News in brief: GI cancers on the rise in younger adults; Niraparib approved for women with ovarian cancer; Instagram helps oncologists personalise care

GI cancers on the rise in younger adults

Falls in the incidence of GI adenocarcinomas in over 50 year-olds over the last three decades are being offset by a concerning increase in younger adults.

An analysis of data from the South Australian Cancer Registry found GI adenocarcinomas reduced from 203.04/100,000 in 1990–1999 to 197.16/100,000 in 2010–2017.

However, rates amongst individuals aged 18–50 significantly increased over the same time period from 9.13 to 12.89/100,000 overall, with increases in each of the sites of oesophagus, stomach, pancreas, colon, and rectum.

As well, overall survival improved significantly for the older age cohort, driven largely by improved survival with colorectal cancer, but OS did not significantly improve over time in 18-50 year-olds.

“Though the underlying causes remain to be deciphered, a similar trend in international studies has been postulated to be due to increases in early-life antibiotic use, obesity, the consumption of processed foods and alcohol, as well as an increase in metabolic disease (especially obesity and type 2 diabetes mellitus) seen in this similar time frame,” the study said.

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PARP inhibitor approved for all women with ovarian cancer

The TGA has approved the PARP inhibitor niraparib (Zejula) for the maintenance treatment of all women with advanced high-grade ovarian, fallopian tube or primary peritoneal cancer who respond to first-line platinum-based chemotherapy.

It is the first PARP inhibitor approved for all women regardless of their BRCA mutational status.

The approval was based on results from the Phase III PRIMA trial which demonstrated statistically significant and clinically meaningful progression-free survival with niraparib compared to placebo in all participants (HR 0.62; p<0.0001) and in a homologous recombination deficient sub group (HR 0.43, p<0.0001).

Professor Clare Scott, from the Peter MacCallum Cancer Centre, said in a statement from GSK that about 75% of women diagnosed in Australia with advanced ovarian cancer were currently not eligible to be treated with a PARP inhibitor.

“With today’s news, Zejula is an important and effective addition to our armamentarium in the fight against ovarian cancer. PARP inhibitors have already revolutionised the treatment of ovarian cancer, and now to have a therapy that is available across the biomarker subgroups is a significant step forward for us as clinicians.”

Instagram patient photos help oncologists personalise care

Patient-defining photos could be key to personalised care, Australian researchers have found in a world-first study of ‘photovoice’ in geriatric cancer patients.

The eight-month ‘Geriatric Oncology in the Instagram Era’ study explored how patient photos and survey responses might affect supportive care.

It found clinicians who reviewed photos representing a patient’s identity, values, home environment and mode of transport, along with a 45-minute photo-directed interview and one-page summary could better tailor care to the patient’s strengths, weaknesses and capabilities.

While the results are promising, researchers from the Border Medical Oncology Research Unit and La Trobe University John Richards Centre for Rural Ageing Research, who conducted the study said it will be a while before ‘photovoice’ enters the clinic, with more research, resources and time needed to make it standard practice.

The study included 18 cancer patients aged 70 years and over and was supported by a $20,000 grant from the Albury Wodonga Regional Cancer Centre Trust Fund.

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