[Clinical Picture] Non-Hodgkin B-cell lymphoma involving the palate
A 69-year-old white woman without risk factors for oral cancer presented at the Plastic Surgery Unit of the University Hospital of Palermo (Palermo, Sicily) in January, 2016, with a fetid and bleeding tumour on the left side of the palate (figure). The mass had developed about 6 months previously and had grown rapidly. The initial suspected diagnosis was squamous cell carcinoma of the oral cavity. No specific other symptoms were reported and her blood tests were almost normal, with the exception of a non-specific state of malnutrition due to a reduced food intake, and anaemia due to malnutrition and bleeding from the tumou...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Sara Di Lorenzo, Bartolo Corradino, Vera Panzarella Tags: Clinical Picture Source Type: research
[Policy Review] Incorporating the patient experience into regulatory decision making in the USA, Europe, and Canada
The clinical development of cancer therapeutics is a global undertaking, and incorporation of the patient experience into the clinical decision-making process is of increasing interest to the international regulatory and health policy community. Disease and treatment-related symptoms and their effect on patient function and health-related quality of life are important outcomes to consider. The identification of methods to scientifically assess, analyse, interpret, and present these clinical outcomes requires sustained international collaboration by multiple stakeholders including patients, clinicians, scientists, and polic...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Paul G Kluetz, Daniel J O'Connor, Katherine Soltys Tags: Policy Review Source Type: research
[Policy Review] The My Child Matters programme: effect of public –private partnerships on paediatric cancer care in low-income and middle-income countries
In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5 ·1%, ranging from −1·5% in Venezuela to 17·5% in ...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Scott C Howard, Alia Zaidi, Xueyuan Cao, Olivier Weil, Pierre Bey, Catherine Patte, Angelica Samudio, Laurie Haddad, Catherine G Lam, Claude Moreira, Augusto Pereira, Mhamed Harif, Laila Hessissen, Salma Choudhury, Ligia Fu, Miguela A Caniza, Julius Lecci Tags: Policy Review Source Type: research
[Policy Review] Combining precision radiotherapy with molecular targeting and immunomodulatory agents: a guideline by the American Society for Radiation Oncology
The practice of radiation oncology is primarily based on precise technical delivery of highly conformal, image-guided external beam radiotherapy or brachytherapy. However, systematic research efforts are being made to facilitate individualised radiation dose prescriptions on the basis of gene-expressssion profiles that reflect the radiosensitivity of tumour and normal tissue. This advance in precision radiotherapy should complement those benefits made in precision cancer medicine that use molecularly targeted agents and immunotherapies. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Robert G Bristow, Brian Alexander, Michael Baumann, Scott V Bratman, J Martin Brown, Kevin Camphausen, Peter Choyke, Deborah Citrin, Joseph N Contessa, Adam Dicker, David G Kirsch, Mechthild Krause, Quynh-Thu Le, Michael Milosevic, Zachary S Morris, Jann Tags: Policy Review Source Type: research
[Perspectives] Investigators' response
In the PORTEC-3 trial, adjuvant chemotherapy given during and after radiotherapy improved failure-free survival (FFS) in women with high-risk endometrial cancer, compared with radiotherapy alone. Overall survival was higher than expected at the time of trial design and the higher overall survival observed with chemoradiotherapy did not reach significance. We agree that analysis of overall survival with a longer follow-up is warranted in the PORTEC-3 trial. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Remi A Nout, Melanie E Powell, Stephanie M de Boer, Carien L Creutzberg Tags: Perspectives Source Type: research
[Perspectives] Treatment toxicity in endometrial cancer: can we identify and manage it better?
We thank Dr Melanie Powell and Dr Remi Nout for taking the time to share their expertise on high-risk endometrial cancer during the March 17 –18 #radonc journal club on Twitter. During our conversation, we discussed the results of the PORTEC-3 trial, which confirms the findings of other randomised trials: a reduced risk of relapse by adding chemotherapy to radiotherapy, without improving overall survival. The risk of distant relapse wa s not significantly lower with chemotherapy, suggesting that a clear survival benefit might not be observed with a longer follow-up. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Matthew S Katz, Lesley Smith, Richard Simcock Tags: Perspectives Source Type: research
[Perspectives] Next generation of cancer survivors —a GP perspective
I first met Sarah 5 years ago in one of my Monday morning surgeries. She was 41 years old and, other than attending for the odd minor illness, we hadn't seen much of her over the past few years. She told me she had started experiencing increasing shortness of breath when exercising. She had a body-mass index of 22, had never smoked, exercised 3 –4 times per week, and had no family history of heart or lung disease. There was nothing abnormal that I could find on examination, and a comprehensive set of blood test results were also normal. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Sinead Clarke Tags: Perspectives Source Type: research
[Perspectives] Does global oncology need artificial intelligence?
Discussing the use of artificial intelligence (AI) for cancer care in low- and middle-income countries (LMICs) might seem like a paradox, but new technologies have sometimes reached LMICs faster than cancer drugs on the WHO Essential Medicines List. One example of AI already starting to take hold in cancer care in some LMICs is Watson for Oncology, developed by IBM in partnership with the Memorial Sloan Kettering Cancer Center (MSKCC, New York, NY, USA). Watson for Oncology is a cognitive computing system developed to provide treatment recommendations based on training it receives from published medical literature, publicl...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Bishal Gyawali Tags: Perspectives Source Type: research
[Corrections] Correction to Lancet Oncol 2018; 19: 705 –14
Laetsch TW, DuBois SG, Mascarenhas L, et al. Larotrectinib for paediatric solid tumours harbouring NTRK gene fusions: phase 1 results from a multicentre, open-label, phase 1/2 study. Lancet Oncol 2018; 19: 705 –14—In the Summary, the following statement should have read as follows: “cohort 3 was assigned to receive a dose of 100 mg/m2 twice daily (maximum 100 mg per dose), regardless of age, equating to a maximum of 173% of the recommended adult phase 2 dose.” This correction has been made to the online version as of April 25, 2018, and the printed version is correct. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research
[Corrections] Correction to Lancet Oncol 2018; 19: 580 –81
Grob JJ. Is there any interest in a new BRAF –MEK inhibitor combination in melanoma? Lancet Oncol 2018; 19: 580–81—In the title of this Comment, “BRAF-MEK inhibitor” was spelt incorrectly, and in the fourth paragraph one instance of the drug “encorafenib” was spelt incorrectly and the dose of encorafenib should have been “300 m g”. These corrections have been made to the online version as of April 25, 2018, and the printed Comment is correct. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Tags: Corrections Source Type: research
[Correspondence] Body-mass index and metastatic melanoma outcomes – Authors' reply
As noted by Wen and colleagues, both the patterns of melanoma and the relationship between body-mass index (BMI) and adiposity vary by race and ethnicity. The incidence of melanoma also varies greatly by geographic region. Melanoma incidence and mortality rates are about 20 –30 times higher in countries with a predominantly white population than in Asian countries.1 In the US, non-Hispanic white people account for more than 95% of cutaneous melanoma cases.2 This disparity is driven by the protective effect of darker skin against UV damage, which is the primary risk f actor for non-acral cutaneous melanoma (the most commo...
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Jennifer L McQuade, Carrie R Daniel, Michael A Davies Tags: Correspondence Source Type: research
[Correspondence] Body-mass index and metastatic melanoma outcomes
Although the apparent obesity paradox reported by McQuade and colleagues1 is attractive and has potential clinical implications, there are several issues that cast doubt on its validity. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hermann Nabi, Jason R Guertin, Denis Talbot, Caroline Diorio Tags: Correspondence Source Type: research
[Correspondence] Body-mass index and metastatic melanoma outcomes
Jennifer McQuade and colleagues1 reported that “obesity is associated with improved progression-free survival and overall survival compared with those outcomes in patients with normal BMI”. Set against the strengths of secondary analyses of trials, this study is undoubtedly an important contribution. They concluded that their “findings sup port the presence of an obesity paradox across the spectrum of melanoma development, progression, and treatment response”, while the supporting Comment2 interprets this relationship as meaning that high BMI has a protective and beneficial effect. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hannah Lennon, Ellena Badrick, Matthew Sperrin, Andrew G Renehan Tags: Correspondence Source Type: research
[Correspondence] Body-mass index and metastatic melanoma outcomes
We read with great interest the study conducted by Jennifer McQuade and colleagues1 reporting obesity (BMI>30 kg/m2) is associated with improved progression-free survival and overall survival in male patients with metastatic melanoma treated with targeted and immune therapies, and that this effect was not observed in women.1 However, we would query if features of body composition could better explain this observation than BMI. Although BMI is a simple, easy and readily available measure in clinical practice, it is flawed by its inability to differentiate between muscle and adipose tissue. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Louise E Daly, Aoife M Ryan, Derek G Power Tags: Correspondence Source Type: research
[Correspondence] Body-mass index and metastatic melanoma outcomes
McQuade and colleagues1 reported a significant association between high body-mass index (BMI) and outcomes in patients with metastatic melanoma treated with targeted therapy, immunotherapy, or chemotherapy in male patients. The findings remained statistically significant after being adjusted for multiple factors that could confound the interpretation. The observation was in strong contrast with current knowledge of the biology of melanoma and, as the authors described, warranted insightful investigation for explanation. (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 26, 2018 Category: Cancer & Oncology Authors: Hui Wen, Ting Guo, Chenchen Feng Tags: Correspondence Source Type: research
