The impact of the COVID-19 pandemic on radiotherapy services in England, UK: a population-based study

Dr Mymoona Alzouebi

“It is estimated that one third of all cancer patients will require radiotherapy during their cancer journey.

In the attached study, the data shows the impact the pandemic has had on radiotherapy services. Whilst some areas have seen significant reduction in radiotherapy treatments – cancers of the bladder, rectum and oesophagus witnessed an increase. This may be a reflection of the reduced surgical activity. Changes in services has also allowed for increased use of hypo-fractionated regimens – especially in breast and prostate cancer.”

Read the full article here https://bit.ly/3aYuDQQ

Maximizing rectal dose sparing with hydrogel: A retrospective planning study

Dr Mymoona Alzouebi

“SpaceOAR© hydrogel (SOH) has been incorporated into the radiotherapeutic management of prostate cancer as a result of the proven benefits in reducing rectal toxicity and improving quality of life.
In this study rectal dose sparing of greater than 25% was achieved in most post‐SpaceOAR© Hydrogel treatment plans generated in this planning study.”‍

Read the full study here https://lnkd.in/dHrUDQN

Management of locally advanced bladder cancer

Dr Omar Din

“Bladder preservation with radiotherapy is an alternative to surgery for the management of locally advanced bladder cancer.  The results of this study show that hypofractionated radiotherapy over 20 fractions is as good as conventional radiotherapy over 32 fractions.

This is good news for patients with a significantly shorter treatment time (4 weeks cf 6.5 weeks) and a high rate of disease-free survival at 5 years.

Interestingly there was a significant contribution to the BCON trial named here, by patients from the South Yorkshire and North Derbyshire region.”

Read the full study here  https://bit.ly/3kqWttm

Study into MR-Linac accelerator showing improved patient outcomes

This study shows that radiotherapy practitioners and members of hospital management expect to see improved patient outcomes.

The majority of respondents in the study saw improved patient outcomes across 4 key areas

Accurate targeting

Real-time magnetic resonance imaging(MRI) means the MRIdian can show the exact position and shape of the tumour during treatment, so it can target radiation at the tumour precisely.

Greater control and precision

The MRIdian is the only MR linac to have automated beam control, so if your tumour moves slightly, your treatment will automatically pause until it comes back into position.

Reduced side effects

The MRIdian’s increased accuracy means the radiation beam is less likely to damage healthy tissue than conventional radiotherapy. Side effects occur when healthy tissue is damaged

Fewer treatments

With conventional radiotherapy, you may need up to 37 treatments. But with the MRIdian, the radiation is much more focused and you may only need five treatments

Read the full study here @ https://www.frontiersin.org/articles/10.3389/fonc.2020.01741/full

New drug available for metastic breast cancer

An ongoing main study (Destiny-Breast01) showed that Enhertu was effective at shrinking the tumour in patients with metastatic breast cancer or breast cancer that could not be removed by surgery. All patients had previously received two or more HER2-based treatments.

Enhertu is used to treat breast cancer that is metastatic(has spread to other parts of the body) or cannot be removed by surgery.

The tumour shrank in around 61% of 184 patients treated with Enhertu and on average controlled the disease for approximately 20 months

It can only be used in breast cancers that ‘overexpress HER2’: this means that the cancer produces a protein called HER2 in large quantities on the surface of the tumour cells, which makes the tumour cells grow more quickly.

Enhertu is used on its own, in patients who have received two or more HER2-targeted treatments, including trastuzumab and TDM1. It contains the active substance trastuzumab deruxtecan.

For more details, follow the links below

https://www.ema.europa.eu/en/medicines/human/EPAR/enhertu

https://www.nice.org.uk/guidance/TA704/chapter/1-Recommendations

https://www.nejm.org/doi/full/10.1056/nejmoa1914510

https://cancerres.aacrjournals.org/content/81/4_Supplement/PD3-06

ESMO: HER2-targeting antibody-drug improves progression-free survival for women with deadly form of advanced breast cancer

Researchers at UCLA’s Jonsson Comprehensive Cancer Center discovered that treating women with HER2-positive metastatic breast cancer with trastuzumab deruxtecan (T-DXd) significantly prolongs disease control and cancer growth compared to current standard of care, trastuzumab emtansine(T-DM1).

T-Dxd is a HER2-targeted monoclonal antibody that delivers high doses of chemotherapy directly to cancer cells that express HER2.

Compared to T-DM1, the medication improved progression-freesurvival by 72%.

At 12 months, 76 percent of patients treated with T-DXd had not progressed, meaning their disease remained under control. By 12 months,only 34% of T-DM1 patients had not progressed.

Read the full article here

ESMO Congress 2021: NEW COMBINATION OF OLD DRUGS IMPROVES SURVIVAL IN PATIENTS WITH PROSTATE CANCER

LUGANO, Switzerland – A novel combination of well-known drugs prolongs survival in patients with hormone/castration-sensitive prostate cancer, according to late breaking research presented at the ESMO Congress 2021. (1,2) The PEACE-1 and STAMPEDE studies found that the addition of abiraterone acetate plus prednisolone (AAP) to standard therapy lengthened survival compared to standard therapy alone.

Commenting on the findings, Dr. Maria De Santis, Chair of Interdisciplinary Urological Oncology, Department of Urology, Charité Universitätsmedizin, Berlin, Germany said: “The findings have the potential to be implemented in our daily practice right away as we do not have to wait for the approval of a new drug. The clearly positive results are reassuring and should convince patients and physicians to intensify the treatment of patients with metastatic and high-risk locally advanced hormone/castration-sensitive prostate cancer early on. I expect this kind of treatment intensification to be implemented as a standard of care.”

For men with metastatic prostate cancer, androgen deprivation therapy (ADT) was the standard of care for decades. In 2015, docetaxel (a chemotherapy agent) was shown to improve survival when added to ADT and in 2017, abiraterone (a next generation hormonal agent) was also shown to improve survival when added to ADT. Until now, though, it was unknown whether one or both agents should be added to ADT to achieve the best outcomes. PEACE-1 found that using three drugs upfront is better than just two in men with metastatic prostate cancer, not only to postpone cancer progression, but also to prolong life. When AAP was added to ADT and docetaxel, men experienced an additional 25% reduction in the risk of death compared to ADT and docetaxel alone.

Read the full article and links to the studies by clicking here