https://www.inquisitiveonc.com/newsreel daily 0.75 2024-06-28 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/2a698717-f407-4dfe-82ac-fdb641339d91/pexels-darina-belonogova-8385083.jpeg https://www.inquisitiveonc.com/newsreel/destiny-breast-03-the-rise-of-the-adc monthly 0.5 2024-06-28 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/650ac60c-4a8a-474b-b268-9b376f7dd3c8/Screenshot+2024-06-28+at+12.29.38%E2%80%AFPM.png Newsreel - DESTINY-Breast 03 - The rise of the ADC - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/bcdf5367-f1dd-4268-8ae6-e674e157d651/Screenshot+2024-06-28+at+12.29.44%E2%80%AFPM.png Newsreel - DESTINY-Breast 03 - The rise of the ADC - Make it stand out Source: https://www.nature.com/articles/s41591-024-03021-7#Fig2 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/3abdc21b-ef9e-44b6-8497-0a469acfd183/Screenshot+2024-06-28+at+12.29.47%E2%80%AFPM.png Newsreel - DESTINY-Breast 03 - The rise of the ADC - Make it stand out Source: https://www.nature.com/articles/s41591-024-03021-7#Fig2 https://www.inquisitiveonc.com/newsreel/enrolment-in-clinical-trials-do-patients-benefit monthly 0.5 2024-05-30 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/d54bfa3a-962b-48ee-9d42-1630cf976c6b/Screenshot+2024-05-24+at+4.03.56%E2%80%AFPM.png Newsreel - Enrolment in Clinical Trials: Do Patients Benefit? - Make it stand out Courtesy JAMA (2024) https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/988e099b-8386-4079-b577-eccb0af6d1ff/Screenshot+2024-05-24+at+4.07.31%E2%80%AFPM.png Newsreel - Enrolment in Clinical Trials: Do Patients Benefit? - Make it stand out Courtesy JAMA (2024) https://www.inquisitiveonc.com/newsreel/hypercalcaemia-of-malignancy-a-foreboding-entity monthly 0.5 2024-05-23 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/d703160a-c0e4-4519-a23c-33476ec9aea8/Screenshot+2024-05-23+at+12.55.35%E2%80%AFPM.png Newsreel - Hypercalcaemia of Malignancy: A Foreboding Entity - Make it stand out Courtesy of National Institute of Health (NIH) [4] https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/4a79fb91-5a90-4bf9-a8c3-7c019e337c32/Screenshot+2024-05-23+at+1.29.42%E2%80%AFPM.png Newsreel - Hypercalcaemia of Malignancy: A Foreboding Entity - Make it stand out Table 1. Courtesy of the Journal or Hormone and Metabolic Research [3] https://www.inquisitiveonc.com/newsreel/renal-toxicity-with-chemotherapy-and-ici-an-underrated-toxicity monthly 0.5 2024-05-09 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/a244a670-a27d-40de-b53a-44ac3c3979ec/Screenshot+2024-05-03+at+2.25.48%E2%80%AFPM.png Newsreel - Renal Toxicity with Chemotherapy and ICI - an Under-Appreciated Toxicity - Make it stand out Image courtesy of Journal of Thoracic Oncology The mechanism of renal toxicity from anti-cancer chemotherapy is variable, but usually falls into one of two categories: Acute tubular necrosis (ATN): intrinsic damage to the kidney caused by either tubular hypoperfusion or accumulation of nephrotoxins. The usual cause of chemotherapy-induced nephrotoxicity Acute tubulointerstitial nephritis (AITN): infiltration of the tubules by immune and inflammatory cells. Almost always caused by medications. The usual aetiology for ICI-induced nephritis Common nephrotoxic anticancer agents include cisplatin, carboplatin, pemetrexed and immune checkpoint inhibitors: Cisplatin principally undergoes renal excretion, causing high concentrations in the renal cortex. It primarily induces ATN through activation of multiple intracellular injury pathways, including inflammation, oxidative stress and apoptosis. The frequently-observed side effect of hypomagnesemia may be a consequence of decreased reabsorption through the tubules Carboplatin is primarily excreted through glomerular filtration, so direct toxicity to the renal tubules is less severe than cisplatin. Dosing is also based exclusively on creatinine clearance, as opposed to body surface area (BSA), so declining renal function will result in a consequential dose reduction. Pemetrexed is an antifolate agent that inhibits multiple enzymes involved in purine and thymidine nucleotide synthesis. It does not undergo significant metabolisis and thus 70-90% of pemetrexed is secreted unchanged through the urine. The exact mechanism of renal injury is unknown. ICIs are most commonly given in the form of PD-(L)1 inhibitors that aim to block the up-regulation of the immunosuppressive PD-L1 receptor that is present on many tumour cells. However, PD-L1 is also expressed in renal cells, and blockage may lead to T cell proliferation and renal cytotoxic injury. It is theorised that peripheral tolerance of self-reactive T cells may be the reason that autoimmune nephritis is not more common, and loss of this self-tolerance is a driver of irAE development. AITN is the most common cause of immune-mediated renal damage, but in rare cases a distinct glomerulonephritis may develop as a result of ICI. https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/cfd2ef39-7816-487f-a557-1df3593dae4a/Screenshot+2024-05-03+at+3.42.31%E2%80%AFPM.png Newsreel - Renal Toxicity with Chemotherapy and ICI - an Under-Appreciated Toxicity - Make it stand out Image courtesy of Journal of Thoracic Oncology https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/ff645bf7-c141-4a17-bc40-315a4640afec/Screenshot+2024-05-03+at+3.45.58%E2%80%AFPM.png Newsreel - Renal Toxicity with Chemotherapy and ICI - an Under-Appreciated Toxicity - Make it stand out Image courtesy of Journal of Thoracic Oncology As always, the first step is an accurate history and physical exam. Dumoulin et al. repeatedly stress the importance of an accurate medication history, as nephrotoxic medications such as non-steroidal anti-inflammatory agents (NSAIDs), diuretics, angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs) are commonly prescribed to patients in the community. Assessment of the eGFR can be difficult in the acute phase; calculation of eGFR is not accurate when serum creatinine is not in a steady state. As a result, many nephrologists prefer changes to the baseline serum creatinine or active calculation of a patient’s creatinine clearance (CrCl) for assessing renal function. No laboratory tests are useful in differentiating between ATN and ATIN. Serum eosinophils may be moderately elevated, but this is not commonly the case; one case series only identified one out of twelve patients with eosinophilia. Urinalysis may be helpful to assess for pyuria, haematuria and the presence of casts. Immune-mediated ATIN commonly presents with sterile pyuria, sub-nephrotic range proteinuria and redd cell casts. If pre-renal disease is excluded or severe AKI is noted, exclusion of a post-renal malignant ureteric obstruction is critical. This can be easily achieved through an ultrasound or non-contrast CT of the kidneys, ureters and bladder (KUB). Opting for a non-contrast imaging modality is critical, as the use of iodine-based contrasts is implicated in worsening AKI. Frequently, a renal biopsy is required to differentiate between ATN and ATIN and to indicate the likely causative agent. ATIN is characterised by mononuclear cell infiltration, including CD3+ T cells, CD4+ T-helper cells, and mild infiltration of CD8+ cytotoxic T cells. https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/0b5a3e89-e000-41f4-b3d4-8238230db554/Screenshot+2024-05-03+at+4.08.28%E2%80%AFPM.png Newsreel - Renal Toxicity with Chemotherapy and ICI - an Under-Appreciated Toxicity - Make it stand out Image courtesy of Journal of Thoracic Oncology The mainstay of management of AKI is withdrawal of the offending agent, cessation of any other nephrotoxic agents, and management of underlying contributory conditions such a heart failure, hypertension and diabetes. Specific recommendations for anticancer agents are also available: Cisplatin: dose reduce (DR) by 25% for CrCl of 46-60mL/min and DR by 50% for CrCl of 30-45mL/min. Consider substituting carboplatin for cisplatin in patients with severe renal impairment where appropriate Carboplatin: consider adjusting the area under the curve (AUC) dosing if required, but usually no specific dose adjustments are required. Pemetrexed: no changes required if CrCl >45mL/min. Not recommended if CrCl <45mL/min, but data are minimal. ICI: can continue if G1 AKI. Withhold if G2-3 AKI and institute steroid therapy. Rechallenge according to local guidelines. If G4 or steroid-refractory AKI, suggestion is to permanently cease ICI therapy. https://www.inquisitiveonc.com/newsreel/aggressive-variant-prostate-cancer-avpc-a-success-storys-dark-side monthly 0.5 2024-05-02 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/49588c1a-483c-4ef5-bfeb-2b4d0cd1df45/Screenshot+2024-04-28+at+11.28.24%E2%80%AFAM.png Newsreel - Aggressive-Variant Prostate Cancer (AVPC) - a success story’s Dark Side - Make it stand out Characteristics of AVPC. Image courtesy of Cancer (2020) https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/562208fb-189c-4262-b21f-075de885d669/Screenshot+2024-04-28+at+11.44.34%E2%80%AFAM.png Newsreel - Aggressive-Variant Prostate Cancer (AVPC) - a success story’s Dark Side - Make it stand out Image courtesy of Cancer (2020) https://www.inquisitiveonc.com/newsreel/management-of-older-patients-with-head-and-neck-cancer-a-forest-of-confusing-evidence monthly 0.5 2024-04-25 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/aa89c386-33c6-44dd-a729-5fa8d961de96/Screenshot+2024-04-19+at+3.09.43%E2%80%AFPM.png Newsreel - Management of Older Patients with Head and Neck Cancer - a Forest of Confusing Evidence - Make it stand out Image courtesy of Auris Nasus Larynx However, few studies of these screening tools have focussed on head and neck cancer (HNC). A pilot study by Neve et al. found that the G8 identified twice as many patients (17 vs 7) as vulnerable as the multidisciplinary meeting (MDM). Another prospective study published by the authors also demonstrated a significant difference in overall survival for eldery patients with HNC deemed abnormal by the G8 screening tool (below). https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/6fa41aa1-0a57-45a7-b739-1a06d12202d9/Screenshot+2024-04-19+at+3.15.36%E2%80%AFPM.png Newsreel - Management of Older Patients with Head and Neck Cancer - a Forest of Confusing Evidence - Make it stand out Image courtesy of Auris Nasus Larynx So, we can see that the decision-making process for elderly patients with cancer is already fraught with difficulty. This difficulty is, in many ways, compounded for patients with head and neck cancer. Surgical, radiological or systemic treatment of HNC can be incredibly disfiguring and distressing, commonly resulting in impairment of swallowing and speech. Elderly patients are particularly prone to airway and oesophageal complications, and outcomes are poor; for example, reviews of short- and long-term outcomes found that elderly patients with oropharyngeal or laryngeal cancer were between 50% and 90% more likely to suffer airway obstruction within one year of treatment. The authors also reinforce that any treatment decision must take patient preference into account, as some patients will elect for palliative treatment — or even no treatment at all — to prioritise quality of life and minimise the risk of permanent disfigurement. So, how does this affect the management of elderly patients with HNC? Again, the evidence is frequently baffling and contradictory. Combined chemoradiotherapy (CCRT) is commonly used as definitive or adjuvant treatment for those with early-stage disease. However, the benefit of either CRRT or radiotherapy alone in this population has long been an area of controversy. The majority of evidence in this space is retrospective, but two prospective studies by Stromberger et al. (2021) and de Vries et al. (2022) found that greater comorbidity, lower functional status and definitive CRT as treatment were all associated with both lower survival and lower quality of life. Due to the higher risk of swallowing difficulties and aspiration pneumonia in elderly patients, nutritional therapy, oropharyngeal rehabilitation and oral care are of particular importance in this population. On the other hand, for patients receiving adjuvant chemoradiotherapy, the SEER database by Woody et al. suggested that chemoradiotherapy for patients >70 with resected HNC conveyed a significant overall survival (OS) benefit (HR 0.74, p=0.04). This suggests that elderly patients should not automatically be disqualified from receiving more intensive anticancer therapy purely based on age, but patient selection needs to be carefully considered. Historically, in the metastatic setting, clinicians had a lower threshold to transition to symptom-based supportive care in elderly patients due to the inherent toxicity — and low effectiveness — of chemotherapy. The emergence of immunotherapy regiments, including 5-flurouracil + pembrolizumab (KEYNOTE-048) and single agent nivolumab (CHECKMATE 141) have significantly changed this outlook, allowing more elderly patients to receive palliative therapy for HCN not amenable to definitive therapy. Similarly, hypofractionated or “quad shot” radiotherapy may be an option for those patients deemed too frail for definitive therapy. Finally, elderly patients with HCN must be discussed in a multidisciplinary team (MDT) context. Now the standard of care for the management of cancer patients worldwide, most MDTs should include at minimum representatives from surgical, radiological, pathological, radiation and medical oncology teams. Larger MDTs for HCN could also include dental specialists, dieticians, social workers, speech pathologists, psychologists and specialised nurses. For elderly patients, it is important to involve a geriatrician as well, as they are frequently those with the most experience conducting CGAs. The Bottom Line: The treatment of elderly patients with HCN is extremely challenging, combining the issues of two already-complex cohorts of patients. Multidisciplinary management is a must in order to maximise outcomes and balance quality and quantity of life. The use of geriatric screening tools and early engagement of specialists in an MDT can help guide treatment decisions in the face of confusing, sometimes contradictory evidence. Source: Ishii, R., Ohkoshi, A., & Katori, Y. (2024). Treatment of elderly patients with head and neck cancer in an aging society: Focus on geriatric assessment and surgical treatment. Auris Nasus Larynx, 51(4), 647-658. https://doi.org/10.1016/j.anl.2024.04.005 Other sources in this article: Neve, M., Jameson, M. B., Govender, S., & Hartopeanu, C. (2016). Impact of geriatric assessment on the management of older adults with head and neck cancer: A pilot study. Journal of Geriatric Oncology, 7(6), 457-462. https://doi.org/10.1016/j.jgo.2016.05.006 Motz, K., Herbert, R. J., Fakhry, C., Quon, H., Kang, H., Kiess, A. P., Eisele, D. W., Koch, W. M., Frick, K. D., & Gourin, C. G. (2018). Short- and long-term outcomes of oropharyngeal cancer care in the elderly. The Laryngoscope, 128(9), 2084-2093. https://doi.org/10.1002/lary.27153 Gourin, C. G., Starmer, H. M., Herbert, R. J., Frick, K. D., Forastiere, A. A., Eisele, D. W., & Quon, H. (2015). Short- and long-term outcomes of laryngeal cancer care in the elderly. The Laryngoscope, 125(4), 924-933. https://doi.org/10.1002/lary.25012 Stromberger C, Yedikat B, Coordes A, Tinhofer I, Kalinauskaite G, Budach V, Zschaeck S, Raguse J-D, Kofla G, Heiland M, Stsefanenka A, Beck-Broichsitter B, Dommerich S, Senger C and Beck M (2021) Prognostic Factors Predict Oncological Outcome in Older Patients With Head and Neck Cancer Undergoing Chemoradiation Treatment. Front. Oncol. 10:566318. doi: 10.3389/fonc.2020.566318 de Vries J, Bras L, Sidorenkov G, et al. Association of Deficits Identified by Geriatric Assessment With Deterioration of Health-Related Quality of Life in Patients Treated for Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. 2021;147(12):1089–1099. doi:10.1001/jamaoto.2021.2837 Woody, N. M., Ward, M. C., Koyfman, S. A., Reddy, C. A., Geiger, J., Joshi, N., Burkey, B., Scharpf, J., Lamarre, E., Prendes, B., & Adelstein, D. J. (2017). Adjuvant Chemoradiation After Surgical Resection in Elderly Patients With High-Risk Squamous Cell Carcinoma of the Head and Neck: A National Cancer Database Analysis. International Journal of Radiation Oncology*Biology*Physics, 98(4), 784-792. https://doi.org/10.1016/j.ijrobp.2017.03.019 https://www.inquisitiveonc.com/newsreel/a-better-prostate-screening-regimen-results-from-proscreen monthly 0.5 2024-04-18 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/8c5b7a54-b025-49ea-8c50-5d2a51379bdf/m_jpc240002va_1712089188.80655.png Newsreel - A Better Prostate Screening Regimen? Early Results from ProScreen - Make it stand out Image courtesy of JAMA, 2024 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/73a1d234-017f-4c10-bcfa-eb5eb091a9ab/Screenshot+2024-04-11+at+3.13.40%E2%80%AFPM.png Newsreel - A Better Prostate Screening Regimen? Early Results from ProScreen - Make it stand out Image courtesy of JAMA, 2024 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/120c4b5d-9b9a-45ad-8231-27ce8023ac7a/Screenshot+2024-04-11+at+3.35.47%E2%80%AFPM.png Newsreel - A Better Prostate Screening Regimen? Early Results from ProScreen - Make it stand out Image courtesy of JAMA, 2024 526 men had PSA values of 3ng/mL or higher, and kallikrein panel scores of 7.5% or higher. 97% of these underwent MRI, of which 41% had a PI-RADS score of 3-5, suggestive of high-grade cancer. Transrectal prostate biopsies were performed in 209 (99%) of these high-risk patients (2.7% of total screening participants), 136 (65%) of which demonstrated prostate cancer. The number of biopsies needed to detect cancer in this group was 1.5. Of those cases, 113 were high-grade (52 GG2 and 61 GG3-5). 53 patients had a PI-RADS score <3 but a PSA density of 0.15ng/L squared or higher. These patients were referred for a systematic biopsy, and 25 biopsies demonstrated cancer (10 GG1, 11 GG2, 4 GG3-5). Detection of high-grade cancer increased with age, PSA value, the 4-kallikrein panel risk score. For reference, among the 45,544 men in the control group 355 new prostate cancers were detected during a median follow-up of 3.2 years, of which 282 (79%) were high-grade histopathology. So what does all this mean? The first thing to note is that the study remains in progress, and drawing definitive conclusions on the program’s mortality benefit from available data is impossible. While the screening program appears to be more efficacious in detecting prostate cancer, that is unsurprising given the investigations involved. In addition, the use of multiparametric MRI at patients’ baseline screening visits may prove to be a limiting factor to this program in many larger, more sparsely-populated countries or those with lower SES. In Australia, for example, the availability of MRIs varies significantly by geographic location. As a result, for a population-based screening program, the benefit may be limited. However, despite these limitations, one number leaps from the page: 1.5. This is the number of biopsies required to detect cancer after completing the prescribed screening program. Ideally, the number needed to treat or detect (NNT) should be as close to 1 as possible; an NNT of 1 means that every test will detect cancer. Given the predominance of high-grade cancer in this group, it is possible that the screening program will lead to earlier detection, more patients undergoing — or at least be provided with the option of — definitive management and prolonged survival. For now, however, the best that communities and general practitioners can do is judiciously use PSA for population screening, with a low threshold to refer patients with high-risk features for radiological or urological evaluation. Source: Auvinen A, Tammela TLJ, Mirtti T, et al. Prostate Cancer Screening With PSA, Kallikrein Panel, and MRI: The ProScreen Randomized Trial. JAMA. Published online April 06, 2024. doi:10.1001/jama.2024.3841 Other useful links: Royal Australian College of General Practitioners guidelines for colorectal screening. Available from: https://www1.racgp.org.au/ajgp/2018/december/colorectal-cancer-screening-in-australia Martin RM, Donovan JL, Turner EL, et al. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. JAMA. 2018;319(9):883–895. doi:10.1001/jama.2018.0154 Rittenhouse, H. G., Finlay, J. A., Mikolajczyk, S. D., & Partin, A. W. (1998). Human Kallikrein 2 (hK2) and Prostate-Specific Antigen (PSA): Two Closely Related, but Distinct, Kallikreins in the Prostate. Critical Reviews in Clinical Laboratory Sciences, 35(4), 275–368. https://doi.org/10.1080/10408369891234219 https://www.inquisitiveonc.com/newsreel/senomac-trial-is-the-answer-less-slice-and-dice monthly 0.5 2024-04-11 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/f23e2b4d-bfce-4e16-9009-c6cb928f52ad/nejmoa2313487_f1.jpg Newsreel - SENOMAC Trial - Is the Answer Less Slice and Dice? - Make it stand out Image courtesy of New England Journal of Medicine https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/1661895f-42cc-4716-b2f4-0da8b1b85d63/nejmoa2313487_t1.jpg Newsreel - SENOMAC Trial - Is the Answer Less Slice and Dice? - Make it stand out Image courtesy of New England Journal of Medicine https://www.inquisitiveonc.com/newsreel/immunotherapy-in-kidney-transplant-patients-the-final-frontier-for-ici monthly 0.5 2024-04-04 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/cee08518-6e48-4a01-a52f-facdb60da325/Screenshot+2024-03-24+at+10.35.33%E2%80%AFam.png Newsreel - Immunotherapy in Kidney Transplant Patients - the Final Frontier for ICI? - Make it stand out Image courtesy of Journal of Clinical Oncology https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/ef91a6b1-d0ac-4aad-b9e0-0269757f0ada/Screenshot+2024-03-24+at+10.38.03%E2%80%AFam.png Newsreel - Immunotherapy in Kidney Transplant Patients - the Final Frontier for ICI? - Make it stand out Image courtesy of Journal of Clinical Oncology https://www.inquisitiveonc.com/newsreel/paloma-2-update-is-this-the-end-of-palbociclib monthly 0.5 2024-03-28 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/d6459af1-10e1-404f-809a-a2cb77eb23e1/Screenshot+2024-03-21+at+12.48.27%E2%80%AFpm.png Newsreel - PALOMA-2 Final Update: Is This the End of Palbociclib? - Make it stand out Image courtesy Journal of Clinical Oncology, 2024 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/a223ee7c-17b1-43f6-a6a8-a558261c2ef4/Screenshot+2024-03-21+at+1.53.59%E2%80%AFpm.png Newsreel - PALOMA-2 Final Update: Is This the End of Palbociclib? - Make it stand out Table courtesy of npj Breast Cancer https://www.inquisitiveonc.com/newsreel/immunotherapy-duration-is-two-years-really-enough monthly 0.5 2024-03-21 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/775dda90-e635-4c7b-b37d-35036f5bcd7c/Screenshot+2024-03-15+at+2.10.52%E2%80%AFpm.png Newsreel - Duration of Immunotherapy - Is Two Years Enough? - Make it stand out Image courtesy of JAMA (2023) https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/850ba5f6-3a3e-4827-8471-2e51acc4053a/Screenshot+2024-03-15+at+2.32.43%E2%80%AFpm.png Newsreel - Duration of Immunotherapy - Is Two Years Enough? - Make it stand out Image courtesy of JAMA (2023) https://www.inquisitiveonc.com/newsreel/mechanisms-of-primary-and-secondary-resistance-to-immunotherapy monthly 0.5 2024-03-15 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/85c94b16-975c-4eec-8bfd-46d173d8a73b/Screenshot+2024-03-14+at+2.10.10%E2%80%AFpm.png Newsreel - Mechanisms of Primary and Secondary Resistance to Immunotherapy - Make it stand out Image courtesy of Journal of Medial Sciences (2019) https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/e244fd7c-1b66-4df6-95b4-ec55ed72da1f/Screenshot+2024-03-14+at+2.45.41%E2%80%AFpm.png Newsreel - Mechanisms of Primary and Secondary Resistance to Immunotherapy - Make it stand out Image courtesy of Frontiers of Oncology (2020) https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/650ed0c5-5ed6-4a9e-9d78-4a0fc470b628/Screenshot+2024-03-14+at+3.04.26%E2%80%AFpm.png Newsreel - Mechanisms of Primary and Secondary Resistance to Immunotherapy - Make it stand out Image courtesy of Frontiers of Oncology (2020) https://www.inquisitiveonc.com/newsreel/neostar-adcs-in-neoadjuvant-triple-negative-breast-cancer monthly 0.5 2024-03-08 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/f8cae4be-8bbd-4e29-9c01-207daab4b6f0/Picture1.png Newsreel - NeoSTAR - ADCs in Neoadjuvant Triple Negative Breast Cancer? - Make it stand out NeoSTAR study design. Courtesy of Annals of Oncology https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/061538f6-02a1-4545-9c6c-53cee77fae56/Screenshot+2024-03-07+at+11.45.14%E2%80%AFam.png Newsreel - NeoSTAR - ADCs in Neoadjuvant Triple Negative Breast Cancer? - Make it stand out Waterfall plot demonstrating best response by RECIST 1.1. 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The most common adverse events were fatigue and peripheral neuropathy, with the most common Grade 3+ adverse events related to haematological toxicity. These toxicities can be associated with the carboplatin and paclitaxel backbone as opposed to the pembrolizumab/placebo. Adverse events of special interest were likewise fairly uncommon; AEs of any grade occurred in 38.5% and 33.3% of patients in the dMMR and pMMR cohorts, respectively. Grade 3+ adverse events of special interest occurred in 8.3% and 3.6% of patients in the two cohorts, respectively. The Bottom Line: comparisons between NRG-GY018 and RUBY are unavoidable, not least because both were published in NEJM on the same day. Both had very similar methodologies, inclusion criteria and patient populations. While the analysis from RUBY is further along compared to NRG-GY018, it is likely that both pembrolizumab and dostarlimab will have similar efficacy in the treatment of advanced endometrial cancer. It is also worth noting that RUBY’s interim overall survival data did not reach the statistical threshold for significance. Ultimately, however, both studies still need time before final results will become available As a result, which agent gains traction will likely be due to local availability and physician preference; unfortunately, a head-to-head study is unlikely in the foreseeable future. But no one said an overabundance of therapeutic options was a bad thing in the oncology space! 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stand out NEJM 2020 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/1874bf46-b956-4867-97b6-138b88446cf4/Untitled.jpg Newsreel - ADAURA - adjuvant osimertinib reigns supreme - Make it stand out NEJM 2020 https://www.inquisitiveonc.com/newsreel/tick-tock-a-metronomic-approach-to-treatment-of-nasopharyngeal-cancer-not-the-social-media monthly 0.5 2023-03-24 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/9940a604-367a-4b63-a75c-6b36eedc58fe/Picture1.png Newsreel - Tick Tock - A Metronomic Approach to Treatment of Nasopharyngeal Cancer, not the Social Media - Make it stand out (C) Lancet Oncology, 2021 https://images.squarespace-cdn.com/content/v1/63f045c31a25a919fdae711c/58627563-ec72-4f75-a32b-5313ea9af587/Picture2.png Newsreel - Tick Tock - A Metronomic Approach to Treatment of Nasopharyngeal Cancer, not the Social Media - Make it stand out (C) Lancet Oncology, 2021 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