Phase 1b/2 study of orally administered pexidartinib in combination with radiation therapy and temozolomide in patients with newly diagnosed glioblastoma.

Background: Glioblastoma (GBM) has a median survival of <2 years. Pexidartinib (PLX3397) is a small-molecule inhibitor of CSF1R, KIT, and oncogenic FTL3, which are implicated in GBM treatment resistance. Results from glioma models indicate that combining radiation therapy (RT) and pexidartinib reduces radiation resistance.

Incidence and Outcomes of Revision Bronchoscopies Following Bronchoscopic Lung Volume Reduction (BLVR).

Background: Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure used to reduce shortness of breath and improve functionality in some patients with emphysema. While BLVR is often effective for improving dyspnea by causing target lobe atelectasis, the treatment effect can sometimes be lost. This study reviews the incidence of revision bronchoscopies in patients who lost or never achieved target lobe atelectasis following BLVR.

Proton Versus CyberKnife Therapy Planning for Hypofractionated Treatment of Prostate With Focal Boost.

Purpose: To compare intensity-modulated proton therapy with CyberKnife (CK) therapy for hypo-fractionated treatments of prostate with focal boost, as a first planning study for prostate with dose escalation to a dominant intraprostatic lesion (DIL).

Materials And Methods: Ten patients who possess one DIL in their prostate and their CK plans that were used to treat the planning target volume of prostate were chosen. Six of the plans were further escalated to DIL.

Melanoma Tumor Mutational Burden and Indoor Tanning Exposure.

Importance: UV-induced mutagenesis leads to a higher tumor mutational burden (TMB) in cutaneous melanoma relative to other cancer types. TMB is an important prognostic marker in advanced melanoma; higher TMB is associated with greater clinical response to immune checkpoint inhibition and improved survival.

Objective: To evaluate the association between cutaneous melanoma TMB and indoor tanning exposure, as well as other demographic, dermatologic, and tumor characteristics.

Echocardiography Findings for Pulmonary Hypertension During Workup for Bronchoscopic Lung Volume Reduction.

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive intervention that improves dyspnea and quality of life in select individuals with emphysema. Echocardiography is the initial screening tool for pulmonary hypertension (PH) in patients evaluated for BLVR. Multiple BLVR and lung volume reduction surgery (LVRS) trials have used and right ventricular systolic pressure (RVSP) of 45 mm Hg as a cutoff for potential significant PH.

Improving plan quality in cervical cancer brachytherapy using knowledge-based planning for direction modulated brachytherapy tandem applicator.

Purpose: The bladder and rectal toxicities in cervical cancer brachytherapy are positively correlated with the DVH parameter: D2cc. This study evaluates the feasibility of knowledge-based planning to predict the D2cc, identify suboptimal plans, and improve the plan quality with Direction Modulated Brachytherapy (DMBT) applicators using knowledge-based planning based on linear relationship between overlap distances and D2cc.

Methods: The overlap volume histogram (OVH) method was used to determine the distances for 2 cm of overlap between the Organs at Risks (OAR) and High-Risk Clinical Target Volume (CTV).

Attention 3D UNET for dose distribution prediction of high-dose-rate brachytherapy of cervical cancer: Intracavitary applicators.

Background: Formulating a clinically acceptable plan within the time-constrained clinical setting of brachytherapy poses challenges to clinicians. Deep learning based dose prediction methods have shown favorable solutions for enhancing efficiency, but development has primarily been on external beam radiation therapy. Thus, there is a need for translation to brachytherapy.

Listening "At the Bedside": Podcasts as an Emerging Tool for Medical Ethics Education.

Medical ethics education is crucial for medical students and trainees, helping to shape attitudes, beliefs, values, and professional identities. Exploration of ethical dilemmas and approaches to resolving them provides a broader understanding of the social and cultural contexts in which medicine is practiced, as well as the ethical implications of medical decisions, fostering critical thinking and self-reflection skills imperative to providing patient-centered care. However, exposure to medical ethics topics and their clinical applications can be limited by curricular constraints and the availability of institutional resources and expertise.

Systematic characterization of new EBT4 radiochromic films in clinical x-ray beams.

. We aim to characterize kinetics of radiation-induced optical density in newly released EBT4 radiochromic films exposed to clinical x-rays. Several film models and batches were evaluated for the film sensitivity, optical signal increasing with time, relative film noise, and minimum detectable limits (MDL).

Onvansertib in Combination With Chemotherapy and Bevacizumab in Second-Line Treatment of -Mutant Metastatic Colorectal Cancer: A Single-Arm, Phase II Trial.

Purpose: This phase II study evaluated the efficacy and tolerability of onvansertib, a polo-like kinase 1 (PLK1) inhibitor, in combination with fluorouracil, leucovorin, and irinotecan (FOLFIRI) + bevacizumab for the second-line treatment of -mutant metastatic colorectal cancer (mCRC).

Patients And Methods: This multicenter, open-label, single-arm study enrolled patients with -mutated mCRC previously treated with oxaliplatin and fluorouracil with or without bevacizumab. Patients received onvansertib (15 mg/m once daily on days 1-5 and 15-19 of a 28-day cycle) and FOLFIRI + bevacizumab (days 1 and 15).

Upper tract urothelial cancer (UTUC) genomic profiling and correlation regarding benefit of platinum-based chemotherapy.

Upper tract urothelial cancer (UTUC) are rare subsets of urothelial cancer, which typically present with more aggressive course. Molecular markers stratifying urothelial tumors as luminal subtype and non-luminal subtype tumors have been proposed to select patients who may have greater or lesser benefit from neoadjuvant systemic therapy in bladder cancer, though not yet evaluated in UTUC. Here, a single-institution study retrospectively obtained clinical and genomic information in patients with UTUC and evaluated four patient tumors using the Decipher Bladder assay and Foundation Medicine test.

The Rapidly Evolving Treatment Landscape of Metastatic Hormone-Sensitive Prostate Cancer.

The management of metastatic hormone-sensitive prostate cancer (mHSPC) or castration-sensitive prostate cancer (mCSPC) has become increasingly complex with the tremendous progress that has been made in this space within the past few decades. In the early days of androgen deprivation therapy (ADT), ADT monotherapy was the mainstay for treatment of advanced prostate cancer. However, novel hormone therapies in the form of androgen receptor pathway inhibitors (ARPI) have emerged; vaccine therapy, chemotherapy with docetaxel and cabazitaxel, and radioactive ligands have shaped the treatment of metastatic prostate cancer in the last decade.

Breast cancer and cardiovascular health.

Modern cancer therapies greatly improve clinical outcomes for both early and advanced breast cancer patients. However, these advances have raised concerns about potential short- and long-term toxicities, including cardiovascular toxicities. Therefore, understanding the common risk factors and underlying pathophysiological mechanisms contributing to cardiovascular toxicity is essential to ensure best breast cancer outcomes.

Real-world treatment patterns and outcomes of patients with advanced melanoma treated with nivolumab plus relatlimab.

The use of programmed death-1 (PD-1) inhibitors has been a pivotal advancement in treating advanced melanoma, yet their efficacy is limited. The approval of relatlimab (RELA), a lymphocyte activation gene 3 protein (LAG-3) antibody, in combination with nivolumab (NIVO), a PD-1 inhibitor, marked a significant stride toward enhancing treatment efficacy for metastatic and unresectable stage 3 and 4 melanoma. This combination has been shown to synergistically improve antitumor activity and effector T-cell activity in the tumor microenvironment, despite limited data on real-world outcomes.

The rapidly changing treatment landscape of first-line advanced urothelial cancer (aUC) or metastatic urothelial cancer (mUC).

The landscape of treatment for first-line therapy in advanced urothelial cancer (aUC) and metastatic urothelial cancer (mUC) has rapidly changed in the last year alone. Maintenance avelumab remains a viable treatment option for many patients across the globe for those who have responded or have achieved stable disease after platinum-based chemotherapy. However, the recent FDA approvals based on EV-302 for enfortumab vedotin (EV) and pembrolizumab, as well as CheckMate-904 with gemcitabine and cisplatin with nivolumab (GC+N) followed by maintenance nivolumab have left clinicians with the complicated decision of determining which regimen is most appropriate for their individual patients with untreated aUC.

Proteomics based selection achieves complete response to HER2 therapy in HER2 IHC 0 breast cancer.

Recent trials have shown the efficacy of trastuzumab deruxtecan (T-DXd) in HER2-negative patients, but there is not yet a way to identify which patients will best respond, especially with the inability of current HER2 IHC and FISH assays to accurately determine HER2 expression in the unamplified setting. Here, we present a heavily pre-treated patient with triple-negative breast cancer (HER2 IHC 0 who had a complete response to T-DXd. In this case, we used a CLIA-certified reverse-phase protein array-based proteomic assay (RPPA) to determine that the patient had moderate HER2 protein expression (HER2 2+, 42%) and activation (HER2 1+, 23%).