Summary of the 2020 J Clin Oncol Magazine Review (II)

J Clin Oncol: Should antioxidants be replenished during cancer chemotherapy?Despite reports of widespread use of dietary supplements during cancer treatment, there is little data on their safety or effectivenessConsidering that some supplements, especially antioxidants, may reduce cytotoxicity of chemotherapy, Ambrosone et alconducted a prospective study to assess the relationship between supplement use and breast cancer prognosisstudy investigated the use of supplements before and during chemotherapy in 1,134 breast cancer patients who were chemotherapyed with cyclophosphamide, amycin and yewolThe recurrence rate and survival rate of patients were evaluated for 6 months after admission to the groupresults show that the use of any antioxidant supplements (vitamins A, C and E, carotenoids, coenzyme Q10) before and during treatment is associated with an increased risk of recurrence (correction risk ratio of 1.41, 95% CI 0.9 8-2.04, P-0.06), and, to some extent, is also associated with an increased risk of death in patients (adjHR 1.40, 95% CI 0.90-2.18, P-0.14)The relationship with individual antioxidants is weak, possibly because of the small numberFor non-antioxidants (vitamin B12), the use of pre-chemotherapy or chemotherapy was significantly related to disease-free survival (adjHR 1.83, 95% CI 1.15-2.92, P 0.01) and shorter overall survival (adjHR 2.04, 95% CI 1.22-3.40, P 0.01)Iron supplementation during chemotherapy was significantly associated with recurrence (1.79, 1.20-2.67, P 0.01)The overall survival outcome was similarMultivitamin applications are independent of survival prognosisthe relationship between survival prognosis and antioxidant and other dietary supplement applications during and during chemotherapy is consistent with the patient's cautious recommendation to use supplements (not multivitamins) during chemotherapyhttps://? id-c1e4185e507J Clin Oncol:alloHCT pre-regulating the effects of chemotherapy on the prognosis in Patients with AML
patients with acute myeloid leukemia (AML) in the remission period are still at risk of recurrence, even after alloHCT The residual lesions (MRD) status that AML can detect prior to alloHCT has been shown to have prognostic significance For MRD-positive AML patients, it is not clear whether changing the intensity of the alloHCT regulatory regimen can prevent recurrence and improve survival the study conducted deep targeted sequencing of 13 common AML mutation genes in the blood before chemotherapy in a Stage III clinical trial in which all adult patients who received complete morphology remission were randomly assigned to the meelregulatory group (MAC) or the dose-reducing group (RIC In the MAC group and 37 percent of patients in the RIC group, 32 percent and 37 percent of the patients did not detect any mutations, the survival rates of these groups were similar (the overall survival rate of 3 years was 56 percent vs 63 percent, p-0.96) In patients with a detectable mutation (NGS positive), there were significant differences in recurrence and survival rates in both the MAC group and RIC (3-year cumulative recurrence rate 19% vs 67%, p 0.001; 3-year OS 61% vs 43%, p-0.02) Multivariate analysis of NGS-positive patients showed that, according to disease risk and donor correction, RIC was significantly correlated with increased recurrence rate (risk vs HR 6.36), no recurrence survival rate (HR 2.94) and OS decrease (HR 1.97) compared to MAC The AML MRD model also shows that MAC is better than RIC in patients who test positive this study shows that MAC is better than RIC in patients with pre-ALLoHCT-positive MRD-positive AML patients, improving patient survival https:// ? id-6aa8185e619 J Clin Oncol: Osimertinib is used to carry rare mutations in patients with EGFR rare mutation NSCLC about 10% of epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) patients carrying a rare mutation This paper reports the effectiveness and safety of osimertinib (Ostinib) in patients with NSCLC who carry rare EGFR mutations This study is a multi-center, single-arm, open Phase II trial conducted in Korea to recruit patients with metastatic or recurrent NSCL in addition to the pathologically diagnosed patients with mutations other than EGFR No 19, L858R and T790M mutations, and mutations other than the insertion of exnomers no 20 The main node is the objective mitigation rate assessed every 6 weeks Secondary nodes are progressionless survival, overall survival, mitigation duration, and safety 37 patients were recruited between March 2016 and October 2017, one of whom withdrew from the study prior to treatment For 36 patients, the median age was 60 years old and 22 (61%) men Sixty-one percent of patients were treated with osimertinib as a first-line treatment The most common mutations were G719X (19 cases, 53%), followed by L861Q (9 cases, 25%), S768I (8 cases, 22%) and others (4 cases, 11%) The objective mitigation rate was 50% (18 cases, 95% CI 33%-67%) The median progression-free survival period was 8.2 months (95% CI 5.9-10.5) and the overall survival period was not reached The median mitigation duration is 11.2 months (95% CI 7.7-14.7) Side effects include red rash (11 cases, 31%), itching (9 cases, 25%), loss of appetite (9 cases, 25%), diarrhea (8 cases, 22%) and dyspnea (8 cases, 22%), all side effects are controllable this study showed good activity and controlled side effects in NSCLC patients with rare mutations in EGFR https:// ? id?cd7185e5469 J Clin Oncol: Effect of enhanced afterduction therapy on the prognosis of standard risk ALL children
has been shown that enhanced postduction therapy can improve the survival prognosis of children with high-risk acute B lymphocytic leukemia (ALL), but whether the enhanced therapy can improve the standard risk (SR) children's prognosis is not clear, the Children's Oncology Association (COGALL) A031 assessment of this trial 2005-2010, the AALL0331 trial recruited 5,377 children, all of which received three drugs (dexamethasone, cravinaldin and Pemendase (PEG) to induce chemotherapy, which was then classified as low SR, general SR, or high SR General SR patients were randomly divided into 4 weeks of standard solidified chemotherapy (SC) or 8 weeks of enhanced amplification bfM-consolidated chemotherapy (IC) Patients with high SR disease are assigned to a complete COG-enhanced BFM treatment regimen, including 2 temporary maintenance and delayed strengthening stages 6-year event-free survival rate was 88.96 percent to 0.46 percent, and the overall survival rate (OS) was 95.54 percent to 0.31 percent For patients with general SR disease, the six-year continuous total remission rate (CCR) and OS rates were 87.8% vs 89.1% vs 89.1% and 95.8% vs 95.2% vs 95.2% Compared to patients with low MRD and IC treatment withnoly improved treatment, the prognosis was poor for patients with general SR disease with the lowest residual disease (MRD) after induction (0.01% - 0.1%) At 6 years, the CCR and OS rates of 635 patients with non-randomized sylladother's high SR disease were 85.55 percent and 92.97 percent, respectively The six-year OS rate for 5,000 children registered in the AALL0331 trial was over 95% For children with general SR disease, adding IC to treatment, even if MRD is higher, did not improve their CCR or OS Overall, the overall EFS and OS rates were excellent for this group of SR ALL patients, especially those with high SR diseases https:// ? id-d10c185e55b1 J Clin Oncol: Cardiovascular disease risk after treatment of male germ cell tumors the purpose of this study is to analyze the risk of cardiovascular disease (CVD) after treatment with male reproductive cell tumors (GCC) collectclinical data from the Danish Testicular Cancer Database For each patient, 10 men with matching dates of birth were screened in a normal Danish population through a sample of risk sets Assess cardiovascular risk factors, CVD and related deaths a total of 5,185 GCC patients and 51,850 normal males were screened Median follow-up 15.8 years The treatment of polymycin and optopoine plus cisplatin (BEP, 1819 bits) was associated with an increased risk of hypertension and hypercholesterolemia THE CVD RISK RATIO (HRs) for 1 year of BEP treatment is as follows: myocardial infarction (HR 6.3, 95% CI 2.9-13.9), cerebrovascular accidents (6.0, 2.6-14.1) and venous thromboembolism (24.7, 14.0-43.6) One year after BEP treatment, the risk of CVD decreased to normal, but after 10 years, the risk of myocardial infarction and cardiovascular death increased again (HR 1.4 and 1.6, respectively) Radiotherapy increases the risk of diabetes during long-term follow-up (HR 1.4, 95% CI 1.0-2.0), but has no effect on other prognosis By monitoring (3332 cases), cardiovascular risk factors, cardiovascular disease and cardiovascular death data were comparable to those of the normal population BEP treatment was associated with an increased CVD risk within 1 year of the start of treatment, with only a mild increase in CVD risk for 10 years of follow-up Chemotherapy can increase the risk of diabetes, but have no significant effect on CVD Patients followed in the monitoring program had a similar risk of CVD development to normal populations https:// ? id-6a66185e85eb J Clin Oncol: The effect of ERCC1 expression on the efficacy of upper gastrointestinal tumor chemotherapy platinum-based chemotherapy is the standard treatment for HER2-negative advanced gastric esophagus cancer (AEGC) Retrospective data indicate that erCC1 levels in the tumor may determine sensitivity to platinum Iqbal et al conducted a randomized Phase II trial to assess whether the efficacy of ECC1 treatments containing Elitik and Dositatha (IT) in the platinum-based chemotherapy of AEGC patients with platinum-based chemotherapy combined fluoroery, metformin tetrahydrofocitis and oshariplatin (FOLFOX) compared to platinum-free treatments containing Ilition and Dositathan (IT) Twenty-two patients with UNtreated HER2-negative AEGC were recruited to assess the level of ERCC1 mRNA expression in a proactive manner, and then randomly assigned to the FOLFOX group or IT group, which were divided into low-level groups (1.7) and high-level groups (1.7) according to the intra-ERCC1 tumor state The main indicators are progressionless survival (PFS) and overall survival (OS), and the interaction between ERCC1 expression and the treatment group is also assessed 86% of patients with ERCC1 status 1.7 Therefore, the analysis of the ERCC1 high state subgroup is limited Anemia, dehydration, diarrhea and fatigue at level 3 and above are more common in IT treatment groups Neuropathy and neutrophil reduction of level 3 and above are more common in the FOLFOX treatment group In all patients, FOLFOX's median PFS was statistically better than IT (5.7 vs 2.9 months, with a risk ratio of 0.68, P-0.02) ERCC1 status 1.7 in patients treated with FOLFOX, PFS and remission rates were statistically superior to IT, but there was no significant difference in OS THE ASSESSMENT OF ERCC1 IN PATIENTS WITH UPPER GASTROINTESTINAL TUMORS WAS HINDERED BY THE OVERWHELMING ADVANTAGE OF LOW EXPRESSION OF ERCC1 MRNA Nevertheless, the effects of treatment on PFS did not change with the expression of ERCC1 FOR ALL PATIENTS AND PATIENTS WITH LOW ERCC1 EXPRESSION, FOLFOX IS MORE EFFECTIVE THAN ERCC1 https:// ? id-bf74185e9079 Source: network