Publications by authors named "Stephen Opat"

Background: The COVID-19 pandemic has significantly impacted people with cancer. Initial vaccine studies excluded patients with malignancy. Immunocompromised individuals remain vulnerable to SARS-CoV-2, necessitating detailed understanding of vaccine response.

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JCO SEQUOIA (ClinicalTrials.gov identifier: NCT03336333) is a phase III, randomized, open-label trial that compared the oral Bruton tyrosine kinase inhibitor zanubrutinib to bendamustine plus rituximab (BR) in treatment-naïve patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The initial prespecified analysis (median follow-up, 26.

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Peripheral neuropathy (PN) is a significant cause of morbidity associated with Waldenström macroglobulinemia (WM). The phase 3 ASPEN study compared the efficacy and safety of zanubrutinib with ibrutinib in patients with WM. This ad hoc analysis examined treatment outcomes with zanubrutinib or ibrutinib on PN symptoms associated with WM in patients enrolled in ASPEN.

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  • Researchers examined treatment options for primary CNS lymphoma in adult patients, focusing on five chemotherapy regimens that include high-dose methotrexate (HD-MTX).
  • Out of 204 patients in the study, a significant majority (93%) received various combinations of HD-MTX and other drugs, with the MPV/Ara-C regimen showing the best results in progression-free and overall survival rates.
  • The study concluded that using tailored treatment strategies can boost recovery rates, especially for older patients not suited for more aggressive therapies.
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Background: Listening to patient voices is critical, in terms of how people experience their condition as well as their treatment preferences. This research explored the patient journey, therapy attributes and goals among treatment experienced adults with chronic lymphocytic leukemia (CLL). We sought to understand patient experiences, needs and expectations to identify areas for improvement of treatment and care delivery.

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Population-based studies have demonstrated a high risk of second cancers, especially of the skin, among patients with chronic lymphocytic leukaemia (CLL). We describe age-standardised incidence ratios (SIRs) of second primary malignancies (SPM) in Australian patients with relapsed/refractory CLL treated with at least two lines of therapy, including ibrutinib. From December 2014 to November 2017, 156 patients were identified from 13 sites enrolled in the Australasian Lymphoma and Related Diseases Registry, and 111 had follow-up data on rates of SPM.

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Marginal zone lymphomas (MZLs) are a rare, indolent group of non-Hodgkin lymphomas with different diagnostic, genetic and clinical features and therapeutic implications. The most common is extranodal MZL of mucosa-associated lymphoid tissue, followed by splenic MZL and nodal MZL. Patients with MZL generally have good outcomes with long survival rates but frequently have a relapsing/remitting course requiring several lines of therapy.

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  • Liquid biopsy is an innovative method that analyzes cell-free DNA to offer insights into diffuse large B-cell lymphoma (DLBCL), a type of cancer.
  • The study by Alcoceba et al. evaluates how effective the EuroClonality-NDC assay is for profiling DLBCL and its potential for practical use.
  • Achieving a major molecular response through this method has important implications for predicting patient outcomes and assessing treatment effectiveness.
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Polatuzumab vedotin (Pola) is an approved therapy in combination with rituximab and bendamustine for relapsed or refractory diffuse large B-cell lymphoma (RR-DLBCL) based on positive results of the landmark phase II randomised G029365 trial. However, trial results for many approved novel therapies in RR-DLBCL have not been replicated in routine care cohorts, as RR-DLBCL patient populations are heterogeneous and trial eligibility is increasingly restrictive. We evaluated outcomes from pola ± bendamustine and rituximab in patients with RR-DLBCL enrolled in a compassionate access program with no alternative treatment options identified via the Australasian Lymphoma and Related Diseases Registry according to their eligibility for the original phase II published study.

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  • The study examined how the GELF criteria, developed for treating follicular lymphoma (FL), are used in clinical decision-making during the rituximab era.
  • Over half of the patients (54%) had at least one GELF criterion at diagnosis, but these criteria did not predict treatment effectiveness or progression-free survival.
  • The findings suggest many clinicians may rely on additional factors beyond GELF criteria to decide on treatment, meaning existing trial data might not represent all patients commonly treated for FL.
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  • Bruton's tyrosine kinase inhibitors (BTKi) are effective in treating patients with relapsed/refractory mantle cell lymphoma (MCL), but there's limited data on those who can't participate in clinical trials.
  • In a study of 44 MCL patients treated with ibrutinib, 41% were ineligible for prior trials due to various reasons, particularly concerning their health status.
  • The findings show that while the median progression-free survival was 13.7 months and overall survival was 15.6 months, those excluded from trials had worse outcomes, indicating a need for broader eligibility criteria in future studies.
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  • The phase 3 ASPEN trial compared the effectiveness of two BTK inhibitors, zanubrutinib and ibrutinib, in treating Waldenström macroglobulinemia, analyzing genetic mutations' impact on treatment response.
  • The study found that patients with mutations in CXCR4 and TP53 had poorer responses and survival rates but those treated with zanubrutinib generally showed better outcomes than those given ibrutinib.
  • Overall, the research indicated that zanubrutinib offers improved clinical outcomes for patients with specific mutations compared to ibrutinib, highlighting the importance of genetic testing in treatment decision-making.
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  • - Despite being at higher risk for severe COVID-19, many individuals with haematological malignancies showed hesitancy towards vaccination, highlighting a need for improved education.
  • - A survey of 869 participants revealed that while 85.3% were vaccinated, younger individuals and those speaking English as a non-dominant language had lower vaccination rates and greater concerns about vaccine side effects.
  • - The study concluded that while vaccination uptake was high, tailored educational efforts could help address specific concerns among groups facing hesitancy, especially in light of the need for boosters.
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  • Anemia in patients with myelodysplastic syndromes (MDS) negatively impacts their quality of life, and the study aims to assess if weekly low-dose red blood cell (RBC) transfusions could stabilize hemoglobin levels and improve health-related quality of life (HRQoL) compared to the standard transfusion schedule.
  • This n-of-1 pilot study involves two treatment arms where patients receive either their usual transfusion schedule or a personalized weekly transfusion, with the effectiveness measured through feasibility, HRQoL, physical function, and RBC usage.
  • The trial is ongoing in multiple countries, highlighting differences in RBC provision practices and aiming to gather insights that will shape a larger study on the potential benefits of personalized transfusion
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  • In Australia, over 50% of patients with relapsed or refractory chronic lymphocytic leukaemia on ibrutinib also take proton pump inhibitors (PPIs).
  • High gastric pH caused by PPIs can lower the effectiveness of some Bruton tyrosine kinase inhibitors, including ibrutinib.
  • The study found no significant impact of PPI use on how long patients remain on ibrutinib treatment (P = 0.61), indicating that PPIs do not affect treatment persistence.
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Background: Epidemiologic evidence suggests an inverse association between sun exposure and follicular lymphoma risk.

Methods: We conducted an Australian population-based family case-control study based on 666 cases and 459 controls (288 related, 171 unrelated). Participants completed a lifetime residence and work calendar and recalled outdoor hours on weekdays, weekends, and holidays in the warmer and cooler months at ages 10, 20, 30, and 40 years, and clothing types worn in the warmer months.

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Follicular lymphoma (FL) is the most common type of indolent non-Hodgkin lymphoma. Despite treatment advances that have improved outcomes for patients with relapsed or refractory (R/R) FL, many patients still die from progressive disease or treatment-related toxicities. In the phase Ib/II GO29365 study (clinicaltrials.

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  • - Chronic lymphocytic leukaemia (CLL) is the most common blood cancer in Australia and New Zealand, with significant advancements in diagnosis and treatment in the past decade.
  • - New technologies like next-generation sequencing and flow cytometry help doctors predict outcomes and monitor treatment responses more effectively, while new therapies have improved care for patients, especially those with high-risk genetic issues.
  • - Given the unique healthcare landscape in Australasia, experts have created a consensus practice statement to provide standardized guidelines for CLL diagnosis and management, keeping in mind public health concerns like the COVID-19 pandemic.
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Objectives: We aimed to examine the relationship between occupational exposure to extremely low-frequency magnetic fields (ELF-MFs) and follicular lymphoma (FL) risk.

Methods: We conducted a family case-control study between 2011 and 2016 in Australia and included 681 cases. Controls were either a family member of cases (related (n=294), unrelated (n=179)) or were unrelated recruited for a similarly designed Australian multiple myeloma study (n=711).

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Background: We previously reported results of a pooled analysis of two zanubrutinib studies in relapsed or refractory (R/R) MCL showing better survival outcomes when zanubrutinib is used in second-line versus later-line. Here, we present an updated pooled analysis with a longer follow-up of 35.2 months.

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  • BTK inhibitors, particularly ibrutinib, have revolutionized treatment for B-cell malignancies, offering better efficacy and safety than traditional chemotherapy.
  • The development of zanubrutinib, a next-generation BTK inhibitor, aimed to enhance specificity and pharmacokinetics, leading to improved patient outcomes.
  • Zanubrutinib shows promising results in clinical trials for various B-cell cancers and emphasizes the need for collaborative research to improve treatment options alongside patient care.
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Synopsis of recent research by authors named "Stephen Opat"

  • - Stephen Opat's recent research focuses on the treatment outcomes of patients with various types of lymphomas, particularly primary central nervous system lymphoma and chronic lymphocytic leukemia, assessing real-world treatment efficacy and patient experiences.
  • - Key findings highlight the need for optimal treatment regimens outside clinical trials, the prevalence of second primary malignancies in chronic lymphocytic leukemia patients, and patterns of survival among those treated with new therapies such as ibrutinib.
  • - Opat's studies advocate for enhanced understanding of patient preferences and individualized treatment approaches to improve healthcare delivery and outcomes in lymphoma care within Australia.