Lessons from 3 phase III trials assessing neo-adjuvant treatment in sarcoma patients

sarcomalevel of evidenceneoadjuvant chemotherapyneoadjuvant radiotherapy

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Editorial on “Exploratory analysis of the association of depth of response and survival in patients with metastatic non-small cell lung cancer treated with a targeted therapy or immunotherapy”

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First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance therapy for patients with advanced EGFR mutation-positive lung adenocarcinoma (CONVINCE): a phase 3, open-label, randomized study

Abstract

Background: Icotinib has been previously shown to be non-inferior to gefitinib in non-selected advanced non-small cell lung cancer (NSCLC) patients when given as second- or further-line treatment. In this open-label, randomized, phase 3 CONVINCE trial, we assessed the efficacy and safety of first-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance in lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutation.Patients and methods: Eligible participants were adults with stage IIIB/IV lung adenocarcinoma and exon 19/21 EGFR mutations. Participants were randomly allocated (1:1) to receive oral icotinib or 3-week cycle of cisplatin plus pemetrexed for up to 4 cycles; non-progressive patients after 4 cycles were maintained with pemetrexed until disease progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS) assessed by independent response evaluation committee (IREC). Other endpoints included overall survival (OS) and safety.Results: Between Jan 2013 and Aug 2014, 296 patients were randomized, and 285 patients were treated (148 to icotinib, 137 to chemotherapy). IREC-assessed PFS was significantly longer in the icotinib group (11.2 vs 7.9 months; hazard ratio, 0.61, 95% confidence interval 0.43-0.87; P = 0.006). No significant difference for OS was observed between treatments in the overall population or in EGFR-mutated subgroups (exon 19 Del/21 L858R). The most common grade 3 or 4 adverse events (AEs) in the icotinib group were rash (14.8%) and diarrhea (7.4%), compared with nausea (45.9%), vomiting (29.2%), and neutropenia (10.9%) in the chemotherapy group. AEs (79.1% vs 94.2%; P < 0.001) and treatment-related AEs (54.1% vs 90.5%; P < 0.001) were significantly fewer in the icotinib group than in the chemotherapy group.Conclusions: First-line icotinib significantly improves PFS of advanced lung adenocarcinoma patients with EGFR mutation with a tolerable and manageable safety profile. Icotinib should be considered as a first-line treatment for this patient population.ClinicalTrials.gov Registration Number NCT01719536.

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Recurrent Bleeding Neck Mass: a Case Report

Abstract

An adult male presented to us with a recurrent, large bleeding tumour in the neck. We describe our approach to the patient, whose tumour was labelled as an atypical glomus on final histopathology. They are relatively uncommon in the head neck, and this case report with literature review is expected to add to our knowledge.

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Motivating Older Adults with Cancer to Keep Moving: the Implications of Lifestyle Interventions on Physical Activity

Abstract

Purpose of Review

The purposes of this review are to describe the unique needs and preferences of older adults with cancer regarding physical activity and to outline the essential characteristics associated with increased physical activity resulting from lifestyle interventions in older adults.

Recent Findings

Functional decline is accelerated in inactive and sedentary older adults. Even a modest increase in physical activity can improve physical function for older cancer survivors.

Summary

Participation in physical activity is influenced by diverse individual-level factors, behavioral characteristics and skills and social and environmental factors. Thus, programs that are tailored to older adults' preferences provide social support and remove obstacles to participation may be more effective, particularly for older adults with low physical activity and sedentary lifestyle.

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The Evolving Role of Tumor Treating Fields in Managing Glioblastoma: Guide for Oncologists.

Glioblastoma (GBM) is a devastating brain tumor with poor prognosis despite advances in surgery, radiation, and chemotherapy. Survival of patients with glioblastoma remains poor, with only 1 in 4 patients alive at 2 years, and a 5-year survival rate of about 5%. Recurrence is nearly universal and, after recurrence, prognosis is poor with very short progression-free survival and overall survival (OS). Various salvage chemotherapy strategies have been applied with limited success. Tumor Treating Fields (TTFields) are a novel treatment modality approved for treatment of either newly diagnosed or recurrent GBM. TTFields therapy involves a medical device and transducer arrays to provide targeted delivery of low intensity, intermediate frequency, alternating electric fields to produce antimitotic effects selective for rapidly dividing tumor cells with limited toxicity. In the phase 3 EF-14 trial, TTFields plus temozolomide provided significantly longer progression-free survival and OS compared with temozolomide alone in patients with newly diagnosed GBM after initial chemoradiotherapy. The addition of TTFields to standard therapy improved median OS from 15.6 to 20.5 months (P=0.04). In the phase 3 EF-11 trial, for recurrent GBM, TTFields provided comparable efficacy as investigator's choice systemic therapy, with improved patient-reported quality of life and a lower incidence of serious adverse events. Primary toxicity associated with TTFields is skin irritation generally managed with array relocation and topical treatments including antibiotics and steroids. TTFields therapy has demonstrated proven efficacy in management of GBM, including improvement in OS for patients with newly diagnosed GBM, and is under current investigation in other brain and extracranial tumors. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of Autologous Cytokine-Induced Killer Cells Infusion in Colorectal Cancer Patients: A Prospective Study

Cancer Biotherapy & Radiopharmaceuticals Aug 2017, Vol. 32, No. 6: 221-226.


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