The most modern oncology
A new approach to the treatment of gliomas and colorectal cancer
Nadezhda Sinitsyna, Medvestnik
The annual meeting of the American Society of Clinical Oncology ASCO 2022 ended on June 6 in Chicago. New approaches to the treatment of various types of cancer were presented at the event.
Ifosfamide surpassed standard treatment regimens for Ewing's sarcoma
Chemotherapy of Ewing's sarcoma with high doses of ifosfamide proved to be more effective than a combination of topotecan and cyclophosphamide, the rEECur study showed.
The authors noted that there are several chemotherapy regimens that are used for the disease, but none of them has previously shown advantages over others.
The study included 146 patients: half received ifosfamide, the other half received traditional chemotherapy with topotecan and cyclophosphamide. Median survival was 15.4 months in the ifosfamide group compared to 10.5 months on the background of standard therapy. Event-free survival was also higher against the background of ifosfamide (16.8 months and 10.4 months). It additionally increased by 5.7 months when using high doses of the drug. The treatment proved to be effective both in patients younger than 14 years and among older participants.
A similar frequency of neutropenia was noted in the groups. Ifosfamide caused renal toxicity and adverse events from the brain more often, but the frequency did not exceed 10%.
Scientists expect that based on the results of the study, ifosfamide will become the standard of treatment for Ewing's sarcoma. However, according to Martin McCabe from the University of Manchester, the effectiveness of therapy is still not high enough.
PD-1 inhibitor caused complete remission of rectal cancer
Neoadjuvant therapy with the PD-1 inhibitor dostarlimab led to complete remission in all participants of the study presented by scientists from Memorial Sloan Kettering Cancer Center in New York.
18 patients with locally advanced rectal cancer with unpaired base repair deficiency (dMMR) were treated. The achieved results made it possible to avoid surgical treatment and radiation therapy.
The observation of 14 patients lasted for six months. According to the MRI, they remained in complete remission. The maximum duration of observation was 25 months. No patients needed additional treatment during the follow-up.
Four participants who later started treatment also showed signs of a clinical response, including one case of complete remission. Adverse events of grade 3 or higher on the background of therapy were not detected.
So far, the number of participants and the follow-up time are not enough to draw conclusions, since tumor recurrence can occur within 2 years.
New hope for pancreatic cancer
The addition of nimotuzumab to gemcitabine increased overall survival in pancreatic cancer, the NOTABLE study showed.
Nimotuzumab is a monoclonal antibody, an EGFR inhibitor. The experimental drug with or without gemcitabine was received by 92 patients with locally advanced or metastatic pancreatic cancer with a wild type of KRAS gene. This resulted in a one-year survival rate of 43.6% with monoclonal antibody administration compared to 26.8% with gemcitabine. The three-year survival rate was 13.9% and 2.7%, respectively.
Overall survival was higher among patients who had not previously received surgical treatment (15.8 months compared to half a year).
Among the grade 3 adverse events, the researchers noted neutropenia in 11.1% of patients, leukopenia in 8.9% of cases and thrombocytopenia in 6.7%. Adverse events of the 4th degree were not detected.
A liquid biopsy will avoid chemotherapy
Researchers from the Peter McCallum Cancer Center in Melbourne presented the results of the DYNAMIC study. The use of liquid biopsy (determination of circulating tumor DNA in the blood) made it possible to identify patients who do not need adjuvant chemotherapy after surgical treatment of colon cancer.
Patients with stage 2 colon cancer who underwent surgical treatment were divided into two groups. The participants of the first performed a liquid biopsy and in the absence of tumor DNA in the blood, chemotherapy was not prescribed. Among the participants of the second group, the decision on further management was made on the basis of traditional criteria based on the stage of the tumor and the prevalence of the process.
Chemotherapy based on the results of a liquid biopsy was prescribed by 15% of the participants. In the second group, 28% of patients received adjuvant chemotherapy. The average follow-up time was 37 months.
The two-year survival rate among patients was comparable. In the absence of treatment, it was 93.5%, during the course — 92.4%.
The three—year survival rate among patients who received adjuvant chemotherapy based on the results of a liquid biopsy was 86.4%, and among patients without circulating tumor DNA who were not treated - 92.5%.
A new approach to the treatment of gliomas in children
Therapy of low-grade gliomas with mutations in the BRAF gene in children with BRAF and MEK inhibitors increased the frequency of the overall response to treatment by 4 times and reduced the risk of disease progression and death. The results of the study were presented by scientists from Sick Kids Children's Hospital in Toronto.
Most children are found to have low-grade gliomas, and mutations in the BRAF V600E gene occur in 15-20% of cases. Although surgical treatment remains the main method of treatment, it is not always possible due to the location of the tumor. At the same time, children with BRAF mutations respond worse to standard chemotherapy.
The study included 110 children with low-grade gliomas and disease progression after surgical treatment. Participants were divided into groups that received dabrafenib in combination with trametinib or standard therapy with carboplatin and vincristine.
The overall response rate was 47% in the group of BRAF and MEK inhibitors and 11% against the background of traditional chemotherapy. Median survival without signs of progression was 20.1 months against the background of the new treatment and 7.4 months in the control group.
A year later, two-thirds of the children who received dabrafenib and trametinib remained alive. In the standard chemotherapy group, the survival rate during the year was only 26%.
Portal "Eternal youth" http://vechnayamolodost.ru