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Treating platelets for pathogens can reduce infection risk in immune-compromised patients but may also affect platelet function. Garban et al conducted a randomized clinical trial to test the hypothesis that amotosalen–UV-A–treated platelets in additive solution were noninferior to untreated platelets in additive solution or in plasma in hemostatic efficacy. Using grade 2 or higher bleeding as an end point, the authors found that treated platelets in additive solution were noninferior to untreated platelets in additive solution but not to untreated platelets in plasma. Pathogen-reduced platelets may thus have reduced efficacy compared with other platelet products. Devine provides an Editorial.
Single-nucleotide polymorphisms (SNPs) have been linked to breast cancer susceptibility. Van Veen et al questioned whether the integration of SNPs into breast cancer risk models improved accuracy. A panel of 18 SNPs was used to predict breast cancer in combination with classic risk factors and mammographic density in 9363 women without a previous breast cancer diagnosis. The SNP polygenic risk score was higher in case patients than controls and added substantial information to risk assessment. Assessment of SNPs in combination with mammographic density could improve classic breast cancer risk prediction.
Does the addition of regional hyperthermia to neoadjuvant chemotherapy translate into improved survival for patients with localized high-risk soft-tissue sarcoma? Issels et al conducted a randomized clinical trial of 341 patients receiving either neoadjuvant chemotherapy consisting of doxorubicin, ifosfamide, and etoposide alone, or combined with regional hyperthermia. Adding regional hyperthermia improved local progression-free survival and 5- and 10-year overall survival rates vs neoadjuvant chemotherapy alone. The authors concluded that for patients who receive neoadjuvant therapy the addition of regional hyperthermia is of benefit. Dewhirst and Kirsch provide an Invited Commentary.
Concurrent chemoradiotherapy for advanced cervical cancer is a challenge in developing countries with nonadherence owing to toxic effects. Shrivastava et al questioned the need for dual-modality therapy and conducted a randomized clinical trial of concurrent cisplatin-based chemoradiotherapy (CT-RT) and radiotherapy (RT) alone in 850 women with FIGO stage IIIB squamous cell cervical carcinoma. The 5-year disease-free and overall survival was significantly higher with CT-RT vs RT alone. Thus, CT-RT should be considered as the standard of care in this population. Nwachukwu et al provide an Invited Commentary.
Atezolizumab is an anti–programmed cell death ligand 1 monoclonal antibody that has shown activity in the treatment of metastatic urothelial carcinoma. Petrylak et al report long-term clinical outcomes of 95 patients with metastatic urothelial carcinoma enrolled in a phase 1 study of single-agent atezolizumab. After 3 years, the median overall survival was 10.1 months; the 3-year overall survival rate was 27%, and median duration of response was 22.1 months. Although the patients described in this study had been heavily pretreated, atezolizumab was well tolerated and provided durable clinical response in some patients.
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Highlights. JAMA Oncol. 2018;4(4):435. doi:10.1001/jamaoncol.2017.3215
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