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Given the abundance of new research, it can be challenging to stay current on the latest advancements and findings. Oncology Times offers summaries of the newest studies to ensure you are up-to-date on the latest innovations in oncology practice.



Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia

Updated results from the ELIANA trial, a global clinical trial of tisagenlecleucel, a CAR T-cell therapy for a high-risk form of acute lymphoblastic leukemia (ALL), found that children and young adults continued to show high rates of durable, complete remission of their disease (N Engl J Med 2018; doi:10.1056/NEJMoa1709866). The current study includes longer-term follow-up of safety and efficacy data in 75 patients aged 25 and younger. All participants received a single infusion of the CAR T cells. Among the patients who received the CAR T cells, 61 (81%) had a response to treatment, defined by researchers as complete remission with or without complete recovery of blood counts, after at least 3 months of follow-up. Relapse-free survival in those 61 patients was 80 percent at 6 months after treatment and 59 percent at 12 months, according to investigators. Overall survival in all 75 patients was 90 percent at 6 months and 76 percent at 12 months. The survival rates are evidence that the early response rates were durable, study authors noted. In addition to the durable responses, the CAR T cells persisted in the patients for as long as 20 months, with a median persistence of 168 days at the point at which data were analyzed for this study. The most common treatment-related side effect was cytokine release syndrome (CRS). Nearly half of the 75 patients received ICU treatment to manage CRS, but the effects were treatable and transient, according to investigators. "In this global study of CAR T-cell therapy, a single infusion of tisagenlecleucel provided durable remission with long-term persistence in pediatric and young adult patients with relapsed or refractory B-cell ALL, with transient high-grade toxic effects," study authors concluded.



Loss of an androgen-inactivating and isoform-specific HSD17B4 splice form enables emergence of castration-resistant prostate cancer

Researchers have confirmed a mechanistic link between the gene HSD17B4 and treatment-resistant prostate cancer, according to a recent study (Cell Rep 2018;22(3):809-819). The findings show that men who lack a certain subtype of the gene may be more susceptible to aggressive prostate cancer that does not respond to treatment. To determine the role of HSD17B4 in the transition to castration-resistant prostate cancer (CRPC), researchers analyzed its expression in tissue from patients with healthy prostates, localized prostate cancer, and CRPC. Data revealed that HSD17B4 expression levels were relatively the same in benign and local prostate cancer tissue, but significantly reduced in CRPC tissue, suggesting that HSD17B4 does play a role in preventing progression to CRPC. Additionally, only one specific isoform of HSD17B4-isoform 2-enzymatically inactivated androgens and prevented tumor growth, according to investigators. It is expressed during the early phases of prostate cancer, but is lost or suppressed in CRPC. The findings were validated in a preclinical model. These findings suggest that a lack of isoform 2 leads to advanced CRPC, researchers concluded.



Night shift work increases the risks of multiple primary cancers in women: a systematic review and meta-analysis of 61 articles

New findings show that night shift work can be associated with an increased risk of breast, skin, and gastrointestinal cancer among women (Cancer Epidemiol Biomarkers Prev 2018; doi:10.1158/1055-9965.EPI-17-0221). A meta-analysis was performed utilizing data from 61 articles, which included 114,628 cancer cases and 3,909,152 participants from North America, Europe, Australia, and Asia. The articles consisted of 26 cohort studies, 24 case-control studies, and 11 nested case-control studies. Researchers analyzed the studies for an association between long-term night shift work and risk of 11 types of cancer. Additional analysis looked specifically at long-term night shift work and risk of six types of cancer among female nurses. Findings showed that long-term shift work among women increased cancer risk by 19 percent. Additionally, investigators found this population had an increased risk of skin (41%), breast (32%), and gastrointestinal cancer (18%) compared with women who did not perform long-term night shift work. Researchers stratified the participants by location and found an increased breast cancer risk was only found among female night shift workers in North America and Europe. Among the occupations analyzed, nurses had the highest risk of developing breast cancer if they worked the night shift. "This systematic review confirmed the positive association between night shift work and the risks of several common cancers in women," study authors wrote. "We identified that cancer risk of women increased with accumulating years of night shift work, which might help establish and implement effective measures to protect female night shifters."



Hypofractionated radiation therapy for basal and squamous cell skin cancer: a meta-analysis

Shorter courses of radiation are preferable to longer ones for older patients receiving treatment for slow-growing skin cancers, according to a recent physician's study review (Radiother Oncol 2017 doi:10.1016/j.radonc.2017.08.011). Researchers reviewed 21 international studies of radiation treatment for slow-growing skin cancers published between 1986 and 2016. The studies included almost 10,000 patients aged 62-84 years old who were followed up for anywhere from a year to more than 6 years after their therapy ended. No difference was found in long-term cosmetic outcomes between shorter- and longer-course therapies. About 80 percent of patients receiving high-dose, short-course therapies had good cosmetic results, similar to longer-course treatments with smaller radiation doses, according to investigators. The most common types of long-term skin damage reported across the studies were discoloration and the appearance of spider veins. Skin cancer recurrence at the same site was rare among all the regimens, and there were no deaths related to the treatments. Based on their findings, the researchers recommend short courses of five, seven, or 15 treatments-all adding up to around the same amount of total radiation exposure-for patients over 70 years old, especially if they have trouble traveling for treatments. Younger patients who are 60-70 years old can also consider these regimens, but they may live to see more skin damage from the treatments, the study authors concluded.


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