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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.



Long-term outcomes of imatinib treatment for chronic myeloid leukemia

After nearly 11 years of follow-up from the open-label, multicenter IRIS trial, the efficacy of imatinib for treatment of chronic myeloid leukemia (CML) persisted over time (N Engl J Med 2017;doi:10.1056/NEJMoa1609324). Researchers "randomly assigned patients with newly diagnosed CML in the chronic phase to receive either imatinib or interferon alfa plus cytarabine." Enrollment began in January 2000, and the last patient visit occurred in January 2012. Patients could cross over to the other regimen if they did not achieve hematologic response by 6 months or major cytogenetic response by 1 year. The trial was extended for imatinib therapy only after 7 years. Patients in the interferon alfa plus cytarabine arm were eligible to continue the trial if they crossed over to imatinib therapy. Median follow-up was 10.9 years (range, 0-11.7). About two-thirds of patients assigned interferon alfa plus cytarabine crossed over to imatinib (median time to crossover, 0.8 years). The estimated overall survival at 10 years was 83.3 percent among patients in the imatinib group. Researchers reported that 48.3 percent of patients assigned to imatinib completed study treatment with the drug, and 82.8 percent had a complete cytogenetic response. Study authors concluded that "long-term administration of imatinib was not associated with unacceptable cumulative or late toxic effects."



Tumor sequencing and patient-derived xenografts in the neoadjuvant treatment of breast cancer

In a recent study, researchers sought to determine the role of tumor sequencing in women with newly diagnosed breast cancer. A prospective study of 140 cancer patients treated with neoadjuvant chemotherapy was conducted. Researchers performed tumor and germline sequencing and generated patient-derived xenografts with core needle biopsies (J Natl Cancer Inst 2017; Findings showed that the most common genetic changes were not more commonly observed in chemotherapy-resistant compared to chemotherapy-sensitive tumors. Investigators identified that an uncommon type of an aggressive breast cancer, the luminal androgen-receptor subtype of triple negative breast cancer, was less likely to respond to chemotherapy and was more likely to contain a unique type of mutation in p53. According to researchers, the study demonstrates "the feasibility of tumor sequencing and patient-derived xenograft generation in the neoadjuvant chemotherapy setting. 'Targetable' alterations were not enriched in chemotherapy-resistant tumors; however, prioritization of drug testing based on sequence data may accelerate drug development."



Clinical trial characteristics and barriers to participant accrual: the MD Anderson Cancer Center experience over 30 years, a historical foundation for trial improvement

A new study found that cancer clinical trials initiated through national cooperative groups, and the time taken from trial activation to first patient enrollment, were among the factors associated with slow accrual (Clin Cancer Res 2017; doi:10.1158/1078-0432.CCR-16-2439). Researchers analyzed data from clinical trials at MD Anderson Cancer Center between January 1981 and March 2011, which included 4,269 trials with a combined enrollment of 145,214 patients. Of these trials, 755 (18%) were identified as slow-accruing, which were defined as trials that accrued fewer than two participants per year. Phase II/III and phase III trials accrued more slowly than phase I/II trials. Additionally, researchers determined that trials associated with national cooperative groups were more than four times likely to accrue slowly compared with industry-sponsored trials. Data found 14 percent of the slow-accruing trials published at least one peer-reviewed paper, compared to 69 percent of the trials that accrued two or more participants per year. The authors concluded, "Given the lack of data on clinical trials at the institutional level, these data will help build a foundation from which targeted initiatives may be developed to improve the clinical trial enterprise."



Novel calculator to estimate overall survival benefit from neoadjuvant chemoradiation in patients with esophageal adenocarcinoma

Researchers sought to develop a novel calculator that more readily identifies esophageal adenocarcinoma patients who may derive overall survival (OS) benefit from neoadjuvant chemoradiation (nCRT) (J Am Coll Surg 2017; doi:10.1016/j.jamcollsurg.2017.01.043). The investigators evaluated clinical data for 8,974 patients diagnosed with early-stage esophageal cancer. Evaluated characteristics included patients' comorbidity score, tumor grade, and neoadjuvant chemoradiation status. According to researchers, patients who benefit more from nCRT included those whose tumors had metastasized to nearby lymph nodes, older patients, and those with more aggressive cancers, such as tumors of higher grade and greater depth of invasion. "A novel OS calculator was developed for esophageal adenocarcinoma that reasonably predicts which patients are expected to derive OS benefit from nCRT," authors concluded. "This tool can be helpful in determining OS benefit from nCRT to assist with treatment decision-making."



Favorable preliminary outcomes for men with low- and intermediate-risk prostate cancer treated with 19-Gy single-fraction high-dose-rate brachytherapy

Results from a new prospective clinical trial indicate that high-dose-rate (HDR) brachytherapy administered in a single, 19 Gray (Gy) treatment may be a safe and effective alternative to longer courses of HDR treatment for men with localized prostate cancer (Int J Radiat Oncol Biol Phys 2017;97(1):98-106). The study presented the results of a nonrandomized, prospective clinical trial of 58 patients with low- or intermediate-risk prostate cancer, with a median follow-up of 2.9 years. All patients received a single, 19 Gy fraction of HDR brachytherapy. The median patient age was 63 years; 91 percent of the patients presented with stage T1 disease, 71 percent had Gleason score <=6 (29% with Gleason score 7), and the median pretreatment prostate-specific antigen level was 5.1 ng/mL. Within the 6 months following HDR therapy, seven patients (12.1%) experienced grade 2 urinary side effects, most commonly frequency/urgency (6.9%). No patients experienced short-term grade 3+ urinary toxicity or grade 2+ gastrointestinal (GI) toxicity. Six patients (10.3%) experienced chronic grade 2 urinary toxicity and one patient (1.7%) experienced grade 3 chronic GI toxicity that subsequently resolved. No patients experienced long-term grade 3+ urinary toxicity or grade 4 GI toxicity. Researchers concluded that "single-fraction HDR brachytherapy is well-tolerated, with favorable preliminary biochemical and clinical disease control rates."