(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
May 27 (Reuters) – Today we feature studies to be presented at the year’s most important cancer conference, the upcoming American Society of Clinical Oncology meeting in Chicago, all with the potential to be practice-changing.
SOME HIGH-RISK BREAST CANCER PATIENTS CAN AVOID CHEMO
A commercially available test from Veracyte can identify patients with early cases of high-risk breast cancer who can safely skip chemotherapy, according to data being presented at the ASCO meeting.
In a randomized trial with more than 4,400 patients with early breast cancer that was particularly aggressive or prone to spread or recur, more than two-thirds of those whose care was guided by Veracyte’s Prosigna genomic test safely avoided chemo.
The Prosigna group’s 5-year cancer-free survival rate was 93.7%, statistically non-inferior to the 94.9% rate in patients randomly assigned to receive chemotherapy as part of standard care.
The test analyzes the activity of 50 specific genes in tumor tissue to determine the molecular subtype and develops a “Risk of Recurrence in the Next 10 Years” score to help oncologists decide if chemotherapy is necessary, Veracyte said.
Chemotherapy can take a serious physical and emotional toll, with younger women facing consequences that can include infertility, cognitive impairment, and early menopause, with up to 43% of survivors experiencing lasting nerve damage.
Dr. Kelly Marcom, Veracyte’s medical director for breast cancer, said the trial results “represent a major milestone in precision breast oncology.”
“These findings have the potential to transform how clinicians treat a large population of patients with breast cancer, helping them to personalize their patients’ treatment choices,” Marcom said.
Separately, researchers in Australia and New Zealand found that Veracyte’s Decipher test could predict which patients with metastatic, hormone-sensitive prostate cancer would benefit from adding the chemotherapy drug docetaxel to standard treatment.
Veracyte said complete findings from both studies will be reported on May 30 at the meeting in Chicago.
PROSTATE CANCER DRUG CHOICE IMPACTS COGNITION
Two common prostate cancer drugs that are similarly effective against the disease have a crucial difference: one more severely impairs patients’ cognitive function over the course of treatment, new research reveals.
The 24-week study of 111 patients with advanced prostate cancer compared darolutamide, sold as Nubeqa by Bayer and Orion, with Xtandi from Pfizer and Astellas Pharma, known chemically as enzalutamide.
Those who received Nubeqa had significantly smaller declines in thinking and memory skills as monitored by computer-based cognitive function testing, compared to those treated with Xtandi, researchers found.
When researchers compared the scores for the cognitive skills with the greatest changes over the course of the study, the median decrease was 15.8% with Nubeqa versus 36.1% with Xtandi.
“Both drugs appear to work similarly in terms of prostate cancer control, but knowing that there can be differences in cognitive effects between these drugs may affect a clinician’s choice for treatment if both options are available,” study leader Dr. Alicia Morgans of the Dana-Farber Cancer Institute in Boston said in a statement.
The researchers, who are due to present their findings at ASCO on Saturday, are continuing to follow these patients, they said.
ORAL DRUG HELPS GI CANCER PATIENTS STAY ON TRACK WITH CHEMO
Patients with gastrointestinal cancers were able to keep their platelet counts high enough to continue chemotherapy with the help of an oral medication already approved for liver disease, according to trial results to be presented at the ASCO meeting on May 30.
Treatment with Sobi’s Doptelet (avatrombopag) proved so effective that researchers stopped their trial after 23 of the 40 patients had received the drug.
Nearly 66% of those patients recovered their platelet counts within two weeks and maintained those levels, compared to only 17% of those who received a placebo.
Thrombocytopenia, or low blood platelet counts, is a common chemotherapy side effect. Platelets help form clots after injuries, and when levels get too low, patients risk excessive, life-threatening bleeding after even minor injuries.
Cancer patients with persistent thrombocytopenia often can’t receive their next scheduled chemotherapy dose, which can lead to worse outcomes.
The mid-stage trial involved 40 patients with gastrointestinal cancers who were experiencing chemotherapy-induced thrombocytopenia and who were unlikely to recover on their own between chemo cycles.
The same team of researchers had recently conducted a late-stage trial in which Amgen’s Nplate, or romiplostim, also proved highly effective in patients with gastrointestinal cancers and persistent thrombocytopenia.
Both agents belong to a class of drugs known as thrombopoietin receptor agonists, but Nplate is given as an injection.
For metastatic cancer patients, “having to go in every single week for a shot is not ideal,” study leader Dr. Gerald Soff of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine said in a statement. “If there’s a good oral option, that would be very appealing for many people.”
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(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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