Durability of response to immune checkpoint inhibitors in metastatic Merkel cell carcinoma after treatment cessation.

Background: Metastatic Merkel cell carcinoma (mMCC) is highly responsive to immune checkpoint inhibitors (ICIs); however, durability of response after treatment cessation and response to retreatment in the setting of progression is unknown.

Methods: Patients (pts) having mMCC from 10 centres who discontinued ICI treatment for a reason other than progression were studied.

Results: Forty patients were included.

Successful immune checkpoint inhibitor rechallenge after immune-related pericarditis: Clinical case series.

Pericardial diseases secondary to immune checkpoint inhibitors (ICI) are rare. Here, we describe two cases of immune-related pericarditis caused by ICI for treatment of advanced NSCLC. Select patients can be successfully rechallenged with ICI after immune-related pericardial disease.

Strongyloides-An uncommon cause of eosinophilia whilst on durvalumab.

Background: In malignancy, eosinophils have been shown to play an important role in the tumour micro-environment. Increasingly, development of eosinophilia with immune checkpoint inhibitor (ICI) use is thought to be predictive of prognosis and development of immune-related adverse events. However, there are many other causes for developing eosinophilia which can contribute to the difficulties in diagnosis and management.

Heart Failure in Breast Cancer Survivors: Focus on Early Detection and Novel Biomarkers.

Purpose Of Review: Breast cancer survival rate has greatly improved in the last two decades due to the emergence of next-generation anti-cancer agents. However, cardiotoxicity remains a significant adverse effect arising from traditional and emerging chemotherapies as well as targeted therapies for breast cancer patients. In this review, we will discuss cardiotoxicities of both traditional and emerging therapies for breast cancer.

Business as unusual: medical oncology services adapt and deliver during COVID-19.

Background: The COVID-19 pandemic has challenged cancer care globally, introducing resource limitations and competing risks into clinical practice.

Aims: To describe the COVID-19 impact on medical oncology care provision in an Australian setting.

Methods: Calvary Mater Newcastle and Newcastle Private Hospital medical oncology data from 1 February to 31 April 2019 versus 2020 were retrospectively analysed.

Factors Associated with Adverse Cardiovascular Events in Cancer Patients Treated with Bevacizumab.

Bevacizumab, a vascular endothelial growth factor (VEGF) monoclonal antibody commonly used for the treatment of various cancers, is often associated with adverse cardiovascular effects such as hypertension, cardiac and cerebral ischemia, thrombosis, and bleeding events. Factors associated with increased risks of adverse cardiovascular effects with bevacizumab have not been intensively studied. In this study, we determined factors associated with hospital admissions due to cardiovascular complications in patients who received bevacizumab for cancer treatment.

A retrospective analysis of nadir-neutropenia directed pegylated granulocyte-colony stimulating factor on febrile neutropenia rates in (neo)adjuvant breast cancer chemotherapy regimens.

Background: Pegfilgrastim, a pegylated granulocyte colony-stimulating-factor (GCSF), reduces chemotherapy morbidity and mortality in early stage breast cancer. The optimal approach to individual patient selection for GCSF is unknown, in particular whether secondary GCSF should be given after asymptomatic neutropenia, or only after febrile neutropenia (FN).

Aims: To determine if preplanned nadir blood counts and subsequent nadir-neutropenia directed GCSF was effective to reduce rates of FN associated with (neo)adjuvant breast cancer chemotherapy.

Retrospective Evaluation of the Use of Pembrolizumab in Malignant Mesothelioma in a Real-World Australian Population.

Introduction: We investigated the efficacy and toxicity of pembrolizumab in patients with mesothelioma from a real-world Australian population. We aimed to determine clinical factors and predictive biomarkers that could help select patients who are likely to benefit from pembrolizumab.

Method: Patients with mesothelioma who were treated with pembrolizumab as part of the Insurance and Care New South Wales compensation scheme were included.

Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI).

Background: Currently, there is no single validated biomarker which can prognosticate survival in patients with stage IV non-small cell lung cancer (NSCLC). This study examines the prognostic significance of four biomarkers: neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI) in patients with stage IV NSCLC.

Methods: This study aimed to establish the relationship between NLR, LMR, PLR, ALI and overall survival (OS) at baseline and post first cycle of treatment using Cox univariate PH models.

Hypercalcaemia due to Sarcoidosis during Treatment with Avelumab for Metastatic Merkel Cell Carcinoma.

Merkel cell carcinoma is a rare but aggressive skin cancer. Response to chemotherapy is not durable but avelumab, an anti-PD-L1 inhibitor, showed promising ongoing response in a phase II trial. Checkpoint inhibitors including avelumab are known to cause overactivation of the immune system, leading to immune-related adverse events (irAE).

Patterns of care for stage III non-small cell lung cancer in Australia.

Stage III non-small cell lung cancer (NSCLC) makes up a third of all NSCLC cases and is potentially curable. Despite this 5-year survival rates remain between 15% and 20% with chemoradiation treatment alone given with curative intent. With the recent exciting breakthroughs in immunotherapy use (durvalumab) for stage III NSCLC, further improvements in patient survival can be expected.

Metastatic Eccrine Porocarcinoma: A Rare Case of Successful Treatment.

The successful treatment of the rare malignancy eccrine porocarcinoma (EP) is extremely challenging, often not rewarding and when associated with metastatic disease, therapy results are disappointing. We present a unique case of treatment response of metastatic EP, with a significant disease-free interval. The patient has remained in clinical and radiological remission for 36 months since diagnosis of metastatic disease.

Reporting time-to-event endpoints and response rates in 4 decades of randomized controlled trials in advanced colorectal cancer.

Background: Reporting of randomized controlled clinical trials (RCTs) often is suboptimal. Cancer drug trials are complicated further by multiple survival and response endpoints. The authors of this report determined the frequency of reporting of time-to-event endpoints and tumor response outcomes in advanced colorectal cancer and examined the relation between the year of publication and the reported effectiveness of 5-fluorouracil or equivalent agents.

Breast cancer in men: should aromatase inhibitors become first-line hormonal treatment?

Breast cancer is an uncommon malignancy in men; therefore, the approach to treatment is mostly modeled on that used in females. First-line use of aromatase inhibitors (AIs) is now standard practice in hormone-sensitive metastatic breast cancer in postmenopausal females. However, tamoxifen continues to be regarded as first-line treatment in hormone-sensitive male breast cancer.

Advances in the adjuvant treatment of colorectal cancer.

Background: There have been numerous advances in the adjuvant therapy of colon cancer in the last two decades.

Methods: This review outlines the historical perspectives of adjuvant treatment as well as current and emerging standards of care.

Results: Although previous regimens included a variety of equivalent schedules of 5-fluorouracil and folinic acid, integration of newer drugs such as oxaliplatin are offering significant improvements in disease-free survival.