Articles related to Oncology, Surgical

Matthew Lunning, DO, Associate Vice Chair of Research at the University of Nebraska Medical Center, reviews treatment implications of emerging research in CAR T-cell therapy for a variety of lymphomas subtypes, and discusses newer study outcomes, limitations to current CAR-T cell products, the state of allogenic CAR-T cell therapy, and key elements to consider when selecting therapy for a given patient.

The authors analyzed a cohort of nearly 5,000 patients with AML for the prevalence and prognostic impact of IDH mutations and found distinct clinical and co-mutational features of the IDH1-R132C mutation. The study identified variable outcomes associated with distinct mutations of IDH and offers additional evidence in support of delineating the IDH2-R172K mutation as a distinct entity based on its co-mutational landscape and significant impact on outcome.

Both immune checkpoint inhibitors (ICIs) and VEGF receptor inhibitors are approved for advanced renal cell carcinoma (RCC) treatment and can cause cardiovascular events (CVs). This randomized study of avelumab plus axitinib vs. sunitinib used prospective monitoring of LVEF and serum cardiac biomarkers to assess for the development of major adverse CV events. The results indicate patients with high baseline troponin T levels and who receive combination ICI and VEGF receptor inhibitor therapy should be monitored closely for adverse cardiac events.

Combining BCG with N-803 “results in significant complete response rates and long-term disease-free rates without significant systemic side effects,” reported lead study investigator Sam S. Chang, MD, of Vanderbilt University Medical Center. N-803 is a high affinity, interleukin 15 immunostimulatory fusion protein that promotes the proliferation and activation of natural killer cells and CD8+ T cells without binding to regulatory T cells. Its use in this phase two/three study including 83 patients with CIS and 77 with papillary NMIBC. In the CIS group, the complete response rate was 71% with a median duration of response of 23.6 months. NMIBC group had 12- and 24-month disease-free survival (DFS) rates of 57% and 48%, respectively. The median DFS was 23.6 months. In both groups, cystectomy was avoided in more than 90% of patients.

The authors analyzed the outcome of 349 patients with primary or secondary myelofibrosis undergoing reduced intensity transplantation, of whom 35 had accelerated-phase myelofibrosis. After a median follow-up of 5.9 years, estimated 5-year overall survival was between the two groups, and median overall survival was not reached. In terms of relapse, five-year incidence was 30% for the accelerated-phase group versus 15% for the chronic-phase group. Reduced intensity transplantation showed excellent survival but higher relapse for accelerated-phase myelofibrosis.

Chemoradiotherapy with high-dose cisplatin every three weeks is the standard adjuvant treatment for patients with locally advanced squamous cell carcinoma of the head and neck with high risk for recurrence. However, the cisplatin dose is frequently reduced because of dose-related toxicities which can result in insufficient cisplatin delivery. Chemoradiotherapy with weekly cisplatin at a dose of 40 mg/m2 is widely used as a possible alternative, albeit without sufficient evidence. This clinical trial was conducted to prove the noninferiority of weekly cisplatin to three weekly cisplatin plus radiation therapy (RT).