Long-Term Results of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer


“In an analysis of long-term outcomes in the SOFT and TEXT trials reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine, Francis et al found that the addition of ovarian suppression to adjuvant tamoxifen significantly improved 8-year rates of disease-free and overall survival vs tamoxifen alone among premenopausal women with breast cancer; risk of recurrence was further reduced with exemestane plus ovarian suppression.

“Initial reports showed that 5-year rates of recurrence were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression vs tamoxifen plus ovarian suppression, with the addition of ovarian suppression to tamoxifen not significantly improving recurrence risk vs tamoxifen alone.”

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Active Surveillance Should Be Standard for Favorable-Risk Prostate Cancer

“Long-term follow-up data supports the use of active surveillance for men with favorable-risk prostate cancer, according to prospective study results.

“These men should be informed of the the low likelihood of harm from their diagnosis and encouraged to consider active surveillance over a curative approach, according to researchers.

“H. Ballentine Carter, MD, director of the division of adult urology at the Brady Urological Institute and the Bernard L. Schwartz distinguished professor of urologic oncology at Johns Hopkins Medicine, and colleagues sought to assess the long-term outcomes for men with favorable-risk prostate cancer in a prospective, active surveillance program.”

Stress Management Techniques Improve Long-Term Mood and Quality of Life

“A new study shows that providing women with skills to manage stress early in their breast cancer treatment can improve their mood and quality of life many years later. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings suggest that women given the opportunity to learn stress management techniques during treatment may benefit well into survivorship.

“At the turn of the century, 240 women with a recent breast cancer diagnosis participated in a randomized trial that tested the effects of a stress management intervention developed by Michael Antoni, Ph.D., professor of psychology in the University of Miami (UM) College of Arts & Sciences. Dr. Antoni and his team in the Department of Psychology found that, compared with patients who received a one-day seminar of education about breast cancer, patients who learned relaxation techniques and new coping skills in a supportive group over 10 weeks experienced improved quality of life and less depressive symptoms during the first year of treatment.

“In their latest report, the researchers found that the women who received the stress management intervention had persistently less depressive symptoms and better quality of life up to 15 years later.

Anxiety, Chronic Pain among Problems That Adult Cancer Survivors Experience Years after Treatment, New Study Finds

“A team of researchers from The University of Texas at Arlington and the University of Central Florida have determined that years after going into remission, many adult cancer survivors still encounter challenges arising from their disease and its treatment.

“From anxiety about a cancer recurrence to physical problems such as chronic pain, survivors aren’t quite done battling the effects of cancer even 2, 5, and 10 years after treatment for the disease.

“The study, ‘Current unmet needs of cancer survivors: Analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II,’ is published online and in the February issue of Cancer, a journal of the American Cancer Society.

” ‘So often, the expectation is that a cancer survivor should be grateful for having survived a diagnosis of cancer. And while this may be true, those survivors with debilitating, lingering effects of cancer and its treatment are not always acknowledged within healthcare systems as needing continued care based on their cancer survivor status,’ said Gail Adorno, assistant professor in the UT Arlington School of Social Work and co-principal investigator on the study.”

Study Confirms Long-Term Benefits of Melanoma Immunotherapy

“A long-term follow up of people on an international clinical trial has confirmed the benefit of immunotherapy for certain patients with advanced (stage 3 or 4) melanoma.

“More than 18 per cent of patients were still alive five years after being treated with ipilimumab (Yervoy) in combination with a chemotherapy drug called dacarbazine.

“This compared to fewer than nine per cent who were treated with chemo alone.

“Ipilimumab is one of a new class of cancer treatments that target the immune system, and works by homing in on a molecule found on immune cells called CTLA-4. This relieves the molecular ‘brakes’ on a patient’s immune system, allowing it to attack their cancer.

“The study, which began recruiting patients 2006 – including several from the UK – also confirmed low rates of serious side-effects among patients who took the drug long-term.”

Ipilimumab Demonstrates Long-Term Survival Benefit in Advanced Melanoma

“Some patients with advanced melanoma treated with ipilimumab continued to derive a survival benefit at least 5 years after treatment, according to study results.

“The results showed that, for certain patients, retreatment with ipilimumab (Yervoy, Bristol-Myers Squibb) can re-establish disease control while demonstrating a safety profile comparable to that observed during ipilimumab induction, researchers wrote.

“The analysis included patients treated with ipilimumab in one of six phase 2 clinical trials. In those trials, ipilimumab was administered in doses of 0.3 mg/kg, 3 mg/kg or 10 mg/kg.

“In the current companion study — conducted by Celeste Lebbé, MD, PhD, professor of dermatology at Hôpital Saint-Louis in Paris, and colleagues — patients underwent ipilimumab retreatment, extended maintenance therapy or follow-up for survival only.”

Switch from Imatinib to Nilotinib Improved Outcomes in Chronic Phase CML

Editor’s note: This story is about the results of a clinical trial – a research study with volunteer patients. The study tested a treatment for people with chronic phase chronic myeloid leukemia (CML) who had persistent minimal residual disease after long-term treatment with the drug imatinib (Gleevec). For the study, half of the 200 participants continued taking imatinib, and half of the patients switched to the drug nilotinib. It was found that the patients who switched to nilotinib had better outcomes than those who didn’t.

“Patients with chronic phase chronic myeloid leukemia who had persistent minimal residual disease after long-term treatment with imatinib achieved deeper molecular responses and undetectable disease when they switched to treatment with nilotinib, according to study results.

“The reduced disease burden associated with the switch to nilotinib may enable patients to enroll on treatment-free remission trials, researchers wrote.

“Timothy P. Hughes, MD, FRACP, FRCPA, head of the division of hematology at South Australia Pathology and clinical professor of medicine at University of Adelaide in Australia, and colleagues evaluated data from 207 patients with CML. All patients were in complete cytogenetic response yet had detectable BCR-ABL1 after 2 or more years of treatment with imatinib (Gleevec, Novartis).”

Pediatric ALL Protocols Have Low Risk of Late Effects

Bone marrow from a 3-year-old ALL patient

“Long-term outcomes of patients treated for pediatric acute lymphoblastic leukemia (ALL) with modern treatment protocols are good, with an overall low risk for serious long-term side effects, according to the results of report from the Childhood Cancer Survivor Study cohort.

“ ‘This data will be useful for oncologists counseling newly diagnosed patients, and provides reassurance that the ‘devastating’ diagnosis of ALL can often have good short- and long-term outcomes,’ study author Paul C. Nathan, MD, of the Hospital for Sick Children, University of Toronto, told Cancer Network.

“With survival rates of childhood ALL at about 90%, researchers and clinicians have to focus not only on curing the disease, but on the quality of that cure and its long-term adverse effects.”

Image: “Bone marrow from a 3-year-old ALL patient”

25-Year Disease-Free Survival Rate After Irradiation for Prostate Cancer Calculated with the Prostate Specific Antigen Definition of Recurrence Used for Radical Prostatectomy

25 Year Disease Free Survival Rate after Irradiation of Prostate Cancer Calculated with the Prostate Specific Antigen Definition of Recurrence Used for Radical Prostatectomy Study, is the first-ever to analyze 25 years of follow-up data after radiation therapy treatment for prostate cancer patients. The study concludes that follow up evaluations are necessary for 15 years after treatment to fully understand the outcomes of any treatment for prostate cancer. Unlike a previous study on patients recurring after prostatectomy, this is the first to include interval censoring analysis when looking at time to recurrence. If a man’s PSA is <0.20 ng/ml 15 years post treatment, later recurrence of the disease should be rare.