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Trial Results: ECOG-ACRIN research round-up – Spring 2022

Research dictionary entry

Health EquityChronic stress is linked to poor breast cancer outcomes

  • Chronic stress is the wear and tear on the body caused by lifelong exposure to stressors such as social isolation, poverty, and racism, which are common among racial/ethnic minorities. Doctors can measure elevated stress levels by various medical tests. Chronic stress can lead to health problems such as high blood pressure, increased body mass index, and inflammation (the body’s natural reaction against injury and infection). It can also lead to kidney disease, arthritis, and other conditions. “We observed that women with breast cancer who had chronic stress at the beginning of our study had a greater likelihood of stopping chemotherapy early and a higher risk of death,” said lead researcher Samilia Obeng–Gyasi, MD, MPH, a surgical oncologist at The Ohio State University Comprehensive Cancer Center. “In contrast, we did not observe an association between genetic ancestry and survival or chemotherapy completion. This finding suggests that chronic stress may be better than genetic ancestry at predicting chemotherapy completion and overall survival.” Dr. Obeng-Gyasi presented this research at the 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, in October 2021. A publication is in development.

Health EquityECOG-ACRIN leaders draw attention to disparities in cancer research

  • Melissa A. Simon, MD, MPH, (Northwestern University) and Edith P. Mitchell, MD, (Thomas Jefferson University) lead the ECOG-ACRIN Health Equity Committee. Recently, Drs. Simon and Mitchell talked about ECOG-ACRIN’s ongoing efforts to improve all patients' diversity, equity, and inclusion in clinical trials research. Read this interview or listen to this podcast with Dr. Mitchell in The Cancer Letter. Also, read ECOG-ACRIN's profile of Dr. Mitchell. In addition, Dr. Simon discussed unmet needs regarding clinical trials for underserved populations with cancer and other essential topics in this recent episode of OncLive On Air®.

NCI-MATCHCancer patients who received online education first before learning the results of tumor gene testing had an increase in genetic knowledge--but the tool only lowered distress in some

  • Enthusiasm for the ability to tailor cancer treatment to the person (precision medicine) may hide patients’ mental, social, and ethical concerns about genetic testing. Tumor gene testing is necessary to identify treatments for each patient. Can online genetic education ahead of time increase patients’ genetic knowledge and decrease distress? These questions were the focus of the COMET (EAQ152) randomized study. A subgroup of patients with advanced cancer in the NCI-MATCH precision medicine cancer trial participated in COMET. Half received self-guided online genetic education before receiving their test results. The other did not receive education ahead of time. The program increased knowledge. It helped reduce distress in women but not men. Patients with lower health literacy who used the program showed increased rates of distress, anxiety, and depression compared to the group who did not have the tool in advance. COMET researchers suggest refining the education program to better assist men and people with lower health literacy. Bradbury AR. Cancer. December 2021

Leukemia For patients with a new diagnosis of acute myeloid leukemia, the presence of cancer in the central nervous system at diagnosis does not appear to indicate a poor prognosis

  • In rare cases, cancer is also present in the central nervous system (brain and spinal cord) in people with newly diagnosed acute myeloid leukemia (AML). Data regarding outcomes in these patients are scarce. Researchers summarized 11 completed ECOG-ACRIN clinical trials for newly diagnosed AML patients. The authors found a low incidence (1.1%) of central nervous system involvement at diagnosis among 3240 patients. There were no significant differences in the complete remission rate or overall survival between patients with central nervous system involvement and without. Ganzel C. Blood Advances. October 2021

Mesothelioma An encouraging development in the treatment of cancer of the tissues lining the lungs

  • After 20 years of limited progress in treating mesothelioma, the PrE0505 phase II trial results provide a potential new strategy to extend survival. The trial found that durvalumab immunotherapy with standard chemotherapy has promising clinical activity in patients with previously untreated malignant pleural mesothelioma (MPM). MPM is a rare and aggressive disease with a poor prognosis and limited treatment options. Forde P. Nat Med. November 2021 and Press Release
  • Now, the DREAM3R phase III trial is currently enrolling patients in the United States, Australia, and New Zealand to evaluate the durvalumab-chemotherapy combination versus chemotherapy alone in patients with MPM, based on the PrE0505 and another clinical trial

Throat CancerA new post-surgery approach for treating HPV-related throat cancer uses less radiation safely and spares the majority of patients from chemotherapy

  • Low-dose radiation at 50 Gy without chemotherapy following transoral surgery led to very high survival and outstanding quality of life in patients with human papillomavirus-positive (HPV+) throat cancer and at medium risk for recurrence. The final published results of the randomized phase II trial E3311 show that 94.9% of such patients were alive and disease-free three years later and had an excellent quality of life after this less intense treatment. The approach preserved patients' swallowing and voice functions and spared them unnecessary short-term toxicities. The trial continues to follow patients to measure long-term survival and quality of life over five years. Ferris RL. J Clin Onc. October 2021 and Press Release

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