Lung Cancer Update April 2021
With the World Conference on Lung Cancer (WCLC) 2020 completed last January, several new and clinical relevant phase 2 and phase 3 studies on Lung Cancer have been published. We summarised some key data for you.
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Abemaciclib: A review of the evidence through clinical cases
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The Role of Patient Blood Management for Inflammatory Bowel Disease
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COVID-19 impacting regular patient care for cardiovascular diseases
Disruption of standard patient care due to the COVID-19 pandemic has been long postulated, and is now supported by a study reported in the Journal of the American College of Cardiology reporting delays in the delivery of essential diagnostic services, particularly for cardiovascular conditions, affecting health outcomes.
SARS-CoV-2 infection in children and an increased risk of thrombotic microangiopathy
While vaccines are starting to become available for the prevention of SARS-Cov-2 infection, it is anticipated that the Coronavirus 2019 (COVID-19) pandemic will continue for at least the next year.
Registry data shows early and large LDL reductions are associated with lowest post-MI cardiovascular event rates
Evidence in recent years has shown that the lower the low-density lipoprotein cholesterol (LDL-C) levels, the lower the risk of future cardiovascular events.
Breast cancer update January 2021
With the San Antonio Breast Cancer Conference (SABCS) 2020 by AACR just completed, several new and clinical relevant phase 2 and phase 3 have been published in the Journal of the American Medical Association, Clinical Cancer Research, New England Journal of Medicine, Journal of Clinical Oncology, and Lancet Oncology. [‘mediPr] provides you with an overview.
Osimertinib approved as the first adjuvant treatment for early non-small cell lung cancer
Lung cancer is a leading cause of cancer-related death. In East Asian non-small cell lung cancer (NSCLC) patients, epidermal growth factor receptor (EGFR) mutations occur in 40-55% of lung adenocarcinomas.
Increasing dose frequency of lanreotide autogel injections in neuroendocrine tumours
Somatostatin analogues (SSA) control the hormonal hypersecretion in pancreatic and midgut neuroendocrine tumours (NETs), with antiproliferative, antiangiogenic and proapoptotic effects. Lanreotide autogel is a long-acting SSA that is considered the therapy of choice along with octreotide, in controlling symptoms associated with gastroenteropancreatic (GEP)-NETs.
Patient Blood Management and Treatment of iron Deficiency Anaemia in Gynaecological Conditions
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Cabotegravir and rilpivirine intramuscular combination safe in women
Women account for a disproportionate percentage of new human immunodeficiency virus (HIV) infections in sub-Saharan Africa, comprising 59% of 18 million new adult HIV infections in 2017.
HCV-infected kidneys safe for transplantation with antiviral treatment
Kidney transplants are the best treatment for end-stage renal disease (ESRD), with better survival outcomes than haemodialysis or peritoneal dialysis. However, in Hong Kong as well as much of the rest of the world, there is an increasing gap between the number of patients requiring a transplant and the number of organs available.
Baloxavir marboxil recommended as post-exposure prophylaxis to influenza by EMA
Seasonal influenza is common between January to March, and July to August in Hong Kong. Baloxavir marboxil is the first influenza antiviral with a novel mechanism of action to be approved in almost two decades, and was registered for use in Hong Kong in February 2019.
Detecting metastases with PSMA-PET in prostate cancer
Conventional imaging with computed tomography (CT), magnetic resonance imaging (MRI) and bone scans, are the current standard of care for imaging prostate cancer. Accurate imaging primarily relies on nodal metastases size for detection.
ASCO Guidelines for the Use of Systemic Therapies in Advanced Hepatocellular Cancer
Hepatocellular carcinoma (HCC) accounts for 80% of all liver cancers, and 55% of all HCC cases worldwide are reported from China. In Hong Kong, liver cancer is the fourth most common cancer and the third most common cause of cancer death.
Sotorasib for the treatment of KRASG12C mutated lung cancer
RAS is the most frequently mutated gene family in cancers, with KRAS mutations being involved as a driver in three of the most lethal cancers – lung cancer, colorectal cancer, and pancreatic cancer. Incidence of KRAS mutations vary between ethnicity with Caucasians having a higher incidence than African-Americans or Asians. In non-small lung cancer (NSCLC), the most common KRAS mutation is G12C. In Asia, G12C mutations in particular account for 14.5% of KRAS mutations in the Chinese population. KRAS G12C was identified in 4.3% of lung cancer samples and 2.5% of colorectal cancer samples.
Capmatinib therapy for the treatment of MET-positive non-small cell lung cancer
A number of tyrosine kinase inhibitors (TKIs) are now available for the treatment of various types of non-small cell lung cancers (NSCLC), including epidermal growth factor receptor (EGFR)-mutated and anaplastic lymphoma kinase (ALK)-rearranged NSCLC. However, amplification of the MET gene, which codes for the hepatocyte growth factor receptor (HGFR), has been found to be one of the most prominent mechanisms of secondary resistance to EGFR TKIs. Similarly, the MET exon 14 (METex14) mutation has also emerged as a potential tumour driver due to its role in cancer proliferation, and thus also a promising target for NSCLC.
Data for safe and effective use of evolocumab in paediatric familial hypercholesterolaemia
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
Psoriasis biologics may help reduce coronary plaque
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
Ticagrelor may not confer post-MI benefits to elderly patients
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
Evidence of SARS-CoV2 in heart cells
While SARS-CoV2 has been previously reported to exist in lung tissue in a 78-year-old patient who died of unexpected cardiac arrest when ready for discharge after COVID-19 hospitalisation, recently the first evidence of SARS-CoV2 infection in heart muscle cells has been reported in a case from Brazil and which is supported by evidence from other reports.
Triple combination effective for hospital- and ventilator-acquired pneumonia
Pneumonia is the second leading cause of death in Hong Kong as of 2019, with annually increasing death rates.
Selpercatinib displays efficacy in RET fusion-positive non-small cell lung cancer
Aberrant RET activation has shown to be a clinical driver of tumour growth and proliferation. It is reported that 1-2% of non-small cell lung cancer patients have activating RET fusions. Clinical characteristics of these patients are generally younger (<60 years) with minimal or no smoking history, and frequent presentation with brain metastases at diagnosis of advanced disease. RET mutations are mutually exclusive with other common lung cancer genetic abberations, such as reported for KRAS, EGFR, and ALK.
First liquid biopsy for NSCLC to receive FDA approval
The development of new targeted therapies for non-small cell lung cancer (NSCLC) in recent years has changed the standard of care for the later stages of NSCLC in specific population groups.
ESMO releases the first guideline on NGS testing in cancers
Precision therapies were first approved for cancer in 1998, when trastuzumab was approved for HER2+ breast cancer, opening the door for other targeted therapies such as imatinib for Philadelphia chromosome-positive chronic myelogenous leukaemia.
Risk of thrombosis with SARS-CoV-2 infection
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/2019-nCoV) in late 2019 has led to a global pandemic.
Class effect of SGLT2 inhibitors on heart failure reduction solidified with dapagliflozin and empagliflozin results
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been used in the treatment of type 2 diabetes mellitus (T2DM) to inhibit renal glucose reabsorption and thereby increase urinary glucose loss.
No difference in kidney transplantation outcomes for HIV-positive recipients regardless of donor HIV status
Human immunodeficiency virus (HIV) has been transformed into a chronic disease to the successful introduction of antiretroviral therapy (ART), and people living with HIV (PWH) now experience morbidity from other chronic conditions, such as kidney, liver, and heart disease.
Residual risk of hepatocellular carcinoma in older Hepatitis C patients even after viral clearance
Infection with the hepatitis C virus (HCV) can lead to chronic hepatitis C infection (CHC) and liver complications such as fibrosis, hepatocellular carcinoma (HCC), cirrhosis, and end-stage liver disease.
Potential protective effects of the influenza vaccine on cardiovascular outcomes in high-risk populations
Influenza A and B viruses are the cause of 3 to 5 million infection, and 250,000 to 500,00 deaths each year worldwide. Particular groups of the population are at higher risk of infection, including the elderly, immunocompromised, and infants.
Updated human papillomavirus vaccination and testing recommendations from the American Cancer Society
Human papillomavirus (HPV) is one of the most common causes of sexually transmitted disease worldwide. HPV is associated with a variety of clinical conditions that can range from cutaneous warts to cervical or anal cancer. Cervical cancer is the third most common cancer in women in the United States, and may constitute up to 25% of all female cancers in developing countries.
Interim results of a Phase 2b/3 trial investigating a long-acting injectable of cabotegravir for pre-exposure prophylaxis of HIV
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Comparison of the metabolic changes from the TANGO trial: a post-hoc analysis
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Lower-risk MDS patients benefit from novel drug, imetelstat
Myelodysplastic syndromes (MDS) are a heterogenous group of clonal haematopoietic disorders that carry a risk of progression to acute myeloid leukaemia (AML). Patients are stratified into risk groups due to the heterogeneity of the disease, which is also exemplified by median overall survival (OS) of 8.8 years for very low risk, and 0.8 years for very high risk patients. Due to symptoms such as anaemia, supportive red blood cell (RBC) transfusions are needed in 80-90% of patients during their disease course, although RBC dependence has been shown to be an adverse prognostic marker.
Carboplatin plus paclitaxel to be the new standard of care for anal cancer
The incidence of anal cancer has been increasing over the past decade, but currently still constitutes 0.5% of all cancer diagnoses in the United States. When the cancer has metastasised, prognosis remains poor, with relative 5-year survival rates of approximately 30%. The current standard of care for metastatic anal cancer is cisplatin-based chemotherapy combined with 5-fluorouracil (5-FU). However, no randomised clinical trial investigating the optimal chemotherapy regimen for this disease has been conducted. The InterAAct trial was launched to investigate cisplatin plus FU against carboplatin plus paclitaxel in advanced anal cancers, and full results were recently published in the Journal of Clinical Oncology.
ASCO 2020 Lung, Breast, and Liver Cancer Update
This year, ASCO 2020 was held as a virtual conference due to the COVID-19 pandemic. This is a summary of key trials presented at ASCO, focusing primarily on breast cancer, liver cancer, and lung cancer.