A Phase III clinical trial has demonstrated that nivolumab in combination with doxorubicin, vinblastine, and dacarbazine (AVD) significantly improves progression-free survival in patients with Stage III or IV advanced-stage classic Hodgkin lymphoma compared to those treated with brentuximab vedotin plus AVD. The study, published in the New England Journal of Medicine, also indicated a better side effect profile in the nivolumab group.
The multicenter, open-label, randomized trial included 994 patients, with 970 in the intention-to-treat population. At a median follow-up of 2.1 years, the two-year progression-free survival was 92% among patients treated with nivolumab plus AVD, compared to 83% for those who received brentuximab vedotin plus AVD. Researchers also noted that immune-related adverse events were infrequent with nivolumab, while brentuximab vedotin was associated with more treatment discontinuation.
"The high rate of progression-free survival with nivolumab + AVD represents another paradigm shift incorporating immunotherapy into the frontline treatment of advanced stage classic Hodgkin lymphoma for adolescents 12 and older with a dramatic reduction and near elimination of the need for radiation therapy," said Dr. Sharon Castellino, Director of the Leukemia and Lymphoma Program at the Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta.
MRI Predicts Outcomes in Rectal Cancer
New data suggests that magnetic resonance imaging (MRI) can predict the risk of recurrence or progression in rectal cancer patients who have undergone chemotherapy and radiation. A secondary analysis of the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial, published in Radiology, assessed the effectiveness of restaging MRI in predicting oncologic outcomes following total neoadjuvant therapy (TNT).
The study included 277 patients with Stage II or III rectal adenocarcinoma. After an average follow-up of approximately 4 years, patients with clinical complete response had higher rates of organ preservation compared to those with near-complete clinical response. The 5-year disease-free survival rates for patients with clinical complete response, near-complete clinical response, and incomplete clinical response were 81.8%, 67.6%, and 49.6%, respectively.
"The MRI response category also predicted overall survival, distant recurrence-free survival, and local regrowth," the authors noted. Among patients with at least 2 years of follow-up, 129 (48.5%) had residual disease. "The MRI response category was predictive of organ preservation and survival. Restricted diffusion and abnormal nodal morphologic features on restaging MRI scans were associated with increased likelihood of residual tumor."
Diet and Prostate Cancer Grade Reclassification
A recent study investigated the association between diet and the risk of prostate cancer grade reclassification in men diagnosed with grade group (GG) 1 disease undergoing active surveillance. The research, published in JAMA Oncology, indicates that greater adherence to American dietary guideline recommendations may be associated with a lower risk of grade reclassification.
The study included 886 patients diagnosed with GG 1 prostate cancer and undergoing active surveillance. After a median follow-up of 6.5 years, 187 (21%) patients had grade reclassification to GG2 or greater. Higher baseline Healthy Eating Index (HEI) and energy-adjusted HEI scores were associated with a lower risk of grade reclassification to GG2 or greater and GG3 or greater.
"In men diagnosed with GG1 prostate cancer undergoing active surveillance, stricter adherence to American dietary guideline recommendations, indicated by higher HEI and energy-adjusted HEI scores, may be associated with reduced risk of grade reclassification, particularly to GG3 or greater disease, which mandates curative treatment," the study authors concluded.
