The Christie School of Oncology: Christie Research Publications Repository
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Racial disparities in ovarian cancer survival transcend the somatic mutational landscape
No full textImpact of prescribing to the PTV on GTV dose heterogeneity in lung SBRT: insight from EORTC studies
No full textTargeting oestrogen receptor signalling in breast cancer therapy
No full textThere has been over 130 years of research into the treatment of breast cancer using approaches that target oestrogen receptor signalling. Here, we summarise the development of the key pillars of such endocrine therapy, namely, oestrogen deprivation, achieved through ovarian suppression and/or aromatase inhibition, and oestrogen receptor blockade, through selective oestrogen receptor modulators, downregulators and novel compounds entering early phase development. The translation of these compounds from advanced to early breast cancer settings is discussed with a focus on the placebo-controlled breast cancer prevention studies to most accurately describe the side effect profiles of the main approaches
Reply to: 'Risks of organ preservation in rectal cancer: beyond distant metastases, ultimate local failure can also be a problem,' 'organ preservation in rectal cancer: Fear of risks versus the risks of fear,' and 'distant metastases with nonoperative management in rectal cancer: challenges in defining risk'
No full textAI evaluation of tumour content and histology sample quality with change in needle type used in Image Guided Lung Biopsy: a retrospective audit
No full textLong-term side effects of testicular cancer and treatment (observational study of mortality and morbidity in testicular cancer survivors)
No full textPURPOSE: Testicular cancer (TC) is a rare cancer, but due to early age at diagnosis and excellent cure rates, there is a large cohort of survivors. Recent studies have highlighted the late side effects of treatments of TC, especially cisplatin-based chemotherapy. These complications make the survivorship care challenging with detrimental effects on health and prognosis of TC survivors (TCS). In this study, we provide a snapshot of common late side effects in TCS and a possible care pathway with a nurse-led specialised clinic. METHODS: We invited TCS to participate in the study at one of the cancer centres in Ireland for a comprehensive screening using questionnaires, examination and blood tests. Further investigations were performed as indicated. Mortality was assessed through retrospective chart reviews. RESULTS: We recruited 78 TCS to participate in the study with a median of 129 months since diagnosis (range 60 to 304 months) and 3 who died in survivorship. Second malignant neoplasms accounted for all three mortalities. Most common conditions after 5 years of diagnosis were hypertension (40%), dyslipidaemia (55.6%), hypogonadism (~ 45%), and high BMI (52%). The majority of conditions were diagnosed during screening, including two cases of coronary artery disease and one case of transient ischaemic attacks. TCS who received chemotherapy and were aged more than 30 years at the time of diagnosis had a higher prevalence of the late side effects. CONCLUSIONS: TC survivorship phase is marred by a range of late side effects. This remains a challenge for patients and healthcare workers as ambiguity surrounds the care pathways in the survivorship setting. We hope this nurse-led, specialised, screening clinic might improve the care and service provision for TC survivors
Targeted therapy for older patients with an oncogene driven non-small cell lung cancer: recommendations from a SIOG expert group
No full textLung cancer is mostly a disease of aging with approximately half of newly diagnosed patients being 70 years or older. Treatment decisions in this population pose unique challenges because of their heterogeneity with regards to daily functioning, cognition, organ function, comorbidities and polypharmacy, their underrepresentation in clinical trials and the impact of treatment on patient-centered outcomes, particularly in frail patients. The advent of targeted therapies and immunotherapy has revolutionized the management of advanced non-small cell lung cancer (NSCLC). Molecular profiling has allowed for the identification of actionable genomic alterations and targeted therapies have become standard of care for oncogene-driven NSCLC, significantly improving prognosis and quality of life. However, the data on the efficacy and tolerability of these treatments in older patients remain sparse. This review, conducted by the International Society of Geriatric Oncology (SIOG) NSCLC task force, examines the available literature on the use of targeted therapies in patients aged 70 years or older with oncogene-driven NSCLC. The task force's expert recommendations aim to guide treatment decisions for older patients with oncogene driven NSCLC
KEYMAKER-U03 Substudy 03B: Pembrolizumab (pembro) and novel immunotherapy agents for advanced clear cell renal cell carcinoma (ccRCC)
No full textEfficacy and safety of olaparib plus abiraterone versus placebo plus abiraterone in the first-line treatment of patients with asymptomatic/mildly symptomatic and symptomatic metastatic castration-resistant prostate cancer: analyses from the phase 3 PROpel trial
No full textBackground and objective: In PROpel (NCT03732820), olaparib + abiraterone resulted in a statistically significant radiographic progression-free survival (rPFS) benefit and numerically prolonged overall survival (OS) versus placebo + abiraterone in first-line (1L) metastatic castration-resistant prostate cancer (mCRPC) patients. Here, we report post hoc exploratory subgroup analyses in patients with asymptomatic/mildly symptomatic or symptomatic disease at baseline. Methods: Patients were randomised 1:1 to olaparib (300 mg b.i.d.) or placebo with abiraterone (1000 mg o.d.) + prednisone/prednisolone (5 mg b.i.d.). For this post hoc exploratory analysis, patients with a Brief Pain Inventory-Short Form (BPI-SF) item 3 score of = 4 and/or opiate use were classified as symptomatic. Subgroup analyses included investigator-assessed rPFS, OS, objective response rate, time to second progression or death, health-related quality of life, and safety. Key findings and limitations: The median rPFS in asymptomatic/mildly symptomatic patients (n = 560) was 27.6 mo for olaparib + abiraterone versus 19.1 mo for placebo + abiraterone (hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.46-0.76). For symptomatic patients (n = 183), equivalent values were 14.1 versus 13.8 mo (HR, 0.78; 95% CI, 0.54-1.13). At the final planned OS analysis, the median OS in asymptomatic/mildly symptomatic patients was not reached for olaparib + abiraterone versus 39.5 mo for placebo + abiraterone (HR, 0.77; 95% CI, 0.59-1.00). For symptomatic patients, equivalent values were 22.9 versus 22.8 mo (HR, 0.82; 95% CI, 0.58-1.16). Other outcomes showed no meaningful differences between the subgroups. Conclusions and clinical implications: Olaparib + abiraterone provided efficacy benefits in 1L mCRPC patients with either asymptomatic/mildly symptomatic or symptomatic disease. A larger benefit occurred in asymptomatic/mildly symptomatic patients. Patient summary: PROpel, a phase 3 clinical trial, looked at whether combining olaparib with abiraterone delays the progression of patients' cancer compared with placebo plus abiraterone. Patients with or without pain symptoms associated with metastatic castration-resistant prostate cancer were eligible for enrolment into the trial. Results showed that olaparib plus abiraterone reduced the risk of disease progression and death, with a larger benefit observed in patients without or with mild pain symptoms than in those with pain symptoms. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/)
