With a plethora of new oncology research at your disposal, it can be difficult to keep track of the latest innovations and findings. Oncology Times is offering our readers summaries of the newest studies to keep you abreast of advancements across the spectrum of oncology care.
BREAST CANCER
Impact of a false-positive screening mammogram on subsequent screening behavior and stage at breast cancer diagnosis
New research suggests that women who had a false-positive result from a screening mammogram were more likely to delay or forgo their subsequent screening mammogram than women who had a true negative result (Clin Cancer Res 2017; doi: 10.1158/1055-9965.EPI-16-0524). Among the 741,150 screening mammograms analyzed from 261,767 women included in the analysis, 12.3 percent yielded a false-positive result; the remaining 87.7 percent yielded true negative results. Utilizing propensity scoring matching, researchers found that women who had a true negative result were 34 percent more likely to return for a subsequent screen than those who had a false-positive result, and the median delays in returning for a subsequent screen were 6 months and 13 months, respectively. Investigators reported a statistically significant difference in 4-year cumulative risk of a late-stage diagnosis for patients who had a false-positive screening mammogram (0.4%) compared to those who had a true negative result (0.3%).
PANCREATIC CANCER
Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase III trial
Conducted across 92 European hospitals, the ESPAC-4 trial involved 730 patients who had undergone complete macroscopic resection for ductal adenocarcinoma of the pancreas (Lancet 2017; doi: http://dx.doi.org/10.1016/S0140-6736(16)32409-6). Within 12 weeks of surgery, patients were randomly assigned to receive either six cycles of gemcitabine, 1,000 mg/m2 once a week for 3 of every 4 weeks, or to gemcitabine plus oral capecitabine, 1,660 mg/m2 for 21 days, then a rest period of 7 days. Overall survival (OS), which was the primary endpoint, was measured as the time from randomization to death from any cause. Researchers found that the median OS was 25.5 months in the gemcitabine-alone group, compared with 28 months in the gemcitabine plus capecitabine group (hazard ratio 0.82 [95% CI 0.68-0.98], p=0.032). A total of 481 grade 3/4 adverse events were reported by 196 (53.6%) of patients receiving gemcitabine-alone, compared to 608 grade 3/4 adverse events in 226 (63%) of the gemcitabine plus capecitabine group. Researchers concluded the study results "indicate that adjuvant gemcitabine plus capecitabine is the new standard of care" for patients with resected pancreatic cancer.
PROSTATE CANCER
Radiation with or without antiandrogen therapy in recurrent prostate cancer
A new double-blind, placebo-controlled trial sought to determine the impact of antiandrogen therapy combined with radiation on cancer control and overall survival in recurrent prostate cancer (N Engl J Med 2017;376:417-428). Conducted between 1998 and 2003, 760 patients who have had a prostatectomy with a lymphadenectomy underwent radiation therapy and received either antiandrogen therapy (24 months of bicalutamide at a dose of 150 mg daily) or daily placebo tablets during and after radiation therapy. Eligible patients had disease with a tumor stage of T2 or T3, no nodal involvement, and a PSA level of 0.2 to 4.0 ng per milliliter. At 12 years, the overall survival rate was 76.3 percent among patients receiving bicalutamide compared with 71.3 percent in the placebo group (hazard ratio for death, 0.77; 95% confidence interval, 0.59 to 0.99; P=0.04). The rate of death from prostate cancer was 5.8 percent and 13.4 percent, respectively. The study showed the incidence of metastatic disease was 14.5 percent in the bicalutamide group and 23 percent in the placebo group (P=0.005). "The addition of 24 months of antiandrogen therapy with daily bicalutamide to salvage radiation therapy resulted in significantly higher rates of long-term overall survival and lower incidences of metastatic prostate cancer and death from prostate cancer than radiation therapy plus placebo," the authors concluded.
CANCER MORTALITY
Trends and patterns of disparities in cancer mortality among U.S. counties, 1980-2014
A recently published study found that cancer deaths in the U.S. declined by 20 percent from 1980-2014, but there were large differences in cancer mortality as well as areas with unusually higher mortality rates across counties (JAMA 2017;317(4):388-406). The study utilized population counts from the Census Bureau, the NCHS, and the Human Mortality Database from 1980 to 2014, and included death records from the National Center for Health Statistics. According to the report, in 1980, mortality ranged from 130.6 per 100,000 in Summit County, Colo., to 386.9 in North Slope Borough, Alaska. In 2014, the numbers ranged from 70.7 per 100,000 for Summit County, Colo., to 503.1 per 100,000 for Union County, Fla. Additionally, the authors observed a cancer type-dependent variation in the death rate, with specific clusters of counties having a high mortality rate. Clusters of breast cancer were documented in southern states, along the Mississippi river; incidence of liver cancer was high along the Texas-Mexico border; and kidney cancer rates spiked in several states. Researchers determined the patterns observed in this study "may inform further research into improving prevention and treatment."
ENDOMETRIAL CANCER
Intentional weight loss and endometrial cancer risk
New study findings suggest weight loss could decrease the risk of endometrial cancer in postmenopausal women by 29-56 percent (J Clin Oncol 2017; doi: 10.1200/JCO.2016.70.5822). Researchers reported the benefit was greatest for obese women who actively worked to lose weight. Thirty-five thousand women from the Women's Health Initiative Observational Study, which enrolled postmenopausal women ages 50-79, were evaluated. Participants' weight was measured by researchers at the beginning of the study and then 3 years later. Participants were then followed for more than 10 years on average to identify those who were diagnosed with endometrial cancer. Findings revealed that, for women who lost 5 percent or more of their body weight after age 50, endometrial cancer risk was 29 percent lower. Additionally, women who were obese and intentionally lost 5 percent or more of their body weight saw a 56 percent reduction in their risk. Comparatively, women who gained more than 10 pounds had a 26 percent higher risk of endometrial cancer. Researchers noted, "These findings should motivate programs for weight loss in obese postmenopausal women."
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