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.

RENAL CELL CARCINOMA

Outcomes following complete surgical metastasectomy for patients with metastatic renal cell carcinoma: a systematic review and meta-analysis

A recently published meta-analysis concluded that patients with late-stage renal cell carcinoma who underwent complete surgical metastasectomy had a longer overall survival (OS) than patients who had an incomplete metastasectomy (J Urol 2017; doi:10.1016/j.juro.2016.07.079). Researchers performed a systematic review of data from eight cohort studies with a low or moderate potential for bias; median OS was the primary endpoint. Analysis included 2,267 patients; 958 of those patients underwent complete surgical metastasectomy and 1,309 had incomplete surgical metastasectomy. According to investigators, median OS ranged from 36.5 months to 142 months for those who had a complete surgical metastasectomy compared with 8.4 months to 27 months for incomplete surgical metastasectomy [adjusted HR=2.37; 95% CI, 2.03-2.87]. Given these results, researchers concluded, "Consideration should be given to performing complete surgical metastasectomy, when technically feasible, in patients with metastatic renal cell carcinoma who are surgical candidates."

HEAD & NECK CANCER

Integrative analysis identifies a novel AXL-PI3 kinase-PD-L1 signaling axis associated with radiation resistance in head and neck cancer

Recurrence of head and neck squamous cell carcinoma (HNSCC) negative for human papillomavirus (HPV) following radiation therapy was associated with high tumor levels of the protein PD-L1 (Clin Can Res 2017; doi:10.1158/1078-0432.CCR-16-2586). Given patients with HPV-negative HNSCC have particularly poor outcomes following treatment, researchers sought to identify and validate potentially targetable biomarkers to improve survival in this population. The in vitro observation that PD-L1 levels correlated with AXL and PI3K signaling was confirmed in samples from two cohorts of 68 and 97 patients with locally advanced HPV-negative HNSCC, respectively, as well as in The Cancer Genome Atlas HPV-negative HNSCC cohort. Researchers utilized three different methods to analyze PD-L1 levels in three different cohorts and found 3-year loco-regional recurrence rates were 60 percent, 70 percent, and 50 percent for tumors with high levels of PD-L1 compared with 20 percent, 25 percent, and 20 percent for tumors with low levels of PD-L1. The association between PD-L1 levels and loco-regional recurrence of disease remained statistically significant in multivariate analysis. Researchers concluded, "Taken together, our data point to a targetable AXl-PI3 kinase-PD-L1 axis that is highly associated with radiation resistance."

BREAST CANCER

Alcohol intake and breast cancer risk in African American women from the AMBER consortium

New data found alcohol consumption was associated with an increased risk of breast cancer in African-American women (Cancer Epidemiol Biomarkers Prev 2017;26(5):787-794). Researchers enrolled 22,338 women from the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium, which includes four epidemiologic studies of breast cancer. Alcohol intake was reported by study participants through a questionnaire and logistic regression was utilized to estimate the association between alcohol consumption and breast cancer cases. Results showed that women who had seven drinks per week showed an increased risk of most subtypes. Additionally, women who consumed 14 or more alcoholic beverages per week were 33 percent more likely to develop breast cancer than women who consumed four or fewer drinks per week [95% confidence interval (CI), 1.07-1.64]. "Among African American women, similar to women of European descent, drinking >=7 alcoholic drinks per week was associated with an increased risk of breast cancer regardless of subtype," investigators concluded. "Alcohol intake is a modifiable risk factor for breast cancer, and reduced intake among African American women should be encouraged."

ENVIRONMENTAL FACTORS

County-level cumulative environmental quality associated with cancer incidence

Nationwide, counties with the poorest quality across five domains-air, water, land, the built environment, and sociodemographic-had the highest incidence of cancer, according to new data (Cancer 2017; doi:10.1002/cncr.30709). Researchers combined data from the Environmental Quality Index, a measure of cumulative ambient environmental exposures in the U.S. between 2000 and 2005, with national county-level cancer incidence data from the NCI state cancer profiles. The study focused on the leading three causes of cancer among men (lung, prostate, and colorectal) and women (lung, breast, and colorectal). The analyzed patient populations included 2,687 counties (34% metropolitan urbanized; 10% nonmetropolitan urbanized; 35% less urbanized; 21% thinly populated). The average age-adjusted rate for all types of cancer was 451 cases per 100,000 people. Counties with poor environmental quality had higher incidence of cancer-on average, 39 more cases per 100,000 people-than counties with high environmental quality. Increased rates were seen for both males and females, and prostate and breast cancer demonstrated the strongest association with poor environmental quality. According to authors, "Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures."

LUNG CANCER

Circulating tumor cells with aberrant ALK copy number predict progression-free survival during crizotinib treatment in ALK-rearranged non-small cell lung cancer patients

Among patients with non-small cell lung cancer (NSCLC) fueled by ALK gene alterations who were being treated with crizotinib, a decrease in the number of circulating tumor cells (CTCs) harboring increased copies of the ALK gene over the first 2 months of treatment was associated with increased progression-free survival (PFS) (Can Res 2017; doi:10.1158/0008-5472.CAN-16-3072). The study included 39 patients with ALK-rearranged NSCLC. After enriching for CTCs, blood samples from patients were analyzed for ALK rearrangements and an increase in the number of copies of the ALK gene. All patients had both CTCs with ALK rearrangements and CTCs with ALK copy number gain before treatment and at 2 months. Median PFS for the 13 patients who had a decrease in the number of CTCs with ALK copy number gain was 14.0 months [95% CI, 2.3 months to NA], compared to 6.1 months [95% CI, 2.5-9.8 months] for the 16 patients who had stable or increased numbers of CTCs with ALK copy number gain, according to researchers. "Although further confirmatory studies are needed, our results offer a new and important perspective on the potential use of CTCs in replacing biopsies for patient monitoring in real time and clinical outcome prediction in this population," authors wrote.

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