Ipatasertib plus abiraterone (Zytiga) was associated with improved radiographical progression-free survival (PFS) in patients with metastatic castrate-resistance prostate cancer (mCRPC) and PTEN-loss tumors, according to data from the ongoing IPATential150 trial (NCT03072238), published in 

Of note, the same improvement was not statistically significant in the intention-to-treat population. Adverse events (AEs) reflected previously reported safety profiles.

At the median follow-up at 19 months, the median radiographical PFS was 18.5 months (95% CI, 16.3-22.1) in the experimental arm and 16.5 months (95% CI, 13.9-17.0) in the control arm (HR, 0.77; 95% CI, 0.61-0.98; 

 = .034). Median PFS in the intention-to-treat population was 16.6 months in the control group and 19.2 months in the experimental group (HR, 0.84; 95% CI, 0.71-0.99; 

“Overall, our findings confirm that combined AKT and androgen-receptor signaling pathway blockade with ipatasertib plus abiraterone is superior to androgen-receptor signaling pathway blockade alone with abiraterone in patients with mCRPC with PTEN loss, as previously observed in the phase 2 study,” wrote the investigators. “This trial is, to our knowledge, the first to provide comprehensive phase 3 data confirming the role of simultaneous AKT and androgen- receptor signaling pathway inhibition.”

The study included 1611 patients with generally balanced baseline characteristics who were divided equally into investigative and control arms. Roughly 18% of the participants had received prior taxane-based therapy for hormone-sensitive prostate cancer, and 14% had visceral metastases, including lung, liver, or a combination of both. The participants consisted of 561 (51%) European patients, 277 (25%) Asian-Pacific, 144 (13%) North American, and 119 (11%) other populations.

Secondary end points assessed overall survival, time to prostate specific antigen (PSA) progression, PSA response rate, and objective response rate.

Around 47% of patients had experienced PTEN loss by immunohistochemistry. Among this population, the PSA response rate was 11.8% (95% CI, 4.3-19.3) greater in the experimental arm (83%) than in the control arm (72%).The difference was less significant in the intention-to-treat population, where the PSA response rate between the ipatasertib and placebo group was 5.9%.

In addition, the median time to PSA progression was greater with ipatasertib in both the PTEN-loss-by-immunohistochemistry and intention-to-treat population.

Overall, AEs were observed in 70% of patients treated with the ipatasertib-abiraterone combination.Treatment was discontinued in 5% of the placebo group and 21% of the ipatasertib group in response to AEs. Two patients died in relation to the AEs from both the placebo and ipatasertib group.

One limitation that the authors noted was that most of the tumor samples were archival, and a percentage of patients might have developed PTEN loss during the time between sample collection and initiation of study treatment. Furthermore, next-generation sequencing could not determine the PTEN status of several tumor samples.The authors argued that the strong collaboration with independent assessments helped validate the investigator assessment of radiographical progression, which was therefore not a limitation.

The study authors concluded that “this study did not reveal a benefit with ipatasertib in the overall population but confirmed that combined AKT and androgen-receptor signaling pathways blockade with ipatasertib and abiraterone provided a significantly reduced risk of radiographical disease progression or death and improved clinical outcomes compared with androgen-receptor blockade alone with abiraterone in men with mCRPC with PTEN loss—a large subgroup of patients who have poor prognosis.”

The authors stated that future studies should evaluate the effect of early and optimal prophylactic measures to prevent the need for drug discontinuation.

Sweeny C, Bracarda S, Sternberg CN, et al.Ipatasertib plus abiraterone and prednisolone in metastatic castration-resistant prostate cancer (IPATential150):
a multicentre, randomised, double-blind, phase 3 trial. 

https://doi.org/10.1016/S0140-6736(21)00580-8

Articles

Patients with metastatic castrate-resistant prostate cancer and PTEN-loss tumors experienced improved radiographical progression-free survival with ipatasertib plus abiraterone. 

Ipatasertib Plus Abiraterone Improves Progression-Free Survival in Prostate Cancer Subtype

A novel triplet combination of chemotherapy as a first-line treatment has demonstrated better responses from patients with 

 V600-mutant metastatic colorectal cancer (CRC). Although doublet and triplet chemotherapy-based therapies are standard treatment options for patients with 

 V600­–mutant metastatic CRC, this population has traditionally demonstrated poor outcomes with chemotherapy-based regimens. Even so, BRAF inhibitors are not effective enough to overcome the feedback activation of EGFR.

Investigators of the ANCHOR-CRC trial (NCT03693170) hypothesized that targeting multiple nodes in the MAPK pathway may elicit better responses for patients and fill an urgent unmet need for patients whose disease harbors 

Specifically, the study was designed to examine the efficacy of the triplet combination of encorafenib (Braftovi), binimetinib (Mektovi), and cetuximab (Erbitux) in the first-line setting.

Updated data analysis presented at the 2021 European Society of Medical Oncology Virtual World Congress on Gastrointestinal Cancer demonstrated that the trial met its primary end point of observed confirmed objective response rate (cORR). In total 92 patients were evaluable and the investigator-assessed cORR was 47.8% (95% CI, 37.3%-58.5%); all responses were partial responses for a disease control rate of 88%. Progressive disease was reported in 5.4% of patients.

The analysis combined 41 patients enrolled to stage 1 of the study with an additional 54 patients enrolled to stage 2. At the time of presentation 6 patients (15%) from stage 1 and 14 patients (26%) from stage 2 remained on treatment. For the 75 patients who discontinued therapy, the cited reasons included progressive disease (64%), adverse effects (AEs; 21%), investigator decision (8%), and other (7%).

Patients with treatment-naïve mCRC and a confirmed 

 V600E mutation were treated with oral encorafenib (300 mg daily), oral binimetinib (45 mg orally twice daily), and intravenous cetuximab (400 mg/m2 loading dose, followed by 250 mg/m2 weekly for the first 28 weeks, followed by 500 mg/m2 once every 2 weeks).

At baseline evaluation, the median age was 65 years (range, 30-84) with median time since initial diagnosis of 66 days. Most patients (60%) had right-side or transverse primary tumors and the remaining (40%) had either left-side tumors or tumors located in the rectum. In terms of metastases, most patients (75.8%) had greater than 2 organs involved including the liver (54.7%), lymph node (51.6%), peritoneum/omentum (48.4%), and lung (36.8%).

Secondary end points of the study were progression-free survival (PFS), overall survival (OS), safety, quality of life, and pharmacokinetics.

At median follow-up of 4.8 months the median PFS was 5.8 months (95% CI, 2.6-6.4) for patients treated with the triplet. At a median follow-up of 14.4 months, the median OS was 17.2 months (95% CI, 14.1-21.1). For 95 patients included in the OS analysis the OS rates at 12, 18, and 24 months were 65%, 49%, and 29%, respectively.

Investigators noted that most patients were able to receive active subsequent therapies. The median time to subsequent therapy was 6.9 months (range, 5.9-8.4). Specifically, 43.2% of patients went on to receive antineoplastic therapy of either oxaliplatin-based doublet with or without bevacizumab (Avastin), FOLFOXIRI with or without bevacizumab, or immunotherapy.

In terms of safety, the results reported for the triplet combination were similar with those reported for recommended chemotherapy-based regimens. The most common all-grade AEs were diarrhea (67.4%), nausea (45.3%). dermatitis acneiform (40%), rash (40%), and vomiting (37.9%). The most common grade 3 or higher AEs were anemia (10.5%), increased lipase levels (10.5%), diarrhea (9.5%), and nausea (8.4%).

Further, the most frequent serious AEs of grade 3 or higher were intestinal obstruction (14.7%), renal failure (7.4%), nausea (5.3%), and abdominal pain (4.2%). Investigators also noted that no meaningful changes in patient reported outcomes.

Eric Van Cutsem, MD, who reported the data at the conference noted that these results were “encouraging” and “support exploring the combination of encorafetinib plus cetuximab with chemotherapy in the first line setting.” Van Cutsem is the division head of clinical digestive oncology at University of Leuven and University Hospitals Gasthuisberg, Leuven, Belgium.

Investigators of the ongoing BREAKWATER study (NCT04607421) will evaluate the efficacy of encorafetinib plus cetuximab with or without FOLFOX or FOLFIRI vs the control of physician’s choice of either FOLFOX, FOLFIRI, FOLFOXFIRI, or CAPEOX with or without anti-VEGF therapy. Patients who received prior systemic therapy in the metastatic setting are not eligible for enrollment. The primary end points of the study are PFS for arm A vs control and arm B vs control by blinded independent central review. Key secondary end points are OS for arm A vs control and arm B vs control. Other end points include incidence of dose-limited toxicities, AEs, dose modifications and drug-drug interactions.

In April 2020, the combination of encorfenib and cetuximab was approved for the treatment of patients with metastatic CRC with a confirmed 

 V600E mutation who experienced disease progression after 1 or 2 prior lines of therapy based on results of the BEACON CRC trial (NCT02928224).4 Investigators of the trial examined outcomes of the doublet regimen as well as the triplet regimen of encorafenib, binimetinib, and cetuximab against the control of investigators’ choice of either cetuximab and irinotecan or cetuximab and FOLFIRI.

Although the triplet combination group outperformed the doublet therapy group against the control arm, respectively, the trial was not powered to compare the 2 experimental arms.

Kopetz S, Grothey A, Yaeger R, et al. Encorafenib, binimetinib, and cetuximab in 

. 2019;381(17):1632-1643. doi:10.1056/NEJMoa1908075

Van Cutsem E, Tabernero J, Taieb J, et al. ANCHOR CRC: results from a single-arm, phase 2 study of encorafenib, binimetinib plus cetuximab in previously untreated BRAF V600E–mutant metastatic colorectal cancer. 

. 2021;32(suppl 3):S222. doi:10.1016/j.annonc.2021.05.014

BRAF V600E-mutant colorectal cancer study of encorafenib taken with cetuximab plus or minus chemotherapy (BREAKWATER). ClinicalTrials.gov. Updated July 12, 2021. Accessed July 28, 2021. 

https://clinicaltrials.gov/ct2/show/NCT04607421

Braftovi. Prescribing information. Array BioPharma Inc; 2020. Accessed July 28, 2021. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/210496s006lbl.pdf

This article was originally published on OncLive as 

“Triplet Combination Demonstrates Promise for Frontline Treatment of BRAF V600E–mutant CRC”

A combination of encorafenib (Braftovi), binimetinib (Mektovi), and cetuximab (Erbitux) in the first-line setting was tested for efficacy in patients with BRAF V600E–mutant CRC.

Triplet Chemotherapy Combination a Viable Option for Colorectal Cancer Mutation

Making lunch for a patient might not be the first task one envisions when thinking about oncology nursing. Luckily, that didn’t stop one nurse from helping a patient who was unable to prepare lunch for herself during chemotherapy.

That nurse is Kathleen Lutz, RN, NP-BC WH, and she addresses a variety of tasks every day to make the journey for her patients a little more comfortable. After 23 years at NYU Langone Health in New York, New York, as a nurse practitioner (NP), Lutz has seen cancer care develop dramatically during her career.

“I started practicing nursing in 1988 after graduating from Molloy College in Rockville Centre, New York. In 1997, I earned my post master’s nurse practitioner (degree) in women’s health from Stony Brook University. By 1998, I was the third NP credentialed to practice as a nurse practitioner at NYU Medical Center and the first NP in ob/gyn at the center, so I basically paved the way for the future of APN within the department of ob/gyn,” she said in an interview with 

Lutz knows that oncology nursing is her calling. Despite some hesitancy moving to her current practice, on her first day working in outpatient gynecologic oncology she fell in love with the facet of nursing. She loved the level of care, the level of involvement with the patients, and the amount of relationship building that comes from helping a patient across the entire spectrum of cancer.

Oncology nurses help their patients through an avalanche of challenges. It is difficult for Lutzwhen she sees patients without a support system at home. “One of the big challenges is when we have a patient with no social support,” she said. “It means getting creative and finding the resources to get them back and forth to appointments and getting them medications.” She explained that patients without support systems need daily phone calls and more frequent home care visits to ensure that somebody is checkingin on a regular basis.

Lutz believes in an interdisciplinary team. She consistently reaches out in the community to see what resources can be provided for patients. This includes getting social services and nutritionists involved, as well as informing the regular staff nurses to ensure they know which patients need this extra level of support.

“I bring [the patients without support] in a little bit more often since they don’t have anybody, and I help coordinate their rides and such,” Lutz said, adding that she also arranges services such as Meals on Wheels for these patients and allows them to call her on the weekends.

Her enthusiasm for the patient’s well-being is clear to all who know her. Bhavana Pothuri, MD, who works at NYU Langone with Lutz, said, “Kathleen is extraordinary in her commitment to the care of the gynecologic oncology patient and is most deserving of this [recognition]. I have worked with her for 15 years and can say she is undoubtedly the most dedicated nurse I have ever worked with.”

This is not the first time Lutz has been spotlighted for being an excellent oncology nurse. At the end of 2014, Lutz received the Advanced Practice Nursing Excellence Award from NYU. Her colleague, Erin Reese, RN, NP-BC WH, nominated her, citing an example of a patient for whom Lutz made lunch every time she came in for chemotherapy. This award served as a pivotal moment for Lutz, causing her to consider the positive impact of her actions. She explained, “Getting that award helped me realize that I am making a difference. I am making things better for patients and I am doing the right thing….I am on the right path.”

Her role as an advanced practice nurse also lends itself to an emphasis on excellent supportive care. Lutz cares for complex gynecologic patients during diagnoses, surgery, and chemotherapy treatments. Along the way, she supports them by providing an environment where they can go through the journey successfully. She also deals with end-of-life issues when appropriate, working closely with the supportive oncology team to help transition patients who go from active treatment for cancer to best supportive care. This entails working closely with the patients and their families.

Lutz said she is always inspired by the evolution of new drugs and successful treatments. A special moment in her career was recognizing that today she can say that patients are living longer, better, quality lives with cancer. She enjoys knowing she can make a difference in women’s lives and looks forward to what the future brings in cancer care, including the different trials and drugs that will arrive.

During the COVID-19 pandemic, Lutz helped orchestrate infusion appointments locally when going to New York City was not feasible for patients. This involved spending many hours on the phone with patients to arrange for them to receive their chemotherapy in 1 of the 2 satellite centers on Long Island. Step 1 involved a telehealth visit where her team would make all the necessary assessments. On the day of the treatment, she would check in with the laboratories, look at the numbers, and ensure all the orders were set and signed so the patient would have a seamless appointment experience.

For approximately 9 months, the team worked tirelessly to help patients navigate the system so they could receive their treatment without traveling to 1 of the major epicenters of the pandemic. Lutz reminisced that “it was a challenge, and an exciting one, and I hope never to go through it again.”

When Lutz thinks about excellence in oncology care, she finds herself repeating the importance of having “big shoulders.”

“You need a lot of wiggle room,” she said. “It is important to recognize that patients are facing the most stressful event of their lives. One needs to allow [patients] multiple chances. Sometimes a patient might get angry, and that’s okay. You can’t get mad at your patients.”

Her message to other oncology nurses is to take a step back, put yourself in the patient’s position, allow them room to express themselves, and support them along the way.

Lutz understands that oncology nurses have to be 100% vested in what they do to be successful. She knows it is that level of commitment that makes her team what she calls “a successful family” and is happy to say she loves being an oncology advanced practice nurse.

From orchestrating local infusion appointments to making lunch for a patient, Kathleen Lutz, RN, NP-BC WH, constantly strives to provide an excellent level of supportive care.

Oncology Nurse Champion: Kathleen Lutz

Patients with favorable-risk prostate cancer were shown to move away from active surveillance following exposure to their Oncotype DX Genomic Prostate Score (GPS), according to data from the ENACT study (NCT02668276) published in the 

These results suggested that patients’ treatment decisions in diverse populations can be influenced through prognostic molecular assessment.

Results regarding treatment choice at the second visit indicated that assignment to the GPS cohort was linked with a marginally lower likelihood of selecting active surveillance compared with immediate therapy (

 = .067). When excluding 10 men who were assigned to GPS and did not receive a test result, the association was found to be slightly stronger (

 = .029). Unadjusted analyses indicated that intervention reduced the relative odds of selecting active surveillance by approximately half.

Moreover, the choice of management approach was found to be closely associated with a change in the urologist's preference of treatment following GPS results. Following the results, preferences changed from active surveillance to treatment 18 times; preference shifted from treatment to active surveillance only 3 times. For controls, urologist preference shifted from active surveillance to treatment only 5 times and only twice from treatment to active surveillance.

Ratings on the Decisional Conflict Scale—which measures a patient's perception of preparedness, support, and uncertainty, ranging from 0 at the lowest and 40 at the highest—did not significantly differ between the control group (mean, 5.56; standard deviation, 7.25) and GPS group (mean, 4.60; standard deviation, 7.17), respectively, (

 = .37). However, differences in scores on the Decision Regret Scale—which ranges from 5 at the lowest and 25 at the highest—were not found to significantly differ between the control group (mean, 7.54; standard deviation, 2.92) and the GPS group (mean, 8.28; standard deviation, 3.38), respectively (

“We completed the first randomized trial, to our knowledge, of a prognostic multigene expression score on initial treatment choice among men with favorable-risk prostate cancer,” lead author Adam B. Murphy, MD, MBA, MSCI, of Feinberg School of Medicine, and his colleagues wrote. “As more biomarkers yielding probability estimates enter the clinic, it is important to understand their impact on cancer treatment choice and decision quality in diverse patient populations.”

Although men with low-risk prostate cancer need to make a choice between receiving immediate therapy or active surveillance with the possibility of deferred treatment, active surveillance is now considered to be a safe alternative for the right population. Although the utilization of active surveillance has increased in the United States over the past several years, its use in Black patients has lagged.

Concerns exist as to whether this strategy is equally safe in this high-risk subset due to differences in biologic aggressiveness of the diseases, reduced compliance due to issues with access to care, and possible undersampling of tumors in the anterior section of the prostate.

After considering these factors, investigators launched a randomized trial in a predominantly Black patient population from 3 public hospitals to assess whether the addition of the Oncotype DX GPS assay to the National Comprehensive Cancer Network (NCCN)–based risk counseling would impact decisionmaking. Investigators theorized that the biomarker would help to improve risk stratification in diverse, high-risk patient populations by detecting aggressive prostate cancer despite reassuring standard clinical measures.

The trial enrolled men with newly diagnosed prostate cancer who were eligible for active surveillance. Additional enrollment criteria included being under the age of 76 years, having an ECOG performance status of 0 to 2, a life expectancy of over 10 years, and a NCCN risk level of favorable intermediate or below.

Based on consensus among participating urologists regarding eligibility for active surveillance, the favorable intermediate definition was slightly modified from NCCN criteria to exclude cases with grade group 2 and over 3 positive cores, and include those with a prostate-specific antigen (PSA) density of 10 ng/mL to 20 ng/mL if PSA density was less than 0.15, 4 unfavorable intermediate cases were included.

During the first visit, patients were diagnosed and given identical counselling regarding treatment options following a diagnostic biopsy. Additionally, during the initial visit, patients were randomized to either the intervention or control arm utilizing a block random assignment scheme, wherein patients were stratified based on trial site and NCCN risk level. From there, standardized instruments were utilized to gather baseline data on comorbidities, urinary and sexual function, health literacy, and psychologic indicators.

Two to 3 weeks later, patients returned for a second visit to discuss their GPS report, if assigned; undergo NCCN-based risk counseling; and make a treatment decision. The third visit would take place 4 weeks after the second and prior to treatment to collect follow-up surveys and assess whether treatment choices had changed.

Lastly, the fourth visit took place following the first clinical encounter after recovering from surgery, completing radiation, or the first active monitoring encounter. Patients were then asked to complete the 10-item Decisional Conflict Scale to assess perceived decision quality during the third visit and validate men with low health literacy who needed to decide about prostate cancer screening. Moreover, patients completed the 5-item Decision Regret Questionnaire at visit 4, which was validated in cohorts who needed to make a decision regarding treatment.

A total of 1315 consecutive patients with positive cancer biopsies were screened, 24% (n = 317) of whom were eligible to participate in the trial. The primary reason patients were ineligible to participate was due to having a risk level above low intermediate risk status. Nine patients had insufficient tumor, and another had excessive inflammation.

Seventy percent of study participants were African American, 16% had a college degree, 46% had a low health literacy, and 12% had private insurance. Eighty-six percent of urologists who participated on the trial were inclined to favor active surveillance immediately prior to the first visit following a diagnosis.

The random assignment carefully balanced key baseline variables except for patients who had a first-degree relative with prostate cancer and men with severe erectile dysfunction. However, severe erectile dysfunction was found to be less common in the interventional cohort. Therefore, particular attention was given as a potential confounder in the analysis.

In the subgroup analysis, GPS results tended to widely vary across risk levels, although investigators noted that there was an association between GPS and pre-test NCCN risk. Moreover, an association was identified between immediate treatment and higher GPS results within risk levels.

Moreover, in multivariable models, low intermediate status was identified as a strong negative predictor for active surveillance vs very low-risk status; low-risk status also had a negative association. Men who had a positive family history of prostate cancer were 4 times more likely to select active surveillance. Those with any health insurance were 3 times more likely to choose active surveillance. Notably, GPS was associated with a 7-fold lower chance of selecting active surveillance in men with a lower health literacy (

When assessing change in NCCN risk following GPS, investigators found that although the intervention effect was independent of baseline risk, 60% of men in the intervention group experienced a shift in NCCN risk following GPS testing. In total, 43% of men who received GPS moved to a higher NCCN risk group, 39% of whom had selected treatment rather than active surveillance. Additionally, 17% of men (n = 15) moved to a lower risk level, 2 of whom selected treatment. All men within the intervention cohort who were very low risk at baseline selected active surveillance, 34% of whom had received GPS results that were consistent with a higher risk level.

When examining changes in treatment choice, 16 men, 10 from the intervention arm and 6 from the control arm, changed their choice of treatment following the second visit, which resulted in the patient receiving a different treatment (

 = .32). Five patients from either arm changed from active surveillance to undecided by their third visit, although they eventually went on to receive active surveillance.

Long-term follow-up on the active surveillance arm is currently ongoing, although among patients who received surgery as their initial therapy, investigators observed negligible differences in adverse pathology following prostatectomy.

Murphy AB, Abern MR, Liu L, et al. Impact of a genomic test on treatment decision in a predominantly African American population with favorable-risk prostate cancer: a randomized trial. 

. 2021;39(15):1660-1670. doi:10.1200/JCO.20.02997

Gray PJ, Lin CC, Cooperberg MR, et al. Temporal trends and the impact of race, insurance, and socioeconomic status in the management of localized prostate cancer. 

. 2017;71(5):729-737. doi:10.1016/j.eururo.2016.08.047

Mahal BA, Butler S, Franco I, et al. Use of active surveillance or watchful waiting for low-risk prostate cancer and management trends across risk groups in the United States, 2010-2015. 

. 2019;321(7):704-706. doi:10.1001/jama.2018.19941.

Yuan J, Kensler KH, Hu Z, et al. Integrative comparison of the genomic and transcriptomic landscape between prostate cancer patients of predominantly African or European genetic ancestry. 

. 2020;16(2):e1008641. doi:10.1371/journal.pgen.1008641.

Ha YS, Salmasi A, Karellas M, et al. Increased incidence of pathologically nonorgan confined prostate cancer in African-American men eligible for active surveillance. 

. 2013;81(4):835. doi:10.1016/j.urology.2012.12.046

Abern MR, Bassett MR, Tsivian M, et al. Race is associated with discontinuation of active surveillance of low-risk prostate cancer: results from the Duke Prostate Center. 

. 2013;16:85-90. doi:10.1038/pcan.2012.38

Gökce MI, Sundi D, Schaeffer E, et al. Is active surveillance a suitable option for African American men with prostate cancer? A systemic literature review. 

. 2017;20(2):127-136. doi:10.1038/pcan.2016.56

Jalloh M, Myers F, Cowan JE, et al. Racial variation in prostate cancer upgrading and upstaging among men with low-risk clinical characteristics. 

. 2015;67(3):458-459. doi:10.1016/j.eururo.2014.03.026

Sundi D, Kryvenko ON, Carter HB, et al. Pathological examination of radical prostatectomy specimens in men with very low risk disease at biopsy reveals distinct zonal distribution of cancer in Black American men. 

. 2014;191(1):60-67. doi:10.1016/j.juro.2013.06.021

“Genomic Prostate Score Could Impact Treatment Decisions in Diverse Prostate Cancer Populations”

Patients with favorable-risk prostate cancer tended to move away from active surveillance to initiating treatment after receiving their Oncotype DX Genomic Prostate Score.
 


Diverse Patient Population Favors Immediate Therapy After Receiving Genomic Prostate Score

In this episode of “The Vitals,” we spoke with Kate Esselen, MD, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, about patients with gynecologic cancer who don’t comply with prescribed treatment in response to financial distress or toxicity.

Dr. Esselen is the corresponding author on the study, titled “Evaluating Meaningful Levels of Financial Toxicity in Gynecologic Cancers,” which was published in the International Journal of Gynecologic Cancer. The data found that nearly half of patients with gynecologic cancer experienced some degree of financial distress and that patients with severe financial toxicity were significantly more likely to engage in behavioral cost-coping by medication non-compliance (adjusted risk ratio, 4.6; 95% CI, 1.2-18.1).


Podcasts

“[Drug adherence] seems like a problem we could potentially solve or, at least, make much better, and we are not really doing enough right now to do that.”


Addressing Medication Non-Compliance and Financial Toxicity in Patients with Gynecologic Cancer

Videos

“More than 90% of serotonin receptors and serotonin is made in the gut.”

The Food-Mood Connection: Diet Directly Impacts Emotional Health

Treating patients with brentuximab vedotin in combination with doxorubicin, vinblastine, and dacarbazine with and without consolidative radiotherapy resulted in strong efficacy and encouraging tolerability in early-stage, unfavorable-risk Hodgkin lymphoma.

Brentuximab Vedotin Plus Chemo Is Effective and Tolerable in Patients with Early-Stage Hodgkin Lymphoma

At 12 months, 97% patients treated with single infusions of cilta-cel had responded to the therapy. 

Cilta-Cel Induces Deep and Durable Responses in Patients with Multiple Myeloma

Multicancer early detection tests provided specified and accurate cancer signal origin detection across more than 50 tumor types. 

Blood-Based Tests Should Be Included in Single-Cancer Screenings

“When the pandemic hit, telehealth was well positioned to be a powerful tool. It really was the silver lining in the entire shift in care.”

Chemotherapy Available at Home with Launch of CTCA Program

Several cancer organizations signed a group statement calling for health care employers to mandate COVID-19 vaccinations for their employees.  

Cancer Organizations Implore Health Care Employers to Mandate COVID-19 Vaccines 

The FDA has determined that more data are necessary to certify the clinical benefit of retifanlimab for the treatment of squamous cell carcinoma of the anal canal. 

FDA Delivers Complete Response Letter for Retifanlimab for SCC Subgroup 


The FDA has approved the first immunotherapy, pembrolizumab (Keytruda), to treat patients with high-risk early-stage triple-negative breast cancer.


FDA Approves Pembrolizumab for High-Risk Early-Stage TNBC

Bristol Myers Squibb has chosen to withdraw the indication for single-agent nivolumab for patients with hepatocellular carcinoma with previous sorafenib treatment following a confirmatory phase 3 trial. 

Bristol Myers Squibb Chooses to Withdraw Nivolumab Indication for Treatment of Liver Cancer in the United States 

New data emphasizes need for routine brain imaging in patients with advanced or metastatic renal cell carcinoma with prior treatment and high metastatic burden. 

Brain Imaging Guidelines Needed for Patients with Metastatic Kidney Cancer

Nomogram May Have the Power to Predict Treatment Outcomes in Patients with Prostate Cancer Subtype 


Patients with multiple myeloma are potentially at greater risk of developing severe COVID-19 after the SARS-COv-2 vaccination induced suboptimal antibody response. 


COVID-19 Vaccine May Not Be Effective in Patients With Multiple Myeloma 

A recent study showed that belumosudil induced clinically meaningful, durable responses among a varied cohort of patients with chronic graft-versus-host-disease. 

Newly-Approved Belumosudil Yields High Overall Response Rate in Patients with Chronic Graft-Versus-Host-Disease


Study results have posited plinabulin as a potentially effective preventative and active therapy due to its unique mechanism of action.


Distinct Mechanism of Action Makes Plinabulin a Potentially Powerful Therapy in Treating Breast Cancer

A diagnosis of COVID-19 was associated with an increased risk of respiratory problems and mortality in patients with urological cancer undergoing elective procedures for their disease. 

Top Medical News

Ipatasertib Plus Abiraterone Improves Progression-Free Survival in Prostate Cancer Subtype

Triplet Chemotherapy Combination a Viable Option for Colorectal Cancer Mutation

Oncology Nurse Champion: Kathleen Lutz

Diverse Patient Population Favors Immediate Therapy After Receiving Genomic Prostate Score

Addressing Medication Non-Compliance and Financial Toxicity in Patients with Gynecologic Cancer

Most Recent