Articles related to ADJUVANT TREATMENT

Short-term radiotherapy with preoperative chemotherapy followed by surgery (total neoadjuvant therapy, TNT) was compared to standard long-term chemoradiotherapy in patients with locally advanced rectal cancer. At a median follow-up of 35.0 months, 3-year DFS was 64.5% and 62.3% in the TNT and CRT groups, respectively. There was no significant difference in metastasis-free survival or locoregional recurrence, but the TNT group had better 3-year overall survival than the CRT group (86.5% v 75.1%; P = .033). Treatment effects on DFS and overall survival were similar regardless of prognostic factors. The prevalence of acute grade III-V toxicities during preoperative treatment was 26.5% in the TNT group versus 12.6% in the CRT group (P < .001).

This retrospective cohort study included 2,833 patients with stage IB to IIIA NSCLC who enrolled in the Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trial (ALCHEMIST) screening study from August 18, 2014, to April 1, 2019. Although 93% received surgical resection, just 53% had adequate lymph node dissection and 57% received any adjuvant chemotherapy. The authors suggest more effort at optimizing use of proven therapies in this patient population.

Initial results of the PREOPANC trial — comparing the addition of neoadjuvant chemoradiation therapy of gemcitabine combined plus Gy radiotherapy to standard care — failed to demonstrate a statistically significant overall survival (OS) improvement versus standard care of upfront surgery followed by adjuvant therapy. The long-term results, however, demonstrate significant benefit with neoadjuvant chemoradiation therapy consisted of gemcitabine combined plus Gy radiotherapy. The five year OS rate was 20.5% (95% CI, 14.2 to 29.8) with neoadjuvant chemoradiotherapy and 6.5% with upfront surgery.

Interest in immune-modulating neoadjuvant therapy for melanoma is growing. It is possible that BRAF/MEK inhibition will be more effective in the neoadjuvant than in the adjuvant setting because of the effect of the tumor biomass. And the benefits neoadjuvant therapy would offer in assessing biologic response assessment to treatment are significant. In this review the authors discuss the rationale for this treatment approach, summarize completed and ongoing neoadjuvant clinical trials, and contextualize these findings within the growing body of knowledge about targeted and immune checkpoint therapy.

This study reports long term outcomes on CALGB 40603 at a median follow-up of 7.9 years. Event-free survival and other LTOs were not significantly improved with either study drug overall or in studied sub-populations. Results showed that patients with any residual disease had significantly worse outcomes. This finding supports considering adjuvant therapy even in the setting of minimal residual disease.

Publication: JAMA Oncology Design: An analysis of data from the I-SPY2 randomized clinical trial that included 938 women with breast cancer.Results: In this randomized clinical trial, the prognostic significance of RCB was consistent regardless of cancer subtype and treatment.