Oncology (all articles)
Clinical validation of a cell-free DNA test for colorectal cancer screening: sensitivity and specificity analysis
20 Mar, 2024 | 19:16h | UTCStudy Design and Population: This study conducted a clinical validation of a cell-free DNA (cfDNA) blood-based test to screen for colorectal cancer in a cohort of 10,258 individuals, 7,861 of whom met the eligibility criteria and were evaluable. The research aimed to assess the test’s performance by comparing its sensitivity for detecting colorectal cancer and its specificity for identifying advanced neoplasia (including colorectal cancer or advanced precancerous lesions) against the outcomes of screening colonoscopy, a standard procedure.
Main Findings: The cfDNA test demonstrated a sensitivity of 83.1% for detecting colorectal cancer, with stage-specific sensitivities of 87.5% for stages I-III cancers. However, its sensitivity for identifying advanced precancerous lesions was notably lower at 13.2%. On the specificity front, the test showed an 89.6% ability to correctly identify individuals without any advanced colorectal neoplasia and had an overall specificity of 89.9% for those with a negative colonoscopy result, indicating no presence of colorectal cancer, advanced precancerous lesions, or non-advanced precancerous lesions.
Implications for Practice: The cfDNA blood-based test presents a promising tool for colorectal cancer screening, boasting substantial sensitivity for colorectal cancer detection and high specificity for advanced neoplasia. Its non-invasive nature could potentially enhance screening adherence, facilitating earlier cancer detection and possibly reducing colorectal cancer-related mortality. However, the test’s low sensitivity for advanced precancerous lesions suggests a need for further research and development to improve early detection capabilities.
Reference: Chung, D.C. et al. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening. Journal Name, Volume(Issue), Pages. Access the study here: [Link]
RCT: Effectiveness of mechanical and oral antibiotic bowel preparation in reducing postoperative complications in elective rectal resection
20 Mar, 2024 | 18:18h | UTCStudy Design and Population
This double-blind, placebo-controlled randomized clinical trial was conducted at three university hospitals in Finland, involving 565 patients aged 18 years and older undergoing elective rectal resection with primary anastomosis for tumors 15 cm or less from the anal verge, as determined by magnetic resonance imaging. Participants were allocated in a 1:1 ratio to either the mechanical and oral antibiotic bowel preparation (MOABP) group, receiving neomycin and metronidazole orally, or to the mechanical bowel preparation (MBP) plus placebo group, with all interventions occurring the day before surgery alongside standard preoperative intravenous antibiotics.
Main Findings
The study found that patients in the MOABP group experienced significantly fewer postoperative complications, with a median Comprehensive Complication Index significantly lower than that of the MBP plus placebo group. Additionally, the MOABP group showed reduced rates of surgical site infections (SSIs) and anastomotic dehiscence compared to the control group, demonstrating a clear benefit in postoperative outcomes.
Implications for Practice
The results of this trial suggest that incorporating oral antibiotics with mechanical bowel preparation prior to elective rectal resection significantly reduces postoperative complications, including SSIs and anastomotic dehiscence. Therefore, MOABP should be adopted as the standard regimen for patients undergoing these procedures to improve postoperative outcomes and reduce the burden of complications. This evidence underscores the importance of updating surgical protocols to include this preparation strategy.
Reference
Laura Koskenvuo et al. (2024). Randomized Clinical Trial: Effectiveness of Mechanical and Oral Antibiotic Bowel Preparation in Reducing Postoperative Complications in Elective Rectal Resection. JAMA Surg, Published online March 20, 2024. DOI: 10.1001/jamasurg.2024.0184. Access the study here: [Link]
Prospective Study: Enhanced detection of colorectal cancer and precancerous lesions with next-generation stool DNA testing
20 Mar, 2024 | 17:41h | UTCStudy Design and Population:
This prospective study evaluated the efficacy of a next-generation multitarget stool DNA test for colorectal cancer screening in asymptomatic adults aged 40 and older. The study encompassed 20,176 participants undergoing screening colonoscopy to determine the test’s sensitivity and specificity in detecting colorectal cancer and advanced neoplasia, including advanced precancerous lesions.
Main Findings:
The next-generation stool DNA test demonstrated a sensitivity of 93.9% for detecting colorectal cancer and a specificity of 90.6% for advanced neoplasia, significantly outperforming the fecal immunochemical test (FIT) in sensitivity for both colorectal cancer and advanced precancerous lesions. However, the test showed slightly lower specificity for advanced neoplasia compared to FIT. No adverse events were reported, indicating the test’s safety for screening purposes.
Implications for Practice:
The findings suggest that the next-generation multitarget stool DNA test offers a superior option for colorectal cancer screening, with significantly higher sensitivity for detecting cancer and advanced precancerous lesions than the currently available FIT. This advance in non-invasive screening technology could lead to earlier detection and treatment of colorectal cancer, potentially improving patient outcomes. Further research may focus on optimizing the balance between sensitivity and specificity to enhance the clinical utility of stool DNA testing.
Reference:
RCT | Superior PFS with avelumab vs. chemotherapy in second-line treatment for mCRC with microsatellite instability
11 Aug, 2023 | 15:25h | UTCSee also: Visual Abstract
Commentary: Avelumab Outperforms Standard Second-Line Therapy in dMMR/MSI Metastatic CRC – Cancer Therapy Advisor
RCT – 2ry analysis | Aerobic exercise intervention shows potential to reduce chemotherapy-induced peripheral neuropathy
11 Aug, 2023 | 15:17h | UTCSee also: Visual Abstract
Commentary: Aerobic Exercise Cuts Chemotherapy-Induced Peripheral Neuropathy Symptoms – HealthDay
Commentary on Twitter
Aerobic exercise improves chemotherapy-induced peripheral neuropathy (CIPN) in women who were treated for ovarian cancer. Incorporating referral to exercise programs as a part of standard of oncology care is recommended. https://t.co/lp9C9seyM6 @anlan_cao
— JAMA Network Open (@JAMANetworkOpen) August 1, 2023
Phase 2 RCT | Adding stereotactic body radiotherapy to immune checkpoint inhibitors fails to improve outcomes in solid tumor patients
9 Aug, 2023 | 15:28h | UTCCheckpoint Inhibitors in Combination With Stereotactic Body Radiotherapy in Patients With Advanced Solid Tumors: The CHEERS Phase 2 Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)
See also: Visual Abstract
Commentary: Addition of SBRT to Immunotherapy in Advanced Solid Tumors – The ASCO Post
Cohort Study | Moderate to heavy drinking linked to increased risk of early-onset colorectal cancer
9 Aug, 2023 | 15:27h | UTCCommentary: Association of Alcohol Intake With Risk of Early-Onset Colorectal Cancer – The ASCO Post
Commentary on Twitter
? Moderate/heavy alcohol intake linked to increased risk of early-onset #ColorectalCancer, particularly distal colon & rectal cancers ➡️ https://t.co/2akaNsHbLu #CRCSM pic.twitter.com/5DGrrmdX4i
— Journal of Clinical Oncology (@JCO_ASCO) July 18, 2023
Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
8 Aug, 2023 | 13:22h | UTC
Commentary on Twitter
What is BORDERLINE respectable?! ?
A global assessment of 30 shades of grey ???
? Interobserver variability among radiologists and surgeons globally is high
?⚖️ Central review of images required for quality control initiativeshttps://t.co/Z2G1cInZ5f pic.twitter.com/mlucwMT5f9
— Giovanni Marchegiani (@Gio_Marchegiani) July 30, 2023
Systematic Review | Pegylated liposomal doxorubicin for relapsed epithelial ovarian cancer
8 Aug, 2023 | 13:11h | UTCPegylated liposomal doxorubicin for relapsed epithelial ovarian cancer – Cochrane Library
Cohort Study | Potential negative survival impact of PPI and palbociclib co-administration in breast cancer patients
8 Aug, 2023 | 13:07h | UTC
RCT | Upfront radiosurgery reduces tumor volume vs. a wait-and-scan approach in small- to medium-sized vestibular schwannoma
7 Aug, 2023 | 14:40h | UTCUpfront Radiosurgery vs a Wait-and-Scan Approach for Small- or Medium-Sized Vestibular Schwannoma: The V-REX Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
Commentary on Twitter
Among patients with small or medium vestibular schwannoma, a treatment strategy consisting of upfront radiosurgery was more effective at reducing tumor volume at 4 years than was the initial wait-and-scan approach. https://t.co/Qv3YZVsq2Q pic.twitter.com/aNeu7MJfl0
— JAMA (@JAMA_current) August 2, 2023
RCT | Zolbetuximab plus CAPOX as potential first-line treatment for CLDN18.2+, HER2- advanced gastric adenocarcinoma
7 Aug, 2023 | 14:38h | UTC
Commentary on Twitter
In the phase 3 GLOW trial, CAPOX plus zolbetuximab significantly improved progression free survival and overall survival in patients with CLDN18.2+, HER2- untreated #GastricCancer or gastroesophageal junction adenocarcinoma @AstellasUS @mdmanishshah https://t.co/YYbLHhiyOq
— Nature Medicine (@NatureMedicine) August 1, 2023
RCT | Mammography screening with AI reduces workload by 44.3% without loss in detection efficacy
4 Aug, 2023 | 12:13h | UTCArtificial intelligence-supported screen reading versus standard double reading in the Mammography Screening with Artificial Intelligence trial (MASAI): a clinical safety analysis of a randomised, controlled, non-inferiority, single-blinded, screening accuracy study – The Lancet Oncology (link to abstract – $ for full-text)
News Release: First randomized trial finds AI-supported mammography screening is safe and almost halves radiologist workload – Lancet
Commentaries:
Large Mammography Study Shows Significant Benefits with AI-Aided Screening – Diagnostic Imaging
Study | Removal of thymus in adults linked to increased death, cancer incidence
4 Aug, 2023 | 12:09h | UTCHealth Consequences of Thymus Removal in Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
Doctors have long considered the thymus expendable. But could removing it be fatal? – Science
The thymus withers away after puberty. But it may be important for adults – Science News
Thymus gland critical for adult health, study finds – News Medical
Commentary on Twitter
In a study by Kooshesh et al., mortality, the risk of cancer, and levels of proinflammatory cytokines were higher among adults whose thymus had been removed than among control patients. Read the full study results: https://t.co/poaAiELsKG
— NEJM (@NEJM) August 2, 2023
NICE Updated Guideline | Diagnosis and management of lung cancer
4 Aug, 2023 | 12:05h | UTCLung cancer: diagnosis and management – National Institute for Health and Care Excellence
ASCO Guideline Update | Management of Stage III Non–Small-Cell Lung Cancer
4 Aug, 2023 | 12:03h | UTC
ACP Guidance | Asymptomatic CRC screening advised from age 50 with fecal occult blood test every 2 years or colonoscopy every 10 years
3 Aug, 2023 | 13:48h | UTCNews Release: ACP issues updated guidance for colorectal cancer screening of asymptomatic adults – American College of Physicians
Commentary: Start screening for colorectal cancer at age 50 years, ACP suggests – ACP Internist
Summary for Patients: Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults – Annals of Internal Medicine
Systematic Review | Interstitial lung disease incidence at 11.7% in metastatic breast cancer patients using trastuzumab deruxtecan
3 Aug, 2023 | 13:36h | UTC
M-A | Significant QOL and mental health improvements in caregivers via targeted interventions
3 Aug, 2023 | 13:28h | UTC
RCT | No significant recurrence-free survival improvement with everolimus post-renal carcinoma surgery
3 Aug, 2023 | 13:17h | UTCAdjuvant everolimus after surgery for renal cell carcinoma (EVEREST): a double-blind, placebo-controlled, randomised, phase 3 trial – The Lancet (link to abstract – $ for full-text)
RCT | Early oral antibiotic switch in low-risk neutropenic sepsis shows mixed results
3 Aug, 2023 | 13:15h | UTC
Review | Atypical hyperplasia of the breast: Clinical cases and management strategies
3 Aug, 2023 | 13:07h | UTC
RCT | Lazertinib offers 20.6-month of median PFS in EGFR-mutated NSCLC vs 9.7 months with gefitinib
2 Aug, 2023 | 13:55h | UTC
RCT | Camrelizumab-rivoceranib outperforms sorafenib as first-line therapy for unresectable HCC
2 Aug, 2023 | 13:53h | UTCCamrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter
New @TheLancet – Qin et al – Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 studyhttps://t.co/YoutfY5IkA#LiverTwitter #OncTwitter #LiverCancer #HCC pic.twitter.com/Tcvm6D3kCW
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) July 25, 2023
M-A | High-volume disease, T stage 4 show largest docetaxel benefit in prostate cancer
2 Aug, 2023 | 13:51h | UTCCommentaries:
Disease Volume and T Stage Affect Docetaxel/ADT Efficacy in Prostate Cancer – Cancer Network
Commentary on Twitter
NEW: A systematic review and meta-analysis of individual patient data from the STOPCAP M1 collaboration aims to obtain up-to-date estimates of the effects of docetaxel in patients with metastatic hormone-sensitive prostate cancer. #pcsmhttps://t.co/7mqXeIXMQ5 pic.twitter.com/A7AmjipnVq
— The Lancet Oncology (@TheLancetOncol) July 5, 2023