Articles related to Oncology, Radiation

Dr. Jyoti Mayadev, a professor of Radiation Medicine at University of California San Diego, discussed the treatment of patients with 1B3 cervical cancer at the Society of Gynecological Oncology’s Annual Meeting on Women’s Cancer. The discussion centered around whether to treat patients with primary chemoradiation and brachytherapy or radical surgery. Dr. Mayadev recommends a multidisciplinary approach, but notes that level 1 evidence data from Landoni et al. in 1997 showed no difference in progression-free survivals or overall survivals between radiation therapy and radical hysterectomy in patients with bulky disease, 1B3, and no lymph node disease. Dr. Mayadev discusses the benefits of chemoradiation, including potential toxicity reduction if a patient needs adjuvant therapy after surgery. She also notes that with technologically advanced radiation and brachytherapy, long-term toxicities can be minimized, including genitourinary toxicities at 6-8%, vaginal toxicities at 5%, and fistula at less than 2%. Dr. Mayadev believes that adaptive radiation therapy may further decrease toxicities and increase cure rates for patients with 1B3 cervical cancer. There are ongoing trials for novel therapeutics and adaptive radiation therapy, such as the ARTIA Cervical Trial, which aims to decrease toxicities and collect patient reported outcomes.

On April 25, 2023, the American Urological Association (AUA), in partnership with the Society of Urologic Oncology (SUO), released the 2023 clinical practice guideline amendment for the management of advanced prostate cancer. This guideline contains a total of 40 recommendations, and the revision includes updates to recommendations under these disease states:

During its April 28 meeting, the FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 11-1 on whether access to the combination should be limited to patients whose tumors carry BRCA mutations. The majority of members shared the FDA reviewers’ concerns regarding clinical trial results and uncertainty about whether people without the BRCA mutation would benefit from the regimen. The FDA argued that the results of the phase 3 PROpel clinical trial could not be applied to patients who had not had their BRCA or HRR mutation status determined. As a result, the FDA contended that the PROpel intention-to-treat (ITT) group was heterogeneous, complicating the interpretation and application of the trial’s results to unselected patients.

The business launched a precautionary global recall of desmopressin formulations used to treat mild-to-moderate hemophilia A and von Willebrand disease after higher-than-specified amounts of desmopressin were discovered in various formulations. Stimate, a nasal spray containing a synthetic form of desmopressin acetate used to control bleeding in hemophilia patients, is among the recalled products, as is Octostim Nasal Spray 1.5 mg/ml, DDAVP 10 micrograms (mcg)/0.1 ml, Minirin Nasal Spray 0.1 mg/ml, and Generic Desmopressin Acetate Nasal Spray 10 mcg/0.1 ml. Products containing higher-than-specified amounts of desmopressin were recalled due to concerns that increased desmopressin exposure can result in water retention, low blood pressure, and low blood salt levels in mild cases, as well as seizure, coma, and death.

According to surveys, up to 40% of cancer patients in the United States use cannabis, yet only one-third of doctors are comfortable advising them on it. Now, a small but significant study has found that cancer patients who use cannabis to treat their symptoms had reduced pain, better sleep, and an unexpected benefit: they appear to think more clearly after a few weeks of consistent use. The study, published in the journal Exploration in Medicine, is one of the first to look at how cannabis purchased via dispensaries, rather than government-supplied or synthetic kinds, affects cancer symptoms or chemotherapy side effects. It also sheds light on the large range of drugs used by cancer patients now that marijuana is legal in the majority of states.

From November 15, 2015, to March 9, 2021, scientists conducted an open-label, phase 3 randomized clinical trial at 17 Spanish centers to assess the efficacy and safety of intraoperative HIPEC in patients with locally advanced colon cancer. The primary outcome was the 3-year locoregional control (LC) rate, which was defined as the proportion of patients who did not have peritoneal disease recurrence after adjusting for intention to treat. Patients included ranged in age from 18 to 75 years old and had been diagnosed with locally advanced primary colon cancer prior to surgery. They discovered that combining HIPEC with complete surgical resection for locally advanced colon cancer enhanced the 3-year LC rate compared to surgery alone, and they recommend that this strategy be evaluated for patients with locally advanced colorectal cancer.