News in brief: Immunotherapy can be safely given after radiation therapy; PBS changes for CRC and breast cancer drugs; Telerehabilitation not second best for cancer patients

17 Jan 2022

Immunotherapy can be safely given after radiation therapy

Concerns about whether it is safe to administer immunotherapy in conjunction with radiotherapy have been addressed by a US study showing no increased risk of serious adverse events if radiation therapy is given within 90 days prior to an immune checkpoint inhibitor.

A pooled analysis of patient-level data from 68 prospective trials in the US FDA databases included 16, 835 patients receiving therapies such as atezolizumab, avelumab, cemiplimab, durvalumab, ipilimumab, nivolumab, or pembrolizumab, of whom 1733 received radiation therapy within the 90 days prior to starting immunotherapy.

Patients receiving radiation therapy had generally similar rates of adverse events overall, with slightly higher rates of fatigue, endocrinopathies, and pneumonitis.
However there was no difference seen in high-grade adverse events compared to those who did not receive radiation therapy.
“Thus, it would appear to be safe to administer an immune checkpoint inhibitor within 90 days of receiving radiation therapy,” the study authors concluded in JAMA Oncology.

PBS changes for CRC and breast cancer drugs

Encorafenib (Braftovi) is listed on the PBS from 1 January for use in combination with cetuximab in the treatment of BRAF V600E-variant metastatic (Stage IV) colorectal cancer.
Access to the drug on the PBS was recommended after the PBAC acknowledged a high clinical need in a patient population with poor prognosis. The listing also follows changes to the descriptor for MBS item 73338 to include BRAF V600 testing.

In another amendment, palbociclib, 75 mg, 100 mg, 125 mg tablets are now PBS listed for locally advanced or metastatic breast cancer. The listing was approved after the sponsor, Pfizer, told the PBAC in August that it intends to discontinue the capsule formulation shortly after the tablets are PBS-listed.

Telerehabilitation not second best for cancer patients

Delivering cancer patients’ rehabilitation clinics by telehealth is safe, effective and removes barriers to participation, such as fatigue, travel and parking costs, La Trobe University research has found.

Published in Journal of Medical Internet Research – Cancer, the study found 88% of surveyed cancer patients were satisfied with completing the rehabilitation exercise program online, and 82% reported an improvement in their health and wellbeing.

Researcher and physiotherapist at La Trobe University, Dr Amy Dennett, said the findings showed that telerehabilitation isn’t a second-best option – and for some cancer patients it might be the only way they can participate in a regular exercise program.

“Although telerehabilitation has exploded world-wide out of necessity, this study highlights that it shouldn’t necessarily take a back seat if the threat of COVID-19 diminishes,” she said.

“Availability of exercise programs for cancer patients is very low in Australia, despite global recognition of the enormous benefits.”

“Add to that the burden of travel – especially for people in regional areas who might have to make a two or three-hour round trip – and it becomes an impossibility for many.

Dr Dennett said the study also found that healthcare workers had a mixed experience of the new format, due to a lack of face-to-face interactions.

“They were proud to have risen to the challenge of the rapid switch to telehealth, but some preferred delivering in-person care as they felt better able to assess, monitor and correct patients exercising,” she said.

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