each 10 percent increase in stromal tumor-infiltrating lymphocytes. Researchers concluded, "In patients with advanced HER2-positive breast cancer treated with docetaxel, trastuzumab, and pertuzumab or placebo, higher [tumour-infiltrating lymphocyte] values are significantly associated with improved overall survival, suggesting that the effect of antitumour immunity extends to the advanced setting."



Quantitative analysis of circulating cell-free DNA for correlation with lung cancer survival: a systematic review and meta-analysis

Researchers conducted a systematic review and meta-analysis to determine the impact of higher baseline circulating cell-free DNA (cfDNA) levels on the survival of patients with lung cancer (J Thorac Oncol 2017;12(1):43-53). A search of PubMed, Web of Knowledge, and Cochrane databases identified 17 studies and the Newcastle-Ottawa scale was utilized to determine the methodologic quality of the research. Of the identified studies, 16 (n = 1,723 patients) were included in the meta-analysis of overall survival and 5 (n = 640) were included when analyzing progression-free survival (PFS). The association with PFS was not statistically significant (hazard ratio 1.12% [95% confidence interval 0.91-1.37]); however the analysis for OS determined there was an increased risk of death in patients with higher baseline cfDNA levels (hazard ratio 1.76 [95% confidence interval 1.38-2.25]; p < 0.001). Researchers concluded that results confirmed the validity of utilizing the quantitative analysis of cfDNA to predict lung cancer survival.



Increase in prostate cancer distant metastases at diagnosis in the United States

New research found that the incidence of metastatic prostate cancer in older men is rising after reaching an all-time low in 2011 (JAMA Oncol 2016; doi:10.1001/jamaoncol.2016.5465). The findings suggest a correlation between the increase and a change in prostate cancer screening guidelines recommending against routine PSA testing. Utilizing the SEER database, investigators identified 400,000 men over the age of 40 who were diagnosed with prostate cancer between 2004 and 2013. Results revealed that, in men over 75, the incidence of metastatic prostate cancer and the proportion of men with aggressive cancer has increased. The study found that 12 percent of men over 75 were diagnosed with metastatic prostate cancer in 2013, compared with 7.8 percent in 2011; the proportion of men diagnosed with aggressive cancer increased from 68.9 percent to 72 percent over the same period. According to researchers this could be a result of the effects of the USPSTF recommendations against routine PSA tests, and emphasize the need for healthcare policy leaders to reevaluate their approach to prostate cancer screenings.



Outcome of men with relapse after adjuvant carboplatin for clinical stage I seminoma

A recent retrospective study found that the majority of men with stage I seminoma who relapsed after adjuvant carboplatin responded to cisplatin-based chemotherapy (J Clin Oncol 2016; doi: JCO2016690958). Data was collected on 185 patients with stage I seminoma who relapsed after adjuvant carboplatin therapy between January 1987 and August 2013. The primary outcomes were disease-free survival and overall survival. The secondary outcomes included time to, stage at, and treatment of relapse as well as rate of subsequent relapses. The median follow-up was 53 months and medium time to relapse was 19 months (95% CI, 71-23 months). Within the first 2 years following carboplatin treatment, 118 relapses occurred (64%; 95% CI, 56-71). Fifteen percent of relapses occurred 3 years after treatment. A second relapse occurred in 28 patients and at the time of last follow-up 174 of 185 patients (94%) were alive without disease and four patients with disease. Five-year disease-free survival was 82 percent (95% CI, 77% to 89%), and the 5-year overall survival was 98 percent (95% CI, 95% to 100%). Researchers concluded that the data supports the use of a cisplatin-based chemotherapy regimen for relapsed stage I seminoma; given 15 percent of relapses occurred after 3 years, investigators recommend a minimum follow-up of 5 years.



Genome-wide association study for anthracycline-induced congestive heart failure

Among women with breast cancer who received anthracycline chemotherapy, those who had a certain genetic biomarker had a significantly increased risk for having anthracycline-induced congestive heart failure (CHF) (Clin Cancer Res 2016; doi: 10.1158/1078-0432.CCR-16-0908). Researchers analyzed genome-wide association data from 3,431 women with breast cancer who received doxorubicin as part of treatment received through the randomized phase III adjuvant breast cancer trial E5103. Researchers identified several single nucleotide polymorphisms (SNPs) associated with risk of anthracycline-induced CHF; based on the chromosomal location of the SNPs, the researchers then chose two of the top SNPs for validation in independent data sets. One of the identified SNPs, rs28714259, was associated with risk of anthracycline-induced CHF among 2,415 women with breast cancer who received doxorubicin through the phase III ECOG 1199 clinical trial. Additionally, rs28714259 was associated with low ventricular ejection fraction, a sign of heart damage, among 828 women with breast enrolled in the phase III BEATRICE clinical trial.


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