Most Read Articles
Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Yesterday
Case presentation: The patient is a 46-year-old Korean lady who first presented with aggravating pleuritic chest pain characterised by a stabbing pain in the chest when inhaling and exhaling. A diagnosis of non-small cell lung cancer (NSCLC) was made from computed tomography (CT)-guided needle aspiration biopsy, and the tumour was found to be epidermal growth factor receptor (EGFR) mutation-positive (exon 19 deletion). Chest imaging revealed the presence of left-sided pleural seeding nodules. The patient was treated with afatanib with partial response as best response. Ten months after starting treatment, the patient experienced disease progression.

Basic tumour properties improve biomarker-based predictor of treatment response

Tristan Manalac
03 Dec 2019
Australian scientists have developed a simpler way to help detect Parkinson's disease: through a blood test.

Incorporating basic tumour characteristics, such as hormone receptor status and tumour origin, improves the power of the cell-loss metric to predict response to treatment, according to a new study presented at the recently concluded 2019 Asia Congress of the European Society for Medical Oncology (ESMO Asia 2019).

“Early prediction of tumour response to therapy is essential for individualized treatment and sparing nonresponders needless harm,” said researchers, noting that a correlation between such response and tumour cell loss has recently been found in breast cancer patients undergoing neoadjuvant chemotherapy. The goal of the present study was to see if basic tumour characteristics could improve the predictive ability of this cell-loss metric.

Of the 58 localized breast cancer patients (median age, 49 years) who underwent neoadjuvant treatment, the median concentration of serum thymidine kinase 1 (sTK1) at baseline was 0.28 ng/mL. This had doubled before the second to fourth treatment cycles and further increased to thrice its original level 48 hours after treatment. [ESMO Asia 2019, abstract 29P]

The volume of the tumour decreased exponentially over the course of treatment, dropping below 50 cm3 by the fourth cycle. More than a quarter (26 percent; n=15) achieved local tumour control.

The biomarker sTK1 is released when tumour proliferation is interrupted and was used as the primary measure for the cell-loss metric, along with tumour volume.

The median cell-loss metric value at baseline was calculated to be 0.0032 ngxml–1/cm3. This grew fivefold by the second treatment cycle, and further to seven times its baseline figure 48 hours after. Participants who had achieved local control had significantly greater cell-loss metric values than those who still had remaining tumours.

In addition to this, forward selection found that the oestrogen receptor (ER) status and histological type of the tumour were also significantly predictive of local control. Other factorssuch as age, menopausal status, positivity of axillary lymph nodes, tumour subtypes, and progesterone (PR) and HER2 receptor statuswere not.

A logistic regression algorithm found that adding ER status to the cell-loss metric increased the resulting area under the curve (AUC) from 0.703 to 0.789. The effect of histological type was stronger, improving the AUC to 0.843.

Moreover, incorporating PR status and the ratio between Ki67 and tumour volume at baseline led to a spike in detection specificity and sensitivity to 0.93 and 0.975, respectively. The resulting AUC of this model was 0.916.

“This cell-loss metric appears useful for early prediction of pathological response as established at surgery,” the researchers said. “Here, we could demonstrate that the predictive power of the metric was significantly improved by adding tumour markers … obtained by routine histopathology at diagnosis.”

“The usefulness of data on macromolecules released from tumour tissue into blood circulation can be improved by combining them with other tumour properties,” they added. “Early prediction of tumour response makes this cell-loss metric potentially useful in personalized oncology and in the evaluation of new therapeutic modalities.”

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Most Read Articles
Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Yesterday
Case presentation: The patient is a 46-year-old Korean lady who first presented with aggravating pleuritic chest pain characterised by a stabbing pain in the chest when inhaling and exhaling. A diagnosis of non-small cell lung cancer (NSCLC) was made from computed tomography (CT)-guided needle aspiration biopsy, and the tumour was found to be epidermal growth factor receptor (EGFR) mutation-positive (exon 19 deletion). Chest imaging revealed the presence of left-sided pleural seeding nodules. The patient was treated with afatanib with partial response as best response. Ten months after starting treatment, the patient experienced disease progression.