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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 is here to help with summaries of the newest studies to ensure you are up-to-date on the latest innovations in oncology practice.



Projections in breast and lung cancer mortality among women: a Bayesian analysis of 52 countries worldwide

A recent analysis found that the global age-standardized lung cancer mortality rate among women is projected to increase by 43 percent from 2015 to 2030 (Can Res 2018; doi:10.1158/0008-5472.CAN-18-0187). During the same time frame the global age-standardized breast cancer mortality rate is projected to decrease by 9 percent. Researchers analyzed breast and female lung cancer mortality data from the World Health Organization Mortality Database from 2008 to 2014. "Age-standardized mortality rates, per 100,000, were calculated (direct method) for 2008 to 2014 and projected for the years 2015, 2020, 2025, and 2030 using a Bayesian log-linear Poisson model," according to investigators. To be included in the study, countries must have reported data for at least 4 years between 2008 and 2014 and must have a population greater than 1 million. Fifty-two countries met these criteria: 29 from Europe; 14 from the Americas; seven from Asia; and two from Oceania. Globally, among women, the mortality rate for lung cancer is projected to increase from 11.2 in 2015 to 16.0 in 2030, according to study findings. Investigators found that the mortality rate for breast cancer is projected to decrease from 16.1 in 2015 to 14.7 in 2030. "The mortality for lung and breast cancer is higher in high-income countries than in middle-income countries; lung cancer mortality is lower in the latter because the tobacco epidemic is not yet widespread," study authors wrote. "Due to these observed characteristics of lung cancer, primary prevention should still be a key factor to decrease lung cancer mortality."



Rectal cancer patients under 50 years of age lack a survival benefit from NCCN guideline-directed treatment for stage II and III disease

Individuals younger than 50 years of age who are diagnosed with rectal cancer do not experience an overall survival benefit from currently recommended treatments, according to new data (Cancer 2018; doi:10.1002/cncr.31527). Notably, the findings showed that the addition of chemotherapy and radiation to surgery does not prolong life for these patients; this suggests that early onset disease may differ from later onset disease in terms of biology and response to therapy. Researchers examined 2004-2014 information from the National Cancer Database to gain a better understanding of younger patients. Investigators found that younger patients do not see a survival benefit from receiving the currently recommended treatment for stages II and III rectal cancer. Data showed that younger patients were more likely to receive radiation treatment outside NCCN guidelines for stage I disease. Investigators reported that among younger patients, neoadjuvant chemoradiation for stage II and III disease was not associated with an overall survival benefit. "Age-specific survival data for patients with rectal cancer treated with curative intent do not support an overall survival benefit from NCCN guideline-driven therapy for stage II and III patients younger than 50 years. These data suggest that early-onset disease may differ biologically and in its response to multimodality therapy," researchers concluded.



Genomic landscape of appendiceal neoplasms

Researchers performed genetic profiling on 703 appendiceal tumors to compare the mutation profiles of appendiceal subtypes to colorectal cancer (JCO Precis Oncol 2018; doi:10.1200/PO.17.00302). The retrospective study found that appendix cancer is comprised of five distinct subtypes: mucinous adenocarcinomas (46%), adenocarcinomas (30%), goblet cell carcinoids (12%), pseudomyxoma peritonei (7.7%), and signet ring cell carcinomas (5.2%). The data suggests mutations in the genes TP53 and GNAS are good predictors of survival among people with appendix cancer. While a mutation in the gene GNAS is rare in colon cancer, researchers found it was quite frequent in appendix cancer, especially in mucinous adenocarcinomas (52%) and pseudomyxoma peritonei (72%). Among patients with tumors harboring a GNAS mutation median survival was almost 10 years, while those whose tumors had a TP53 mutation had median survival of only 3 years. Investigators reported that patients who had neither gene mutation had a 6-year median survival rate. "Epithelial appendiceal cancers and goblet cell carcinoids show differences in KRAS and GNAS mutation frequencies and have mutation profiles distinct from CRC," study authors wrote. "This study highlights the benefit of performing molecular profiling on rare tumors to identify prognostic and predictive biomarkers and new therapeutic targets."



Next-generation sequencing identifies a highly accurate miRNA panel that distinguishes well-differentiated thyroid cancer from benign thyroid nodules

New research suggests a panel of 19 microRNAs (miRNAs) identified using next-generation sequencing (NGS) could categorize indeterminate thyroid nodule samples into malignant and benign (Cancer Epidemiol Biomarkers Prev 2018; doi:10.1158/1055-9965.EPI-18-0055). To develop the miRNA panel, researchers analyzed biopsies from 102 patients undergoing thyroidectomy. Following removal of the thyroid gland, ex-vivo fine needle aspiration biopsy was performed on the thyroid nodules, resulting in 274 total biopsies. Researchers categorized samples as benign (71%) or malignant (29%) based on pathological diagnoses, and RNA was isolated from the biopsied tissue and analyzed via deep sequencing to reveal the types and quantities of miRNAs present. Utilizing the miRNA diagnostic panel, investigators analyzed 66 biopsies from 35 patients with indeterminate pathology and found that 22 patients had malignant thyroid nodules, while 13 patients had benign thyroid nodules. Of the patients with malignancy, 15 patients were diagnosed with papillary thyroid cancer, and seven patients were diagnosed with follicular thyroid cancer, according to study results. The sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy of the diagnostic panel as compared to the gold standard pathology were 91 percent, 100 percent, 87 percent, 100 percent, and 94 percent, respectively. "Using NGS technology, we identified a panel of 19 miRNAs that may be utilized to distinguish benign from malignant thyroid nodules with indeterminate cytology," study authors concluded. "Our panel may classify indeterminate thyroid nodules at higher accuracy than commercially available molecular tests."


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