News in brief: Cancer of Unknown Primary trial problems; Radiotherapy underused in metastatic disease; Cancer patient vaccine responses


16 Mar 2021

Radiotherapy utilisation suboptimal for metastatic disease patients

Radiotherapy uptake is suboptimal for patients with metastatic cancer on diagnosis (MCOD), despite its known benefits in improving overall survival and quality, an Australian study has found. A review of records for 2392 patients with MCOD showed that radiotherapy utilisation rate was 32.3%, significantly lower than the optimal rate of 45%. The most common site was primary lung cancer. Patients were less likely to receive radiotherapy if they were elderly (aged ≥80 years), needed help with daily tasks and/or had a Charlson Comorbidity Index ≥2, according to researchers from the Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute for Applied Medical Research, UNSW Sydney.

Read more: Clinical Oncology.

Will cancer patients respond to COVID19 vaccine?

A new study will investigate whether patients with conditions such as cancer that compromise the immune system are likely to be well-protected by current COVID-19 vaccines.

The OCTAVE trial will enrol up to 5,000 people in the UK, and will compare immune responses to COVID-19 vaccination in those with cancer, inflammatory arthritis, liver or kidney diseases, or who have undergone a stem cell transplant with a control group of individuals without these conditions.

The results will be based on blood test-based measures of immune response taken before and after vaccination.

“Patients with significant underlying diseases were generally excluded from COVID-19 vaccine studies to date – it is now important to confirm that the COVID-19 vaccines work well in such conditions,” said Prof Pam Kearns, of the University of Birmingham’s Cancer Research UK Clinical Trials Unit.

“Current evidence shows that people with these medical conditions may not obtain optimal protection from established vaccines,” Prof Kearns said.

CUP is not overflowing for trial eligibility

Clinical trials to determine the best treatment for cancer of unknown primary (CUP) have encountered great difficulty in definitively distinguishing CUP from other cancer types based on ESMO guidelines, researchers have found.

A high failure rate (56%) in eligibility screening to confirm the diagnosis of CUP has plagued the ongoing CUPISCO trial, which aims to compares treatments guided by patients’ unique genetic signatures versus standard chemotherapy. Study investigators, including Dr Linda Mileshkin of the Peter MacCallum Cancer Centre, Melbourne, say that their experience to date with 628 patients has shown the need for uniform and more detailed consensus diagnostic guidelines for CUP to guide eligibility for future trials.

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