memo - Magazine of European Medical Oncology

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00639-4

Hilbe, Wolfgang; Pircher, Andreas; Füreder, Thorsten; Rumpold, Holger; Gunsilius, Eberhard; Bartsch, Rupert

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00636-7pmid: 32983274

Gunsilius, Eberhard

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00629-6

Nguyen, Van Anh

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00634-9

Amann, Arno

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00631-y

Gampenrieder, Simon Peter

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00635-8

Beslija, Semir

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00643-8pmid: 32983275

Sillaber, Alois

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00648-3

Bohn, Jan-Paul; Wolf, Dominik

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00615-y

Summary A deeper understanding of disease biology and the advent of targeted drugs have implemented chemotherapy-free treatment options in chronic lymphocytic leukemia (CLL). With consistently superior outcome data and good tolerability, the Bruton’s kinase inhibitor ibrutinib as well as the B‑cell lymphoma 2 inhibitor venetoclax +/− CD20 antibody have recently been licensed for first-line treatment independently of TP53 status and are currently recommended as therapy of choice in most patient subgroups according to international management guidelines. Survival curves, however, have not reached a plateau and relapse due to acquired resistance or drug intolerance remain major hurdles in CLL treatment. Clinical trials currently focus on the most promising combinations and sequences of highly effective targeted drugs aimed at avoiding drug resistance by further enhancing eradication of minimal residual disease and optimizing drug tolerability. This brief review provides an update on the recently presented clinical trial data in first-line CLL at ASH 2019 and discusses clinically relevant obstacles to overcome.

Schmitt, Clemens A.

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00619-8

Summary Despite its significant cure rate, diffuse large B‑cell lymphoma (DLBCL) remains a tumor entity of unmet medical need. The 2019 meeting of the American Society of Hematology (ASH) in Orlando, Florida, presented numerous directions, whereby clinicians may expect practice-changing innovations soon or in the near future. In this ASH highlight feature on “aggressive B‑cell lymphoma”, a selection of prominent findings will be summarized. Targeted therapeutics try to meet the needs of patients subgroups that would benefit, and novel immune oncology agents now represent established treatment principles for relapsed/refractory (R/R) DLBCL. Moreover, intense research efforts have been undertaken to identify biomarkers of response. Imaging-based and molecular diagnostic tools are becoming increasingly instrumental in appraising individual risk prior to the first treatment encounter and in the early phase of induction therapy. Genomic analyses of circulating tumor DNA conducted in the peripheral blood has gained attention in terms of assigning patients to dedicated tumor subtypes, monitoring their molecular tumor burden in the course of the disease, and steering personalized treatment extensions in the near future.

Petzer, Andreas L.

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00616-x

Summary The recent American Society of Hematology (ASH) annual meeting, held in Orlando, Florida, in December 2019 was an exciting meeting for researchers and clinicians working in the field of chronic myeloid leukemia (CML), as well as for patients suffering from the disease. Interesting updates were presented on new kinase inhibitors (TKI) demonstrating great potential with low toxicities in heavily pretreated patients. Moreover, the 10-year follow-up data of the ENESTnd Study, comparing 2nd generation (2ndG) TKI nilotinib with imatinib showed a continuous benefit of the 2ndG TKI in achieving deeper molecular responses and less progressions to accelerated phase (AP) and blast crisis (BC), but no benefit in progression-free (PFS) or overall survival (OS). Encouraging data were also presented on the treatment of CML BC by combining conventional chemotherapy (FLAG-IDA) with TKI therapy (Ponatinib). Furthermore, great efforts have been undertaken to be able to predict the likelihood of successful TKI cessation in deep molecular remission for individual CML patients in first chronic phase (CP).

Seidl-Philipp, Magdalena; Nguyen, Van Anh

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00618-9

Summary Cutaneous T cell lymphomas (CTCL) are a heterogeneous group of rare non-Hodgkin lymphomas. The most common type of CTCL is Mycosis fungoides (MF). Much less common but clinically and histopathologically related to MF is Sézary syndrome (SS). CTCL are incurable and associated with a reduced quality of life. While early stage MF has a good prognosis and is usually treated with skin directed therapies, advanced-stages require systemic therapies, including retinoids, interferon, cytotoxic chemotherapeutic drugs, low-dose methotrexate, histone deacetylase inhibitors and alemtuzumab. However, relapses are frequent and long-term remissions are achieved only in few cases, e.g. with allogenic stem cell transplantation. In recent years, new therapeutic options have evolved by the approval of brentuximab vedotin and mogamulizumab. Both recently approved therapies demonstrated superiority with regard to overall response rate and progression free survival over traditional systemic therapies. Other promising treatments such as lacutamab and PD-1/L-1 inhibitors are in the pipeline, and more therapeutic agents are currently investigated in clinical trials.

Lehmann, Jens; Wintner, Lisa M.; Sztankay, Monika; Willenbacher, Wolfgang; Weger, Roman; Weyrer, Walpurga; Rumpold, Gerhard; Holzner, Bernhard

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00628-7

Summary Patient-reported outcomes (PROs) have gained increasing importance in oncology. PROs can supplement medical treatment with important information about the patient’s quality of life (QoL), which is typically assessed using standardized questionnaires. PROs capture the symptomatology and functional impairments as perceived by the patient without further interpretation by another party. In this article, we describe how routinely assessed electronic PROs (ePROs) at the outpatient unit of the Department of Hematology Innsbruck complement the Austrian Myeloma Registry (AMR) and clinical routine. There is a broad body of literature showing that ePRO assessments can supplement patient–physician contact and help focus communication on clinically relevant issues that matter for the patient. Based on ePRO results, physicians can initiate clinical action such as referring patients to psycho-oncological treatment. Electronic PRO assessments might facilitate communication between healthcare providers among themselves but also between healthcare providers and patients, and make it possible to incorporate the patients’ point of view into treatment in a standardized way. The example depicted herein demonstrates how ePRO assessments can be integrated and used in routine monitoring and for psycho-oncological screening.

El-Ghammaz, Amro Mohamed Sedky; El-Zimaity, Maha; Abdel-Ghaffar, Afaf Abdel-Aziz

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00621-0

Summary Background A comparison was performed of outcomes of two non-BCNU-containing conditioning regimens used in autologous stem cell transplantation (ASCT) for lymphoma due to the lack of superiority of any regimen over others in the setting of the global BCNU shortage. Methods CCVP-16 and LEAM conditioning regimens were compared in 55 relapsed/refractory lymphoma patients regarding engraftment timing, hospitalization duration, toxicity profile, disease progression and survival. Results There was insignificant difference between the two regimens regarding engraftment timings, hospitalization durations and toxicities. However, LEAM was associated with a lower post-ASCT disease progression rate than CCVP-16 in the whole cohort and in the Hodgkin lymphoma subgroup. Overall survival did not differ between the two regimens in the whole cohort and in Hodgkin lymphoma and diffuse large B cell lymphoma subgroups. In contrast, progression free survival was superior with LEAM in comparison to CCVP-16 in the whole cohort and in the Hodgkin lymphoma subgroup. Conclusion LEAM is more effective than CCVP-16 in ASCT for lymphoma, especially Hodgkin lymphoma, and has a comparable toxicity profile.

Hoeller, Christoph

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00640-x

Summary The combination of Cytotoxic T-Lymphozyte Antigen-4 (CTLA‑4) and Programmed death-1 (PD‑1) antibodies and the combination of BRAF and MEK inhibitors are the current clinical standards for combination immune and targeted therapy for melanoma, respectively. The success of these therapies has stimulated research into novel drug combinations for melanoma, of which a large majority are based on combination with PD‑1 or PD-Ligand 1 (PD-L1) blocking drugs. Thus, the aim is to provide an overview of the most important combination strategies in late stage clinical development and an outlook on drug combinations in early development that might enter larger clinical trials within the next few years.

Zaid, Amir M.; Aboelnaga, Engy M.; Halim, Amal; Abdelkhalek, Mohamed; Elbalka, Saleh S.; Zuhdy, Mohamed; Fareed, Ahmed M.; Ibrahim, Eman M.; Halim, Hosam; Metwally, Islam H.

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00622-z

Summary Our younger rectal carcinoma cases had poorer pathologic criteria but the therapy was the crucial factor affecting their survival. Full course of radiotherapy was crucial for better OS of the younger group (P = 0.014), while chemotherapy was crucial for better DFS/PFS in both the young and old age groups (P = 0.00).

Witte, Frédéric H.; Hilbe, Wolfgang; Müldür, Ercan

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00627-8

Summary We report on a 42-year-old woman with colorectal cancer of the sigmoid colon with synchronous pulmonary metastases being treated since June of 2016. With a poorly differentiated, KRAS, NRAS and BRAF wildtype cancer and an advanced stage of the disease we look back to almost four years of treatment and a sequence consisting of four lines of polychemotherapy. Dynamic treatment without achieving relevant treatment-free periods resulted in a satisfying quality of life and prolonged overall survival. Exceptional cases in young and very fit patients support the benefit of a more aggressive treatment strategy.

Suppan, Christoph; Balic, Marija

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00609-w

Summary With a main focus on the early stage triple-negative breast cancer (TNBC), new data on immunotherapy in combination with chemotherapy, the role of capecitabine, the potential of circulating tumor DNA as a predictive tool in the postneoadjuvant setting and new treatment approaches were presented and discussed at the San Antonio Breast Cancer Symposium (SABCS) 2019.

Galid, Arik

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00642-9

Summary The San Antonio Breast Cancer Summit is one of the most important meetings worldwide for physicians who treat breast cancer. As traveling there is always somewhat of an adventure due to the distance and the time of the year (winter) and access is not easy for all physicians, the goal of this article is to provide an overview of the presentations dealing with hormone-receptor-positive breast cancer, capecitabine, prevention, and hormone replacement therapy. Data and results should positively influence daily practice.

Tanaka, Osamu; Funaguchi, Norihiko; Toyoshi, Sayaka; Taniguchi, Takuya; Ono, Kousei; Makita, Chiyoko; Matsuo, Masayuki

2020 memo - Magazine of European Medical Oncology

doi: 10.1007/s12254-020-00617-w

Summary Stereotactic body radiotherapy (SBRT) delivers precise concentric radiation to a tumor. It is well established that local control depends on the biologically effective dose (BED) delivered, with BED10 of ≥100 as a significant predictor of local control. The aim of this study was to evaluate factors associated with overall survival (OS) in inoperable lung cancer cases treated with SBRT. From 2013 to 2016, 22 patients with inoperable lung cancer treated with SBRT who could be followed up until their time of death were retrospectively enrolled. Data on sex, age, dose (Gray), number of fractions, BED (α/β = 10), pathology, tumor location, performance status, and background lung disease were collected. The median total dose at the isocenter was 50 Gy, and median BED was 120 Gy. OS was compared in groups with BED of ≥120 Gy (“high-BED”; n = 15) and BED of <120 Gy (“low-BED,” n = 7). Overall, 1‑year OS was 48%. In the univariate analysis, the number of fractions, BED, and pathology were significantly associated with OS. The high-BED group showed better OS, with 1‑ and 2‑year OS of 64% and 21%, respectively, compared with 25% and 0%, respectively, for the low-BED group (p = 0.04). No adverse event of grade 3 or higher occurred. For these inoperable lung cancer cases treated with SBRT, BED was significantly associated with OS. The poor OS rate observed in this case series might be associated with the fact that all the tumors were inoperable.