Explore the role of androgen deprivation therapy in prostate cancer treatment and its impact on patient survival and oncologic benefits. The recent NRG Oncology/Radiation Therapy Oncology Group study offers fresh insights on androgen deprivation therapy in prostate cancer treatment. The researchers focused on patients with intermediate-risk prostate cancer. They used a sample of 1,492 patients, randomly assigned to receive either escalated radiation therapy alone, or combined with short-term androgen deprivation therapy (ADT). Strikingly, the results didn’t point to a significant survival advantage. The five-year survival estimates were almost identical for both groups, at 90% and 91% respectively. Yet, when it comes to oncologic benefits, adding short-term ADT had a substantial impact. Importantly, this therapy reduced the risk for PSA relapse, distant metastasis, and prostate cancer-specific mortality by 48%, 75%, and 90% respectively. Also, patients on ADT exhibited a 38% lower risk of requiring salvage ADT. However, physicians need to be aware of the potential drawbacks. The study observed that the adverse event rates were notably higher with ADT use, at 69% compared to 21% for radiation therapy alone. Indeed, 12% of the ADT group experienced acute grade 3 or higher adverse events, compared to just 2% of the radiation-only group. […]

Cilta-cel CAR-T-cell therapy: A ray of hope for refractory multiple myeloma patients. A new study on ciltacabtagene autoleucel CAR-T-cell therapy (cilta-cel) shows promise for relapsed/refractory multiple myeloma (RRMM) patients. Published in Blood, the study led by Dr. Adam Cohen from the University of Pennsylvania, focuses on patients with previous exposure to noncellular anti-B-cell maturation antigen (BCMA) therapies. The team’s objective was achieving the primary endpoint of minimal residual disease (MRD) negativity, alongside multiple secondary endpoints. They tested on patients above 18 with RRMM, progressive disease within 12 months of their last treatment or six months of prior therapy, and measurable disease at baseline. They conducted a multicohort study, primarily focusing on cohort C which entailed cilta-cel treatment. A total of 20 patients met the eligibility criteria and received cilta-cel. Among them, 35% had BsAb as their latest anti-BCMA treatment, while 65% had ADC. With a median follow-up of 11.3 months, 7 patients achieved MRD negativity. The overall response rate stood at 60%, with 55% achieving very good partial response (VGPR) or better, and 30% achieving complete remission (CR) or better. However, all patients experienced treatment-emergent adverse events, majorly grade 3 to 4 cytopenias. Most of these cytopenia events recovered to […]

Enhancing Platelet Dysfunction Diagnosis with Platelet Function Screen The Platelet Function Screen (PFA-100®) is a critical in vitro system for detecting platelet dysfunction. It uses citrated whole blood samples under high shear flow conditions, demonstrating its sensitivity. As blood is aspirated through collagen-coated membranes, platelet adhesion forms an initial matrix. Adding to the mix, platelet aggregation is stimulated by either epinephrine (COL/EPI) or adenosine diphosphate (COL/ADP), coating the membranes. In this process, the time required to form a platelet plug that blocks the aperture, known as closure time (CT), is the key measure of platelet function. Interestingly, several conditions can cause prolonged CT, including drug effects, low hematocrit, thrombocytopenia, von Willebrand Disease (vWD), and platelet disorders. Notably, aspirin therapy impacts the COL/EPI closure time more than COL/ADP. While assessing results, hematological considerations are pivotal, particularly with anemia and thrombocytopenia that could extend CT. Platelet counts below 150,000/uL or hematocrit below 35% could interfere with the results, thus, the test might not serve patients with counts below 100,000/uL or hematocrit under 30%. Moreover, hematocrit over 50% could generate inconsistent outcomes. Fundamentally, normal CT with both COL/EPI and COL/ADP signifies healthy platelet function. The COL/EPI membrane, while sensitive to primary hemostasis disorders, […]

Discover a holistic perspective on advanced bladder and renal cell cancers management, encompassing everything from pathogenesis to adverse event mitigation. Let’s dive into the “Advanced Bladder and Renal Cell Cancers Management” webcast, released on April 30, 2023, offering valuable 1.00 ANCC contact hour, inclusive of 0.75 pharmacology hours. Presented by expert Mary W. Dunn, MSN, RN, OCN, NP-C from the University of North Carolina, this program targets oncology nurses, nurse navigators, advanced nursing providers, and nurses from other cancer-related subspecialties. It remains available until April 30, 2024, leaving ample time to gain this crucial knowledge. Primarily, this webcast zeroes in on bladder cancer (BC), a malignancy notorious for its high mortality rate, and renal cell carcinoma (RCC), a top-10 common cancer. Unfortunately, BC’s 5% survival rate for metastatic disease cases paints a grim picture. Luckily, hope emerges in the form of novel therapeutic agents for advanced, recurrent, and metastatic BC and RCC. Next, the program navigates through the pathogenesis of these cancers. Equipped with this knowledge, healthcare providers can better understand the intricacies of disease progression. As the treatment landscape rapidly evolves, so does the complexity in selection, sequencing, and adverse event (AE) management. Thus, the webcast outlines how to […]

This article reviews the novel CXCR4 inhibitor motixafortide and its use in hematopoietic stem-cell mobilization. We present a history of stem-cell mobilization and update of recent innovations in novel mobilization strategies. Hematopoietic stem-cell mobilization is a crucial step in autologous stem-cell transplantation. Motixafortide is a novel CXCR4 inhibitor that has been shown in preclinical and clinical trials to mobilize hematopoietic stem cells (HSCs) for transplantation. The drug has extended in vivo activity (>48 h) and high affinity (Ki, 0.32 nM). In a phase 1, two-part study, motixafortide administered to healthy subjects was safe, well tolerated, and led to a rapid and robust increase in the number of circulating HSCs. Motixafortide has been evaluated in a randomized phase 3 trial for autologous transplantation in multiple myeloma. The study showed that the combination of motixafortide and granulocyte colony-stimulating factor (G-CSF) was superior to G-CSF alone in terms of the number of CD34+ cells collected and the time to engraftment. The drug has also been evaluated in combination with plerixafor, another CXCR4 inhibitor, in a phase 1/2 study for autologous transplantation in multiple myeloma. The study showed that the combination of motixafortide and plerixafor was safe and effective in mobilizing HSCs. Motixafortide has […]

Oncologists and cancer drug shortages are creating a crisis, with patient care at risk and legal liabilities looming. In the face of critical cancer drug shortages, oncologists grapple with suboptimal patient care and possible legal liabilities. The issue worsens due to insufficient guidelines for alternative treatment options. A contributing factor is the weak financial incentive for drug manufacturers to produce unprofitable generic drugs, compared to branded ones. Consequently, there’s greater dependence on foreign factories, leading to supply chain hitches and quality control issues. Barbara McAneny, MD, CEO of New Mexico Cancer Center, foresees drug shortages persisting, particularly affecting low-cost treatments. The American Society of Health-System Pharmacists (ASHP) reports shortages of vital oncology drugs like methotrexate, cisplatin, carboplatin, and fluorouracil, crucial for treating various common cancers. Furthermore, the lack of guidelines on alternative treatments exacerbates oncologists’ concerns about patient outcomes and legal liabilities. This absence of direction leaves physicians making crucial decisions single-handedly. In response, the American Society of Clinical Oncology (ASCO) has formed an advisory group to develop clinical guidance during these drug shortages. Immediate recommendations include reprioritizing nonessential use of scarce antineoplastic drugs, increasing interval cycles, reducing doses when clinically acceptable, and selecting evidence-based alternatives. Dr. Jeff Patton, CEO […]