Posters at this month’s MOGA 2024 annual scientific meeting featured research from across the field of oncology, with studies on breast cancer, drug funding, and the abscopal effect amongst those catching our attention.
Here, the limbic presents a selection of some of the more interesting posters presented at the conference.
Treatment of de novo bone-only oligometastatic breast cancer
The study: Retrospective database review examined survival outcomes over 10 years of breast cancer with de novo bone-only involvement treated with ‘curative-intent’ at Chris O’Brien Lifehouse, Sydney.
Findings: These patients seemed to benefit from such treatment, with six of the 10 included remaining disease free over a median follow-up of 29 months. Trimodality treatment consisted of breast surgery perioperative chemotherapy with HER2-director and/or endocrine therapy if warranted, and radiation to local and metastatic sites.
Local patients have statistically significant improved survival compared with rural and regional patients when treated with PRRT
The study: Survival and toxicity outcomes for 306 neuroendocrine tumour patients receiving PRRT at Sydney’s St George Hospital were stratified based on travel distance.
Findings: Local patients (living within 10km of the hospital) had significantly better OS than those from the wider Sydney metro and regional areas. By contrast, there was no association with travel distance and severe toxicity, nor with other socio-economic factors.
The abscopal effect: more common than we think
The study: Case series of the abscopal effect in seven metastatic melanoma patients treated in Brisbane between 2022 and 2024.
Findings: Two patients demonstrated disease progression on immunotherapy and subsequent radiotherapy was administered. In each case, complete metabolic response was observed thereafter at the site of radiation and distally. Five patients demonstrated an abscopal response after biopsy, having received a variety of systemic treatments, although one was treatment naïve. The researchers called for more studies to understand the mechanism of the abscopal effect and “harness its potential clinical benefit”.
Understanding the clinical and molecule phenotype of cancer of unknown primary with a lung cancer profile
The study: 32 cancer of unknown primary (CUP) patients were identified within the SUPER cohort study as having a lung cancer profile, based on genomic analysis. Clinical and histopathological characteristics were reviewed for possible consistencies with a typical lung cancer diagnosis.
Findings: CUP patients with a lung cancer profile often had typical symptoms and sites of disease, but most had TTF-1 negative immunohistochemistry. Results showed the detection of a dominant tobacco signature and lung adenocarcinoma mutational profile could aid in diagnosis. SMARCA4 (BRG1) mutations occurred in 38% of cases, compared to 10% incidence in NSCLC. The team said clinicians should be aware of this poor prognosis group of lung cancers with atypical histopathological characteristics that may be labelled as CUP.
Drug-induced interstitial lung disease in the era of HER2 targeted antibody-drug conjugates (HER2 ADCs): a single centre experience
The study: Retrospective audit of 86 adult solid tumour patients treated with HER2 ADC at Macquarie University Hospital, evaluating risk factors for developing interstitial lung disease (ILD).
Findings: Some 13% of patients developed drug-induced ILD, with deaths due to pneumonitis and four cases involving ILD events of grade 3 or higher. The median time to onset of ILD was four months. Risk factors included higher median age, smoking history, pre-existing lung disease, lung metastasis and prior thoracic radiation.
Similar benefit, better value
The study: Public summary documents for all solid cancer drugs considered by the Pharmaceutical Benefits Advisory Committee between June 2005 and March 2023 were examined for their evidentiary basis, effectiveness and health economic assessment.
Findings: 128 of 302 (42%) of submissions received positive recommendations. 86% of recommended drugs were palliative intent, 60% targeted (including hormonal) therapies, 60% approved as monotherapy, 55% first-line and 11% novel/first in class drugs. Some 46% of recommended drugs had an OS benefit, with a median survival advantage of 3.5 months, while 65% had a PFS benefit (median advantage 2.6 months). Incremental cost-effectiveness ratios remained unchanged over the study period (median $60,000 per quality adjusted life year).