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Minimal Residual Disease in Patients With Multiple Myeloma
This meta-analysis addressed the utility of minimal residual disease (MRD) assessment in predicting survival outcomes in patients with multiple myeloma. In a Medline search from 1990 and to 2016, MRD-negative status following treatment was associated with a significant improvement in progression-free and overall survival. Munshi et al note that MRD assessment after initial treatment could thus be a useful surrogate end point for progression-free and/or overall survival in clinical trials. Gormley et al provide an Editorial.
Predicting Breast Cancer Recurrence With Boost vs No Boost
This randomized clinical trial analyzed pathological prognostic factors related to ipsilateral breast tumor recurrence (IBTR) using long-term follow-up of the EORTC “boost no boost” trial. In the EORTC trial, 5569 patients with early-stage breast cancer were randomized from 1989 to 1996, with a median follow-up of 18.2 years. After lumpectomy and 50-Gy whole-breast irradiation, 815 patients received a 16-Gy boost and 801 received no boost. Young age and associated ductal carcinoma in situ (DCIS) increased IBTR risk. Vrieling and colleagues conclude that patients with high-grade invasive tumors need to be monitored closely for 5 years, whereas patients with invasive tumors with associated DCIS need long-term follow-up of at least 20 years. Cuttino and Kubicky provide an Editorial.
Author Audio Interview
Androgen Deprivation Therapy and Risk of Dementia
This cohort study sought to determine whether there is evidence of an association between use of androgen deprivation therapy (ADT) in the treatment of prostate cancer and the subsequent development of dementia. Nead and colleagues analyzed electronic medical record data in 9272 patients with prostate cancer, including 1826 men who received ADT. The authors identified a statistically significant association between the use of ADT and increased risk of dementia, suggesting that further prospective studies are needed. Walsh and Johnson provide an Invited Commentary.
Locoregional Control and Survival in Aggressive Lymphoma
This cohort study of 1332 patients in China with early-stage extranodal natural killer/T-cell lymphoma (NKTCL) investigated the dose-dependent effect and potential survival benefits of radiotherapy (RT) on locoregional control. Yang et al found that RT had a dose-dependent association with locoregional control, progression-free survival, and overall survival. The authors conclude that clinicians should be aware of the essential role of RT in both locoregional disease control and maintaining long-term survival, noting that these findings will help to define the standard of care in treatment of NKTCL.
Patient-Centered Communication Trial in Advanced Cancer
In a cluster randomized clinical trial of communication training for oncologists paired with coaching for patients, Epstein et al tested a combined intervention to promote patient-centered communication. Thirty-eight medical oncologists and 265 community-dwelling adults with advanced cancer were randomized to intervention or control. Oncologists received individualized communication training, while patients received question prompt lists and individualized communication coaching. The intervention resulted in significant improvements in patient-centered communication but did not affect secondary outcomes such as understanding of prognosis or aggressive treatments and hospice use.
Highlights. JAMA Oncol. 2017;3(1):3. doi:10.1001/jamaoncol.2016.1662
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