Trametinib option in recurrent low-grade serous ovarian carcinoma

The MEK inhibitor trametinib is  a potential new standard-of-care for patients with recurrent low-grade serous ovarian carcinoma, a preliminary trial suggests

Published in The Lancet, a phase 2/3 study involving 260 patients at 84 centre in the US and UK found that those randomised to treatment with oral trametinib had the risk of disease progression or death reduced by 52% compared to standard-of-care therapies that included chemotherapy such as paclitaxel or doxorubicin and aromatase inhibitors.

The median PFS for patients receiving trametinib was 13 months compared to 7.2 months in those receiving standard-of-care therapies. The objective response rate (ORR)with trametinib was 26%, with 59% having stable disease for at least eight weeks. The median duration of response on trametinib and standard-of-care were 13.6 months and 5.9 months, respectively. Median overall survival was 37.6 months in the trametinib group and 29.2 months in the standard-of-care group.

Study investigator Professor David Gershenson at the University of Texas MD Anderson Cancer Center said this was the first positive randomised clinical trial of any therapy to demonstrate significantly increased PFS and ORR in low-grade serous carcinoma,.

“Previous treatment recommendations for patients with low-grade serous carcinoma were based on studies that focused on the more common high-grade serous carcinoma, despite the subtypes having distinct developmental pathways, molecular biology and clinical behaviours,” he said.

“Now we have encouraging data for this specific group of patients …The results from our study show trametinib should be considered a new standard-of-care option for women with progressive or relapsed low-grade serous carcinoma.”

HNC treatment plans associated with delays

More than one in four patients newly diagnosed with head and neck cancers do not start treatment within the recommended 56-day time frame, South Australian research shows.

A review of  data for 72 patients treated at the Flinders Medical Centre found that 28% did not receive treatment within 56 days, and those undergoing primary radiotherapy treatment with or without chemotherapy, rather than surgery, were eight times more likely to experience delays.

“Our analysis found the delays during any type of treatment were generally as a result of logistical challenges accessing supporting medical producers such as PET scans, dental reviews and the insertion of a gastrostomy tube, which are all often required depending on the treatment plan,” said study investigator Associate Professor Eng Ooi, Head of Otolaryngology Head and Neck Surgery at Flinders Medical Centre.

“Given that patients undergoing primary radiotherapy are much more likely to need a PET scan, gastrostomy tube insertion and/or a pre-treatment dental review, it’s thought this is what likely leads to treatment delays.

“This is therefore the area that must be streamlined to bring about the greatest improvements, including the implementation of the resources for patients to receive prompt dental reviews, PET scans and gastrostomy tube insertion to ensure a timely start to treatment in the public healthcare system.”

While the patients who received delayed treatment did not have worse outcomes when followed up after 12 months in this study, the authors say the core message should still be heeded, with longer studies likely to show a negative outcome.

The findings are published in Medicina.

Patient satisfaction remains high for hospital doctors

Patients’ satisfaction with the way they are treated by hospital doctors or specialists has remained during the COVID-19 pandemic, according to the latest figures.

The 2022 Report on Government Services for public hospitals covering the period 2020-2021 shows that nationally, 91.8% of patients reported that doctors “always or often listened carefully to them and 93.2% always or often showed respect to them. Likewise, 90.3% of patients said doctors spent enough time with them.

The figures for 2020-21 were not significantly different from previous years.

However the report also showed that elective surgery waiting times increased significantly for public hospitals in 2020-21. Nationally, 50% cent of patients were admitted within 48 days (up from 39 days in 2019-20) and 90% of patients were admitted within 348 days (up from 281 days in 2019-20).