International recognition for Prof Anna Nowak
Professor Anna Nowak has been awarded the prestigious Wagner Medal from the International Mesothelioma Interest Group (iMig) for her contribution to mesothelioma research.
The Wagner Medal, presented every two years to an individual who has made major original contributions to the understanding of mesothelioma, honours South African research pathologist John Christopher Wagner who first linked asbestos with pleural mesothelioma.
Professor Nowak, Director of the National Research Centre for Asbestos Related Diseases (NCARD) and Pro Vice-Chancellor (Health and Medical Research) at the University of Western Australia, was presented with the medal by her colleague and mentor Professor Bruce Robinson, who was the first Australian recipient of the Wagner Medal in 2004.
Professor Nowak was one of the first researchers to demonstrate that chemotherapy exerts positive immunological effects, which can be exploited by combining chemotherapy with immunotherapy.
“What I’m most excited about is seeing the combination of immunotherapy and chemotherapy move into completed clinical trials and international clinical trials. The hope is that this combination will offer a better treatment than chemotherapy on its own,” she said.
Oncology infusion sets don’t need replacing so often
Routine replacement of infusion sets can be safely extended from 4 to 7 days without any increase in catheter-related bloodstream infections (CRBSI).
An Australian RCT of almost 3,000 adult and paediatric acute medical, surgical, oncology, haematology and critical care patients across 10 hospitals found CRBSI rates in patients with central venous access devices were 1·46% in the standard care, 4-day group versus 1·78% in the 7-day group.
For patients with peripheral arterial catheters, no patients in the 4-day group had CRBSI and 0·28% of patients in the 7-day group.
There were no treatment-related adverse events.
Lead author Professor Claire Rickard, from the Alliance for Vascular Access Teaching and Research, said extending the time to replacement would save healthcare costs by reducing demand on skilled nursing time as well as the quantity of plastic waste.
“We found replacing infusion sets at four days made absolutely no difference to infection risk, compared to waiting seven days. Nurses are too busy to be changing equipment if there is no good reason to change it.”
BRCA clues to immune response
BRCA2 alteration in combination with tumour mutation burden (TMB) is a potential biomarker associated with response to immune checkpoint inhibitors (ICIs).
A Research Letter in JAMA Open reported a 5.3% frequency of BRCA1/2 alterations across more than 39,000 tumour samples from multiple tumour types.
“Among them, 164 patients (0.4%) had double alteration, 662 patients (1.8%) had BRCA1 single alteration, and 1151 patients (3.1%) had BRCA2 single alteration.”
The study found BRCA1/2 altered tumours had higher median TMB than that in wild-type tumours (p< 0.001).
A survival analysis of 1,661 patients receiving ICIs showed that while BRCA1 alteration was not associated with OS, patients with BRCA2 altered tumours had better OS than those without.
“Patients with low TMB BRCA2 altered tumours had comparable OS with patients with high TMB tumours ( 44.0 v 41.0 months), and both groups had better OS than patients with low TMB WT BRCA2 tumours (median 16.0 months; P < .001).
“Further studies are warranted to pinpoint the specific tumour types that are responsive to ICIs when BRCA2 is altered, and to verify whether the addition of CXCR2 inhibition can further improve survival in these patients,” they concluded.