Annals of Oncology
ISSN / EISSN : 0923-7534 / 1569-8041
Published by: Elsevier BV (10.1016)
Total articles ≅ 46,202
Latest articles in this journal
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.013
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.005
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.010
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.009
National health plans prioritized cancer patients on active treatment for SARS-CoV-2 vaccination because of high morbidity and mortality rates associated with COVID-191Kong X. Qi Y. Huang J. Zhao Y. et al.Epidemiological and clinical characteristics of cancer patients with COVID-19: A systematic review and meta-analysis of global data.Cancer Lett. 2021; 508: 30-46Crossref PubMed Scopus (1) Google Scholar. The mRNA vaccine approval studies excluded recipients of immunosuppressive therapy2Polack F.P. Thomas S.J. Kitchin N. et al.Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine.N Engl J Med. 2020; 383: 2603-2615Crossref PubMed Scopus (1991) Google Scholar, 3Baden L.R. El Sahly H.M. Essink B. et al.Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine.N Engl J Med. 2021; 384: 403-416Crossref PubMed Scopus (1206) Google Scholar, raising concerns among the oncology community. Herein, we assessed the effects of active treatments on safety and immunogenicity of SARS-CoV-2 mRNA-BNT162b2 vaccine in patients with solid malignancies.
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.008
Lung cancer is the leading cause of cancer death worldwide. The absence of symptoms in early stage (I/II) disease, when curative treatment is possible, results in greater than 70% of cases being diagnosed at late stage (III/IV), when treatment is rarely curative. This contributes greatly to lung cancer's poor prognosis which sees only 16.2% of individuals diagnosed with the disease alive at 5 years. Early detection is key to improving lung cancer survival outcomes. As a result, there has been longstanding interest in finding a reliable screening test. After little success with chest radiography and sputum cytology, in 2011 the US National Lung Screening Trial (NLST) demonstrated that annual Low Dose Computed Tomography (LDCT) screening reduced lung cancer specific mortality by 20%, when compared with annual chest radiography. In 2020, the NELSON study demonstrated an even greater reduction in lung cancer specific mortality for LDCT screening at 0, 1, 3 and 5.5 years of 24% in men, when compared to no screening. Despite these impressive results, a call to arms in the 2017 European position statement on Lung Cancer Screening (LCS), and the widespread introduction across the US, there was, until recently, no population-based European national screening programme in place. We address the potential barriers and outstanding concerns including common screening foes, such as false positive tests, overdiagnosis, and the negative psychological impact of screening, as well as others more unique to LDCT LCS, including appropriate risk stratification of potential participants, radiation exposure and incidental findings. In doing this, we conclude that whilst the evidence generated from ongoing work can be used to refine the screening process, for those risks which remain, appropriate and acceptable mitigations are available, and none should serve as barriers to the implementation of national unified LCS programmes across Europe and beyond.
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.006
Background Disease progression is often considered a binary state reflecting presence or absence of response. However, meaningful heterogeneity between metastatic sites of a given patient may exist and may impact therapeutic outcomes. To characterize the heterogeneity of progression with immunotherapy, we evaluated lesion-level dynamics of pembrolizumab-treated patients across three tumor types. Patients and methods Individual metastatic lesion dynamics were analyzed retrospectively in patients with advanced melanoma, non–small cell lung cancer (NSCLC), and gastric or gastroesophageal junction (G/GEJ) cancer who received pembrolizumab in KEYNOTE-001 or KEYNOTE-059. Primary progression was defined as radiologic progression per RECIST v1.1 occurring at the first on-treatment study scan (∼9-12 weeks, + 2-week window) and secondary progression as progression occurring beyond the first scan (∼14 weeks and beyond). The change in sum of target lesions and of individual lesions was examined, as were patterns and timing of progression. Results 9239 individual lesions from 1194 patients were analyzed. Among patients with primary progression (39% [200/511] of patients with melanoma, 41% [179/432] with NSCLC, 61% [154/251] with G/GEJ cancer), most patients (51-63%) had a mixture of growing, stable, and shrinking lesions. Despite overall primary progression, a minority of patients (19-25%) had tumor growth at every metastatic site and 17-32% had ≥1 shrinking lesion. Among patients with secondary progression (22% [113/511] of patients with melanoma, 27% [117/432] with NSCLC, 18% [44/251] with G/GEJ cancer), few patients had rebound growth (>20% increase in diameter from nadir) in all lesions whereas the majority (74-84%) had sustained regression in ≥1 lesion. Conclusions Lesion-level heterogeneity at the time of disease progression was common in pembrolizumab-treated patients, with many patients demonstrating ongoing disease control in a subset of tumor sites. These results may inform clinical decision-making, trial design, and tumor sampling in the future.
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.003
Background Current genetic and genomic tests measuring homologous recombination deficiency (HRD) show limited predictive value. This study compares the performance of an immunohistology-based RAD51 test with genetic/genomic tests to identify patients with HRD primary triple-negative breast cancer (TNBC) and evaluates its accuracy to select patients sensitive to platinum-based neoadjuvant chemotherapy (NACT). Patients and methods This is a retrospective, blinded, biomarker analysis from the GeparSixto randomized clinical trial. TNBC patients received neoadjuvant paclitaxel plus Myocet-nonpegylated liposomal doxorubicin (PM) or PM plus carboplatin (PMCb), both arms including bevacizumab. Formalin-fixed paraffin-embedded (FFPE) tumor samples were laid on tissue microarrays. RAD51, BRCA1 and γH2AX were quantified using an immunofluorescence assay. The predictive value of RAD51 was assessed by regression models. Concordance analyses were performed between RAD51 score and tumor BRCA (tBRCA) status or genomic HRD score (myChoiceHRD). Associations with pathological complete response (pCR) and survival were studied. Functional HRD was pre-defined as a RAD51 score ≤10% (RAD51-low). Results Functional HRD by RAD51-low was evidenced in 81/133 tumors (61%). RAD51 identified 93% tBRCA-mutated tumors and 45% non-tBRCA mutant cases as functional HRD. The concordance between RAD51 and genomic HRD was 87% (95%CI 79-93%). In patients with RAD51-high tumors, pCR was similar between treatment arms (PMCb 31% vs PM 39%, odds ratio (OR) 0.71, 0.23-2.24, p=0.56). Patients with RAD51-low tumors benefited from PMCb (pCR 66% vs 33%, OR 3.96, 1.56-10.05, p=0.004; interaction test p=0.02). This benefit maintained statistical significance in the multivariate analysis. Carboplatin addition showed similar disease-free survival in RAD51-high (hazard ratio (HR) 0.40, log-rank p=0.11) and RAD51-low (0.45, p=0.11) groups. Conclusions The RAD51 test identifies tumors with functional HRD and is highly concordant with tBRCA mutation and genomic HRD. RAD51 independently predicts clinical benefit from adding Cb to NACT in TNBC. Our results support further development to incorporate RAD51 testing in clinical decision-making.
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.001
Background Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators. Methods PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. Systematic reviews that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021 were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research. Results Twenty-nine systematic reviews were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels. Conclusions This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.
Annals of Oncology; https://doi.org/10.1016/j.annonc.2021.09.002