312 results match your criteria: "The Royal Marsden Hospital NHS Foundation Trust.[Affiliation]"

Histone mutations (H3 K27M, H3 G34R/V) are molecular features defining subtypes of paediatric-type diffuse high-grade gliomas (HGG) (diffuse midline glioma (DMG), H3 K27-altered, diffuse hemispheric glioma (DHG), H3 G34-mutant). The WHO classification recognises in exceptional cases, these mutations co-occur. We report one such case of a 2-year-old female presenting with neurological symptoms; MRI imaging identified a brainstem lesion which was biopsied.

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Introduction: SCLC is characterized by aggressiveness and limited treatment options, especially in extensive-stage SCLC (ES-SCLC). Immunotherapy added to the platinum-etoposide combination has recently become standard in this setting. This retrospective study aims to evaluate the real-world effectiveness of chemo-immunotherapy in patients with ES-SCLC, focusing on subpopulations excluded from clinical trials.

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Introduction: Cancer complicates approximately 1 in 2000 pregnancies, with increasing incidence due to factors such as increased maternal age, obesity and advancements in antenatal testing. Anaesthetists play a crucial role in managing pregnant patients with cancer, both during delivery and in providing anaesthesia for oncological treatments. This review explores the challenges in anaesthetic management and specific considerations for common cancers encountered in pregnant patients.

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Efforts to deconvolve the complex interactions of cancer cells with other components of the tumor micro- and macro-environment have exposed a common tendency for cancers to subvert systems physiology and exploit endogenous programs involved in homeostatic control of metabolism, immunity, regeneration, and repair. Many such programs are engaged in the healing response to surgery which, together with other abrupt biochemical changes in the perioperative period, provide an opportunity for the macroevolution of residual disease. This review relates contemporary perspectives of cancer as a systemic disease with the overlapping biology of host responses to surgery and events within the perioperative period.

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Transformative or transitional? Deciphering the role of NIAGARA in shaping future practice.

Med

December 2024

Genitourinary Oncology, The Royal Marsden Hospital NHS Foundation Trust, Sutton, London, UK; The Institute of Cancer Research, London, UK.

The phase 3 NIAGARA trial demonstrated a statistically significant improvement in event-free and overall survival in cisplatin-eligible patients with muscle-invasive bladder cancer treated with perioperative durvalumab in combination with neoadjuvant chemotherapy, compared to neoadjuvant chemotherapy alone. The combination was manageable and did not adversely impact surgery. NIAGARA positions perioperative durvalumab with chemotherapy as a potential new standard of care.

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Background: Over 200,000 patients are referred onto the suspected head and neck cancer (HNC) pathway annually in the UK, with around 3% receiving a cancer diagnosis. With new HNC advancements in identifying patients at low risk of a cancer diagnosis, one proposal is a speech and language therapy (SLT)-led first point of contact clinic for low-risk patients presenting with voice or swallowing symptoms.

Aims: To explore ear, nose and throat (ENT) surgeons' views regarding this model.

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Article Synopsis
  • Nivolumab (NIVO) combined with ipilimumab (IPI) shows better long-term overall survival (OS) in patients with unresectable/metastatic melanoma than NIVO alone, based on pooled data from major trials.
  • Patients treated with the combination therapy had a median follow-up OS of 45.0 months, with 6-year survival rates at 52%, compared to 41% for NIVO monotherapy after a median follow-up of 35.8 months.
  • Clinical factors affecting survival include elevated lactate dehydrogenase (LDH) levels, age over 65 with the combination therapy, and presence of liver metastases with NIVO alone.
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This comment discusses the use of PD-L1 as a biomarker to guide treatment decisions for metastatic melanoma.

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Article Synopsis
  • The tumor microenvironment (TME) is crucial for tumor growth and affects responses to treatments like chemotherapy, which has been less studied than its influence on immunotherapy.
  • The researchers created DECODEM, a computational tool that analyzes gene expression from various cell types in the TME to predict patients' responses to neoadjuvant chemotherapy in breast cancer.
  • Their results show that gene expression from specific immune and stromal cells is better at predicting treatment outcomes than that from cancer cells alone, emphasizing the need for immune presence before treatment to improve chemotherapy effectiveness.
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Article Synopsis
  • - Asciminib is a targeted treatment for BCR::ABL1 that minimizes side effects from disrupting other kinases, with a study of 49 patients showing it is generally well tolerated over a median follow-up of 14 months.
  • - Most patients (59%) continued treatment, with only 12% stopping due to intolerance; however, treatment cessation was primarily due to intolerance rather than drug resistance (65% vs. 35%).
  • - Out of 44 patients evaluated, 66% achieved a complete cytogenetic response, with lower success rates seen in patients with specific genetic variants; further analysis indicated that the drug can influence the growth of certain resistant cancer cell populations.
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Isolated limb perfusion (ILP) is a regional chemotherapy technique used in the treatment of locally advanced or unresectable extremity soft tissue sarcoma (ESTS) or malignant melanoma (MM) of the limbs. It allows for high concentrations of chemotherapeutic agents to be perfused in the limb while minimising the risk of systemic side-effects. While the technique has been utilized for decades, the role of ILP has evolved as other treatment strategies have become available.

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Elacestrant in ESR1-mutant, endocrine-responsive metastatic breast cancer: should health authorities consider post hoc data to inform priority access?

ESMO Open

September 2024

Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. Electronic address:

Article Synopsis
  • Elacestrant, an oral selective estrogen receptor degrader (SERD), has been shown to be superior to standard therapies for patients with ESR1-mutant tumors, based on the EMERALD trial results, and is now included in clinical guidelines.
  • Access to elacestrant in Europe is subject to local health authority decisions, but it offers a significant benefit to certain patients by avoiding more aggressive treatments and improving their quality of life.
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Immunotherapy has revolutionised cancer treatment over the past decade. Long-term durable responses can be achieved in some cancer patient populations that were previously facing terminal disease. In this chapter, we summarise current phase 3 clinical trial evidence for the use of immunotherapy in gastrointestinal cancers (oesophageal squamous cell carcinoma, oesophago-gastric adenocarcinoma, pancreatic cancer, biliary cancer, hepatocellular carcinoma, colorectal cancer, and squamous cell cancer of the anus).

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Background: KEYNOTE-199 (NCT02787005) is a multicohort phase 2 study evaluating pembrolizumab in patients with metastatic castration-resistant prostate cancer (mCRPC). Results from cohorts 4 (C4) and 5 (C5) are presented.

Methods: Eligible patients had not received chemotherapy for mCRPC and had responded to enzalutamide prior to developing resistance as defined by Prostate Cancer Clinical Trials Working Group 3 guidelines.

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Article Synopsis
  • Measuring overall survival (OS) is the best way to see how well new treatments for multiple myeloma work in big studies, but it's getting harder to use OS since treatments are improving and they want to approve new medicines faster.
  • Other measures like progression-free survival (PFS) and response to treatment are being used to help decide if a treatment is good enough for approval, and the FDA even thinks minimal residual disease (MRD) can be used for quick approval.
  • This review talks about how PFS can sometimes be tricky to understand for different groups of patients, and it looks at how to design studies that take these differences into account so doctors can find the right treatments for the right people.
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Pre-operative chemoradiotherapy followed by mastectomy and breast reconstruction-A systematic review of clinical, oncological, reconstructive and aesthetic outcomes.

J Plast Reconstr Aesthet Surg

September 2024

Imperial College Healthcare NHS Trust, Department of Breast Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, United Kingdom; Department of Surgery and Cancer, Imperial College London, United Kingdom.

Background: Pre-operative radiotherapy (PRT) and pre-operative chemoradiotherapy (PCRT) prior to mastectomy and immediate breast reconstruction for locally advanced breast cancer have the potential to reduce radiation late-effects and expedite oncologic treatment. Recent feasibility work indicates that PCRT is safe and technically possible. Here, we present a systematic review of currently available data on clinical, oncological, reconstructive and aesthetic outcomes.

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The purpose of this study was to determine if dual-energy CT (DECT) vital iodine tumor burden (ViTB), a direct assessment of tumor vascularity, allows reliable response assessment in patients with GIST compared to established CT criteria such as RECIST1.1 and modified Choi (mChoi). From 03/2014 to 12/2019, 138 patients (64 years [32-94 years]) with biopsy proven GIST were entered in this prospective, multi-center trial.

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Background: Robotic assisted surgery (RAS) has seen significant advancement in many surgical specialties, although the application of robotics in plastic and reconstructive surgery remains to be widely established. This systematic review aims to assess the role of RAS in plastic and reconstructive surgery.

Methods: The review protocol was published and registered a priori as CRD42024507420.

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Advances in artificial intelligence have paved the way for leveraging hematoxylin and eosin-stained tumor slides for precision oncology. We present ENLIGHT-DeepPT, an indirect two-step approach consisting of (1) DeepPT, a deep-learning framework that predicts genome-wide tumor mRNA expression from slides, and (2) ENLIGHT, which predicts response to targeted and immune therapies from the inferred expression values. We show that DeepPT successfully predicts transcriptomics in all 16 The Cancer Genome Atlas cohorts tested and generalizes well to two independent datasets.

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Purpose: The absence of postoperative circulating tumor DNA (ctDNA) identifies patients with resected colorectal cancer (CRC) with low recurrence risk for adjuvant chemotherapy (ACT) de-escalation. Our study presents the largest resected CRC cohort to date with tissue-free minimal residual disease (MRD) detection.

Experimental Design: TRACC (tracking mutations in cell-free tumor DNA to predict relapse in early colorectal cancer) included patients with stage I to III resectable CRC.

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Aims: WHO Grade 3 (G3) meningiomas are rare tumours with limited data to guide management. This retrospective study documents UK management approaches across 14 centres over 11 years.

Materials And Methods: Patients with WHO G3 meningioma between 01/01/2008 and 31/12/2018 were identified.

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OncoFlash - Research Updates in a Flash!

Clin Oncol (R Coll Radiol)

September 2024

Radiotherapy and Proton Beam Department, University College London Hospitals NHS Foundation Trust, London, UK; The Royal Marsden Hospital NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK; Radiotherapy Trials Quality Assurance (RTTQA) Group, London, UK. Electronic address:

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A brain metastasis liquid biopsy: Where are we now?

Neurooncol Adv

May 2024

Department of Biochemistry and Biomedicine, School of Life Sciences, University of Sussex, Falmer, Brighton, UK.

Brain metastases remain a challenging and feared complication for patients with cancer and research in this area has lagged behind research into metastases to other organs. Due to their location and the risks associated with neurosurgical biopsies, the biology underpinning brain metastases response to treatment and evolution over time remains poorly understood. Liquid biopsies are proposed to overcome many of the limitations present with tissue biopsies, providing a better representation of tumor heterogeneity, facilitating repeated sampling, and providing a noninvasive assessment of tumor biology.

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B cells and T cells are important components of the adaptive immune system and mediate anticancer immunity. The T cell landscape in cancer is well characterized, but the contribution of B cells to anticancer immunosurveillance is less well explored. Here we show an integrative analysis of the B cell and T cell receptor repertoire from individuals with metastatic breast cancer and individuals with early breast cancer during neoadjuvant therapy.

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