Breast cancer

News in brief: Adjuvant olaparib recommended for early-stage breast cancer; Prof Eva Segelov to lead SerOzNET study; Hospital doctors bullied to discharge patients early

ASCO recommends olaparib for early-stage breast cancer

An update to ASCO guidelines recommends one year of adjuvant olaparib for patients with high-risk, HER2-negative early breast cancer and germline BRCA1 or BRCA2 pathogenic or likely pathogenic variants after completion of (neo)adjuvant chemotherapy and local treatment, including radiation.

The expedited update is based on the results of the OlympiA randomised controlled trial presented at the recent 2021 ASCO Annual Meeting.

The new guideline states that  for patients who had surgery first, adjuvant olaparib is recommended for patients with TNBC and tumour size > 2 cm or any involved axillary nodes.

For patients with hormone receptor-positive disease, adjuvant olaparib is recommended for those with at least four involved axillary lymph nodes.

For patients who had neoadjuvant chemotherapy, adjuvant olaparib is recommended for patients with TNBC and any residual cancer.

Adjuvant olaparib is recommended for patients with residual disease and an oestrogen receptor status and tumour grade (CSP+EG) score ≥3.

In the OlympiA trial, which involved 1836 patients, treatment with Olaparib was associated with a significantly better 3-year invasive disease–free survival (hazard ratio for invasive disease or death, 0.58) compared to placebo.It was also associated with a reduced risk of distant disease or death (HR 0.57).

Prof Eva Segelov to lead SerOzNET study

A large Australian clinical trial SerOzNET study is to investigate the safety and efficacy of the COVID-19 vaccines in people with cancer.
Launched by Cancer Australia and led by Professor Eva Segelov of Monash Heakth, Melbourne, the trial will be modelled on a study protocol from the US National Cancer Institute (NCI) Serological Sciences Network for COVID-19 (SeroNet), which examine the immune responses to COVID-19 vaccines in different disease populations.
Patients with any cancer diagnosis, on current or past treatment, who have not yet been vaccinated, will be eligible for the SerOzNet trial.
“People with cancer were largely excluded from the initial international clinical trials for the COVID-19 vaccines, but we know that they are more vulnerable to COVID-19 infection and are at increased risk of more severe infection,” said Professor Dorothy Keefe, CEO Cancer Australia.
“The [SerOzNET ]study may also be able to give us important insights, including potentially how different therapies impact on vaccine response; how patients with different types of cancers, including blood cancers, respond to the vaccines; and the impact of timing of the vaccine for patients on cancer treatments,” she said.

Hospital doctors bullied to discharge patients early

More than 60% of hospital doctors feel coerced to discharge patients before they are medically ready, according to a survey conducted by the SA Salaried Medical Officers Association.

Almost 40% of doctors said the pressure to discharge patients came from hospital executives and half said the early discharges negatively impacted on care, according to report In Daily.

The survey supports a “Time to Care” campaign by SASMOA which says that medical care is being compromised by lack of staff numbers to meet demand and lack of time to provide appropriate medical care for patients.

“Medical decisions should be made by doctors based on a medical assessment of patient need and not based on cutting costs,” the Association said.

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