Articles related to CHEMOTHERAPY

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.

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.

The authors present the findings of a large retrospective cohort study that used national data from the SEER-Medicare-linked database to better understand the relationship between antibiotics and PDAC survival. They discovered that perichemotherapy antibiotics were associated with improved survival in patients treated with first-line gemcitabine but not fluorouracil, implying that perichemotherapy antibiotic treatment may have a role in patients with metastatic PDAC receiving gemcitabine. Prospective studies on the effect of perichemotherapy antibiotics with high pancreatic penetration and gram-negative coverage on survival in diverse populations of patients with metastatic PDAC treated with gemcitabine are recommended.

The findings of this randomized clinical trial support the notion that, despite improved DFS, patients 60 years or younger with intermediate-risk AML, as defined by Medical Research Council cytogenetic criteria, do not benefit from allo-HCT during first CR in terms of OS. Early identification of a suitable donor allows for the timely rescue of patients who have relapsed following conventional consolidation chemotherapy. Future research that uses longitudinal monitoring of residual disease dynamics will aid in personalizing the optimal time point for allo-HCT in the majority of patients.

Zev Wainberg, MD, professor of medicine and co-director of the UCLA GI Oncology Program at the University of California, Los Angeles, presented the results of the NAPOLI-3 trial at the ASCO Gastrointestinal Cancers Symposium last month, and in this podcast, he discusses the data with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer. In addition, the physicians discuss what advances might be on the horizon in the metastatic setting and in earlier disease, as well as what factors influence Dr. Wainberg’s treatment decisions.

Data on patients with mismatch repair deficiency (MMRD) CRC, the majority of whom could not undergo surgery due to various health conditions unrelated to cancer, were presented at the 2023 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO GI). Instead of radiation therapy or chemotherapy, the patients received immunotherapy with checkpoint inhibitors. It should be noted that the patients were treated outside of clinical trials. The overall response rate in this patient group was 74%, with 57% of those who responded experiencing complete tumor regression. Some of the patients have been in complete remission for a year or more after their diagnoses. The data indicate that immunotherapy is an effective treatment for patients who are unable to undergo surgery for a variety of reasons, including advanced age or a variety of health issues.