Articles related to Oncology, Radiation

A JAMA Oncology study of nearly 480,000 patients found immune-mediated diseases are associated with a greater risk of cancer at the local and systemic levels. The findings support the role of local and systemic immunoregulation in carcinogenesis and could lead to a new way of viewing immune-mediated diseases.

The authors of this JCO study used a PET-adaptive approach to reduce the need for radiotherapy (RT) in early PET (-) disease and escalate therapy in patients with PET (+) disease. The study reports excellent outcomes for the approach, which allowed omission of radiotherapy in more than three-quarters of patients.

A “breakthrough therapy” designation has been granted by the FDA to CLN-081 for the treatment of a subset of non-small cell lung cancer. The designation applies to use of the agent by patients with locally advanced or metastatic EGFR-mutated NSCLC who previously received chemotherapy and comes as a phase 1/phase 2a clinical trial is underway.

Jacob Laubach, MD, at the Dana-Farber Cancer Institute provides a summary of the most recent update from the GRIFFIN trial, assessing daratumumab plus lenalidomide, bortezomib, and dexamethasone in newly diagnosed multiple myeloma patients. After 24 months of maintenance therapy or treatment discontinuation (median follow-up of 38.6 months), the rate of stringent complete response (sCR) was 66% in the D-RVd treatment arm versus 47.4% in the RVd treatment arm. At the time of data collection, median PFS had not been reached in either arm but is trending towards favoring D-RVd versus RVd. The estimated 36-month PFS rate was 88.9% for D-RVd and 81.2% for RVd.

The GLOW study is a phase 3 clinical trial evaluating the efficacy and safety of ibrutinib plus venetoclax (I+V) in elderly or unfit CLL patients. Patients receiving I+V are compared to patients receiving chlorambucil plus obinutuzumab (C+O). Previously this study reported reduced risk of disease progression with I+V vs C+O. This update, presented at ASH 2021, looked at undetectable minimal residual disease (uMRD) – a surrogate for PFS. uMRD was significantly higher in both peripheral blood and bone marrow in the I+V group.

An oncologist reflects on his last decade as a physician and what he’s learning through the art of oncology — the daily practice that is outside the latest data and is often not explicitly taught in fellowship — that has become ever more important and gratifying. Age, a changing work environment, a pandemic and telemedicine, reports of physician burnout, and colleagues leaving practice — all part of the daily routine. Here, the oncologist shares a few key rules that that have helped and sustained his practice.