Guardant Health’s Post

A question may remain as to whether an FDA advisory panel's recommended approval of a colorectal cancer blood test is a win for early screening and detection. If approved, it would not be the first blood-based screening tool available, but it is another less invasive option than colonoscopies which remain the gold standard. The upside is that an additional less invasive blood test could potentially increase diagnosis rates if it’s able to reach people who may typically refuse a colonoscopy. Fast facts: - 91% of patients with colorectal cancer detected by a colonoscopy tested positive with the blood test, so some false negatives which contribute to the controversy. - 89.9% of patients without cancer tested negative on the blood test, so some false positives - but it missed about 87% of advanced precancerous lesions, with a specificity rate of just 13.2% which is where a lot of the controversy appears to lie https://lnkd.in/eS65bGzZ #cancer #biotech #insights

These are the guidelines I follow for colorectal cancer screening: #coloncancer #colorectalcancer #45isthenew50 1: American College of Gastroenterology 2021 Colorectal cancer screening guidelines suggesting to start screening in average risk individuals at age 45 2: American Cancer Society Recommends that people at average risk of colorectal cancer start regular screening at age 45 3: U.S. Preventive Services Task Force Recommends starting colorectal screening at age 45 https://lnkd.in/gJywpy3v

📃Scientific paper: Impact of next-generation hormonal agents on treatment patterns among patients with metastatic hormone-sensitive prostate cancer: a real-world study from the United States, five European countries and Japan Abstract: Background Until five years ago, the metastatic hormone-sensitive prostate cancer (mHSPC) treatment landscape was dominated by the use of androgen deprivation therapy (ADT) alone. However, novel hormonal agents (NHAs) and chemotherapy are now approved for male patients with mHSPC. This study aimed to understand the impact NHA approvals had on mHSPC real-world treatment patterns and to identify the key factors associated with NHA or chemotherapy (± ADT) usage vs ADT alone. Methods Data were collected from the Adelphi Prostate Cancer Disease Specific Programme (DSP)™, a point-in-time survey of physicians and their consulting patients conducted in the United States (US), five European countries (France, Germany, Italy, Spain, and the United Kingdom), and Japan between January and August 2020. Data were analysed using descriptive statistics for individual countries, regions, and all countries combined. Pairwise analyses were used to further investigate differences between treatment groups at global level. Results 336 physicians provided data on 1195 mHSPC patients. Globally, at data collection, the most common mHSPC regimen initiated first was ADT alone (47%), followed by NHAs (± ADT) (31%, of which 21% was abiraterone, 8% was enzalutamide, and 2% was apalutamide) and chemotherapy (± ADT) (19%). The highest rates of ADT alone usage were observed in Japan (78%) and Italy (66%), and the lowest in Spain (34%) and in the US (36%). Our results showed that clinical decision ... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/Lmez

#immunotherapy #cancerresearch #lipids #oncology #cancertreatment https://lnkd.in/gMNxppz6 Implications for Practice In patients with advanced solid #tumours treated with immune checkpoint inhibitors, combining total #cholesterol with #triglycerides in a “lipid score” allowed us to define three subgroups of patients with different #survival benefit from immune checkpoint inhibitors. Among total cholesterol components, HDL, but not LDL, had an impact on patient survival, and combining HDL with triglycerides, we were able to define again 3 subgroups of patients with different survival benefit. The assessment of baseline patient lipid profile before immune checkpoint inhibitors therapy may represent a useful and easily available tool to guide clinical-decision making and stratify prognosis of patients’ with cancer.

Informative review in cardio-oncology. Recent studies report on the cardiotoxic activity of such promising therapies as BRAF and MEK inhibitors or CAR-T therapy. They treat melanomas, breast cancer, lung cancer, prostate cancer, and lymphoid neoplasms. The most common arrhythmia observed in oncological patients is atrial fibrillation, followed by other types, such as QT-prolongation, ventricular arrhythmias, and bradyarrhythmias, but less frequently. The context of arrhythmia in an oncological patient depends on the cancer type, oncological treatment, patient characteristics, and risk factors. Four major categories of risk factors are identified: 1. Non-chemotherapeutic factors (prior arrhythmogenic substrate, post-surgery arrhythmia, arrhythmogenic medications); 2. Cardiotoxicity of chemotherapeutic treatment; 3. Direct cardiac involvement (primary cancer of heart, metastasis to heart); 4. Electrolyte abnormalities (as a result of vomiting or drug-induced). It is essential to be aware of the risks associated with the oncological treatment and know how to act in case of cardiotoxicity. #cardiooncology #arrhythmia #chemotherapy #immunotherapy https://lnkd.in/eG9dn5ct

📃Scientific paper: Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study Abstract: Purpose Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC). Methods A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC. Results After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7–39.8; p  < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1–3.1, p  = 0.0431). Conclusions The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/Jwnol

Proud to share our work published in #NatureMedecine MEDITREME trial : - 🔢 57 pts with metastatic colorectal cancer, 1st Line, MSS, KRASm - 💉FOLFOX6 + Durvalumab + Tremelimumab - ✅3months- PFS = 90,7% - ✅Response rate = 64,5% - 🧪Biomarkers of response : ↗️ High TMB, ↗️ High immune signature, ↘️ Low EMT and ↘️ Low GIS - 🩸Blood tumor specific T cell response CGFL - Centre Georges-François Leclerc Marion Thibaudin francois ghiringhelli AstraZeneca #oncology #clinicaltrial #immunology

Another trial of an oral SERD on ER positive, HER2 negative, previously treated advanced breast cancer has been recently published.  The results of this trial somewhat match the results of other trials, and reflect the complexity in this space.  This phase II trial compared giredestrant to physician's choice.  75% of patients in the physician's choice arm received fulvestrant, while 25% received an aromatase inhibitor.  In the full patient population, there was no significant difference in investigator-assessed progression-free survival (5.6 vs 5.4 months).  However, a secondary endpoint analysis of only the ESR1-mutated patients showed much stronger benefit than the overall population (5.3 vs 3.5 months).  This data does correlate with other trials, where the main benefit in oral SERDs comes from its activity in ESR1-mutated patients, where aromatase inhibitors/fulvestrant are less effective.  Some trials, like the EMERALD trial, have shown a PFS benefit in the entire population, but in the subgroup analyses, the benefit mainly comes from the ESR1-mutated subgroup.  It's possible SERDs could have a benefit in the ESR1-unmutated population because tumors cannot develop an ESR1 mutation as a mechanism of resistance.  However, that should be compared against a strategy of physician's choice followed by ESR1 testing on progression, and switching to an oral SERD if the mutation has developed.  At this point in the disease course, we are treating breast cancer more like a chronic disease, and should be utilizing older agents whenever possible. #breastcancer #orserdu https://lnkd.in/e2aBusUS

📃Scientific paper: Refractory Shock Secondary to Denosumab-induced Severe Hypocalcaemia Abstract: Denosumab is one of the most commonly used antiresorptive drugs for osteoporosis treatment and the prevention of skeletal-related events in cancer patients. The purpose of this case report is to highlight potentially life-threatening severe hypocalcaemia as a side effect of denosumab complicated by refractory shock that failed to respond to medical management including intravenous calcium, vasopressors and inotropes in an elderly man with a history of prostatic cancer. LEARNING POINTS: Denosumab is a commonly used antiresorptive drugs for the treatment of osteoporosis and to prevent skeletal-related events in patients with cancer. A common side effect of denosumab is hypocalcaemia; conditions associated with a higher risk of hypocalcaemia include chronic kidney disease, pre-existing hypocalcaemia, and metastatic cancer. Severe hypocalcaemia may induce cardiovascular manifestations such as hypotension, bradycardia, impaired cardiac contractility, impaired vascular tone, and arrhythmias. Shock results from diminished vascular smooth muscle tone and tends to occur with rapid severe hypocalcaemia; it is usually refractory to fluid and pressor therapy until hypocalcaemia is corrected. Continued on ES/IODE ➡️ https://etcse.fr/9yEAz ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

📃Scientific paper: Efficacy of regorafenib combined with PD-1 inhibitors in elderly patients with advanced metastatic colorectal cancer Abstract: Objective This is the first clinical study that wants to investigate the treatment patterns, clinical outcomes, and prognostic factors of regorafenib plus PD-1 inhibitors therapy in Chinese elderly patients with advanced colorectal cancer. Methods A cohort of metastatic colorectal cancer patients 60 years or older who received treatment with regorafenib combined with PD-1 inhibitors was included in our analysis. The endpoints included overall survival (OS), progression-free survival (PFS), and prognostic factors. Results In total, 24 patients were enrolled with the median age of 68 years, and 62.5% were female. The median OS and PFS were 15.03 months (95% CI 7.0–23.0) and 4.0 months (95% CI 1.8–6.2), respectively. The objective response rate was 8.3%, and the disease control rate was 70.8%. Patients previously treated with regorafenib had a longer median PFS than those without (6.3 versus 2.8 months). In terms of final daily doses, it showed a trend toward better PFS (median PFS was 10.0 months) in high-dose group (daily dose above 80 mg of regorafenib) compared to low-dose group (daily dose no more than 80 mg of regorafenib) (median PFS was 3.5 months). Conclusions This real-world evidence confirms that Chinese elderly patients with advanced colorectal cancer may benefit from the treatment of regorafenib combined with PD-1 inhibitors, similarly with this combination therapy strategies in all age patients. Continued on ES/IODE ➡️ https://etcse.fr/bEc ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.