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In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5
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Rhabdoid tumour associated with poor outcomes among youths with high-risk renal tumours

11 Sep 2018

In young people with high-risk renal tumours (HRRT), survival is poor in the presence of rhabdoid tumour (RTK) and favourable in the presence of clear cell sarcoma (CCSK), according to a study.

The study included 349 patients aged ≤30 years who were diagnosed with anaplastic Wilms tumour (AWT; 38.1 percent), CCSK (34.4 percent) or RTK (27.5 percent). Compared with those in the AWT or CCSK group, patients in the RTK group were less likely to undergo surgery (94 percent vs 99 percent vs 77.1 percent, respectively; p<0.001) and to receive chemotherapy (96.2 percent vs 95 percent vs 84.4 percent, respectively; p=0.013) or radiation therapy (81.2 percent vs 86.7 percent vs 52.1 percent, respectively; p<0.001).

Estimated 5-year overall survival (OS) was 76.1 percent (67.9–84.4) in the AWT group, 92.7 percent (87.4–97.9) in the CCSK group and 33.5 percent (23.1–43.9) in the RTK group (p<0.001).

Multivariate Cox regression analysis showed that worse OS was significantly associated with AWT (hazard ratio [HR], 3.372; p=0.032) and RTK histology (HR, 12.595; p<0.001), whereas improved OS was associated with receipt of radiation therapy (HR, 0.43; p=0.006). No such associations were observed for LN positivity, margin status, and undergoing surgery.

When HRRTs were analysed individually, factors associated with OS included undergoing surgery for AWT (HR, 0.308; p=0.031), and both undergoing surgery (HR 0.209, p=0.007) and receipt of radiation therapy for RTK (HR, 0.411; p=0.008).

According to researchers, adjuvant radiation, while significantly associated with improved outcomes for all HRRTs, may be underutilized in patients at the highest risk, namely those with RTK. This indicates a potential for future improvement in the care of this population.

Additional investigation into the specific biology of RTKs is needed to allow for more precision and targeted therapies, which should translate to gains in the prognosis of such tumours, researchers added.

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Most Read Articles
5 days ago
In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course