Latest scientific information in oncology

Breast cancer

Unnecessary chemotherapy that causes a temporary decline in cognitive skills can be avoided with gene tests

Studies show that initial cognitive problems occur in breast cancer patients more frequently when a combination of chemotherapy and hormonal therapy is used instead of hormonal therapy alone. After a year of therapy, however, the frequency is approximately the same.

According to Tom Wiklund, Chief Clinical Director of Docrates Cancer Center, the OncotypeDX gene test makes it possible to avoid administering chemotherapy to patients who are not likely to benefit from it. This allows patients to avoid temporary cognitive problems and other possible adverse effects caused by cytostatic drugs.

Docrates Cancer Center applies the OncotypeDX test whenever deemed necessary by the physician and the patient.

Prostate cancer

First orally administered testosterone blocker

The results of a clinical drug trial predict a new orally administered hormonal drug entering the market. The results of an international phase III randomised study were released on the last day of May.

The purpose of the hormonal drug used in the treatment of advanced prostate cancer is to lower the activity of testosterone in male patients in order to stop the progress of a testosterone-dependent prostate cancer.

The results show that the tablet has many advantages over conventional injections. In addition to the ease and safety of taking the drug at home, the castrate level can be achieved faster and the temporary initial increase in testosterone levels associated with injections can be avoided.

The study also indicated that the new tablet medication has a lower risk of cardiovascular diseases. The drug can also be administered in phases, which means that the patient can be relieved of its castrating effect.

Docrates Cancer Center can start using the drug in an flexible manner once it enters the market.

Do more sensitive imaging methods improve the outcomes of prostate cancer treatment?

One of the topics of the world’s largest oncology meeting ASCO was whether the more sensitive mode of imaging prostate cancer, PSMA-PET, improves the outcomes of treatment. PSMA-PET imaging is based on a radioactive tracer that enters the circulatory system and seeks PSMA-positive cancer cells, revealing their location.

The main advantage of PSMA-PET is that, whenever an increase in PSA levels indicates the recurrence of cancer, the method shows the location of the cancer in the body. Traditional imaging methods are not capable of indicating this early-stage “biochemical recurrence”.

Studies show that using a more sensitive imaging method changed the treatment plan of 46–57% of patients. However, it is not yet known how much of an impact changing the treatment plan has on the life expectancy of the patient. More studies are thus required.

Nevertheless, it is likely that the more accurate treatment plans created on the basis of more accurate imaging methods also improve the outcomes as, according to studies, administering radiotherapy on the metastases revealed by the PSMA-PET method allows for postponing hormonal therapy. On the other hand, PSMA-PET can also indicate the metastases resistant to chemotherapy, which means that administering radiotherapy can have better outcomes.

The meeting concluded that future studies should consider the advantages of PSMA-PET by taking its effects on the quality of the patient’s life into account in addition to its effect on the patient’s life expectancy.

PSMA-PET was introduced by Docrates Cancer Center as the first service provider in the Nordic countries a few years ago. According to our experience, the method is ideal for making individual cancer treatment plans. PSMA-PET can be used to study the early stages of cancer, diagnose a recurrent cancer and plan Lu-PSMA treatment.

Colorectal cancers

Patients diagnosed with metastatic colon or rectal cancers and microsatellite instability should primarily be treated with immunotherapy

A small proportion of patients with colon or rectal cancer are diagnosed with a microsatellite instability in the tumor. According to the latest research, these patients should be treated with immunotherapy (pembrolizumab) immediately after the diagnosis of a metastatic condition instead of starting treatment with cytostatic drugs and moving on to immunotherapy later on.

These findings have already been applied at Docrates Cancer Center on the basis of previous studies.

Liver cancer

Immuno-oncological therapy becoming more common in the treatment of hepatocellular cancer

The latest scientific information indicates that immuno-oncological pharmacotherapy is becoming more common also in the treatment of hepatocellular cancer. It is likely that a combination of two immuno-oncological drugs will soon be the standard mode of treating advanced hepatocellular cancers that cannot be treated surgically.

Studies show that the combined immunotherapy is not only more effective but it is also generally tolerated better than sorafenib, the current primary mode of treatment.

These findings are also applied in the treatment of patients at Docrates Cancer Center.

References:

• https://dailynews.ascopubs.org/do/10.5555/ADN.20.200151/full/?cid=DM5257&bid=47041285&
• https://dailynews.ascopubs.org/do/10.1200/ADN.20.200201/full/
• https://dailynews.ascopubs.org/do/10.1200/ADN.20.200065/full/
• https://dailynews.ascopubs.org/do/10.1200/ADN.20.200206/full/?cid=DM5237&bid=46828129
• https://dailynews.ascopubs.org/do/10.1200/ADN.20.200021/full/?utm_source=TrendMD&utm_medium=cpc&utm_campaign=ASCO_Daily_News_TrendMD_0